Same principle would seem to apply in both scenarios; plenty of kids willing to volunteer for puberty blockers, so just give some of them placebos.
If giving untested drugs to kids was a FDA dealbreaker, it would be impossible to bootstrap ANY pediatric drugs through the approval process. "Can't give it to kids because it's untested; can't test it because that would require giving it to kids" would be an insurmountable obstacle if it was that cut and dry.
That's fine as a scientific study, but it's not how FDA approvals work.
Same principle would seem to apply in both scenarios; plenty of kids willing to volunteer for puberty blockers, so just give some of them placebos.
If giving untested drugs to kids was a FDA dealbreaker, it would be impossible to bootstrap ANY pediatric drugs through the approval process. "Can't give it to kids because it's untested; can't test it because that would require giving it to kids" would be an insurmountable obstacle if it was that cut and dry.