I leave it to the reader to determine whether they think having to take vitamin supplement counts as a significant side-effects. I would note, however, that it is also important to put these side effects in context. The contraceptive pill, for instance, also has reduced bone density as a possible side-effect.
My reading of the research also does not indicate that it is majorly lacking. Medical research is written in a very conservative manner. Researchers avoid making claims beyond the limits of their research. This can look like doubt or uncertainty when it is not.
My experience as a Ph.D. researchers is exactly this.
> This can look like doubt or uncertainty when it is not.
No, it is absolutely real uncertainty. The difference between knowing a topic and knowing something about it is vast, and in the space is sophistry.
Possible long-term side effects of puberty blockers Lower bone density. To protect against this, we work to make sure every patient gets enough exercise, calcium and vitamin D, which can help keep bones healthy and strong. We also closely monitor patients’ bone density. Delayed growth plate closure, leading to slightly taller adult height. Less development of genital tissue, which may limit options for gender affirming surgery (bottom surgery) later in life. Other possible long-term side effects that are not yet known.
https://www.stlouischildrens.org/conditions-treatments/trans...