Irreversible changes to the bodies of minors before they reach sexual maturity, particularly regarding fertility due to long-term puberty suppression, raise concerns among lawmakers and authorities about providing puberty blockers to transgender youth. Despite these widespread assertions, the implications of potentially limiting the futures of transgender youths have not been thoroughly examined in bioethical discussions. Joel Feinberg’s theory of the “right to an open future” serves as a foundation for exploring various childcare decisions, such as religious upbringing or fostering specific talents. However, its application to pediatric transgender medical decisions is less common. This article evaluates Feinberg’s theory concerning puberty suppression for transgender youth and argues that these individuals should have the autonomy to make informed choices regarding the timing of puberty suppression. Allowing such decisions is essential for protecting their physical health, mental well-being, personal autonomy, and future self-fulfillment.