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My understanding is by medical standards, the evidence is pretty low quality, which is why GnRH agonists aren't approved by the EMA, MHRA, FDA, or NICE for gender dysphoria.
It highlights a wider issue in medicine though, the obsession with randomised controlled trials, which is basically the only evidence the GRADE method considers "high quality". We are seeing exactly the same problem with MDMA assisted therapy, any therapy where blinding is difficult is dismissed by the medical establishment. NICE dismissed (es)ketamine for depression for the same reason. Add to that the fact that GnRH agonists are off patent, so there's no incentive for industry to fund studies.
Your understanding is wrong and influenced by transphobic rhetoric, not "medical standards", which have considered puberty blockers safe and effective since at least the 1980s.
source
E: and before you try throwing bone density at me, most of the people impacted are cis (and will not be stopped from taking blockers), and either way, there is simple treatment to counteract this minor issue (and which is completely insignificant when compered to the alternative). The ban is 100% motivated by transphobia and cruelty.
We're not talking about the use of puberty blockers in cases of precocious puberty, we're talking about them in cases where they'd block typical puberty in cases of gender dysphoria.