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Young adult psychological outcome after puberty suppression and gender reassignment. Footnotes Conflicts of Interest: Requiring participation in therapy in order to access medical care related to physical gender transition is neither successful, nor does it promote honest communication between young people and therapists. Management of female-to-male transgender persons: The issue of future infertility is often far more problematic for parents and family members than for youth, especially at the beginning stages of discussing moving forward with gender-affirming hormones.

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The journal of sexual medicine. The criteria for therapy include: The approach to care may be simplified by defining two distinct cohorts of youth: Once implanted, the pellets slowly release testosterone for a long-acting androgenic effect.

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For example, a youth who has experienced endogenous male puberty and enters care at age 16 or 17 may follow a dosing schedule such as:.

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