The recently revised Ministry website says that “blockers are a safe and fully reversible medicine”. … “to help ease distress and allow time to fully explore gender health options.”
And the best practice advice says that “although some neurodiverse people may have difficulty in articulating their gender identity, this should not create an unnecessary barrier to access any relevant gender affirming services. Some people may express their gender identity non-verbally.”
In other words children, who may have autism, or be mute or unable to explain abuse, trauma or homophobia may be put on puberty blockers even if they cannot properly express what they feel.