Physician Training: What Age Should Transgender HRT Start in Teens?

Hormone replacement therapy (HRT) is one of the most important – and controversial – tools in the medical treatment of transgender youth. Perhaps no area of medicine, other than induced termination of pregnancy, has been met with such a contentious intersection of law and healthcare.

As a physician, you want to put politics aside and do what is in the best interest of your patients. You have taken the Hippocratic Oath, promising to prioritize the well-being of your patients above all else – upholding the dignity and respect of all patients regardless of their background or circumstances.

If treating transgender patients is a regular part of your medical practice, the issues you likely continually face include determining at what age to start administering HRT, and how to dose HRT appropriately for younger patients. In this article the SottoPelle® Method physician BHRT training experts discuss the research on these important topics – and explain how SottoPelle® Method transgender HRT training can help you offer your teen patients the best possible outcomes.

Benefits of HRT for Transgender Teens

For many transgender teens, HRT can be a critical component in helping them achieve a gender identity that matches their inner sense of self. By suppressing endogenous hormone production and introducing the hormones of the opposite sex, HRT can facilitate physical changes that align with a transgender teen’s gender identity.

Studies have shown that starting HRT during the teenage years can have significant physical and psychological benefits for transgender youth. In terms of physical changes, HRT can help transgender teens develop more masculine or feminine features, depending on their gender identity. For example, female-to-male transgender teens may experience voice deepening, increased facial and body hair growth, and muscle development, while male-to-female transgender teens may experience breast development, fat redistribution, and reduced body hair growth.

Beyond the physical changes, HRT can also have a significant impact on the mental health and well-being of transgender teens. For many transgender youth, HRT can alleviate feelings of gender dysphoria and improve overall mental health. A study published in the Journal of Adolescent Health found that transgender youth who received HRT reported lower levels of depression and anxiety compared to those who did not receive HRT.

Clinical Studies on HRT for Transgender Teens

There have been several clinical studies conducted on the benefits of beginning gender-affirming hormone replacement therapy (HRT) during the teen years.

The Amsterdam Cohort of Gender Dysphoria Study, conducted by the VU University Medical Center in Amsterdam, followed transgender adolescents who started gender-affirming HRT during their teens. The study found that the adolescents had significant improvements in psychological well-being, including reductions in anxiety and depression, after starting HRT. 1

Similarly, The Trans Youth Care Study, conducted by the Children’s Hospital Los Angeles, followed a group of transgender youth who were treated with gender-affirming HRT. The study found that the youth had significant improvements in mental health and quality of life after starting HRT. 2

Another clinical research study, conducted by the Tavistock and Portman NHS Foundation Trust in the UK, followed a group of transgender adolescents who started gender-affirming HRT during their teens. This study also found that the adolescents had significant improvements in their mental health and quality of life after starting HRT. 3

These studies provide evidence for the benefits of starting gender-affirming HRT during the teen years, including improvements in mental health and quality of life. It is important for physicians and parents to be aware of these benefits when considering treatment options for transgender youth.

What Age Should Physicians Start HRT in Transgender Teens?

The optimal age for starting HRT for transgender teens is a topic of ongoing debate and research. The World Professional Association for Transgender Health (WPATH) recommends that HRT be initiated after the onset of puberty and the development of secondary sex characteristics, which typically occurs between the ages of 14 and 16. However, some medical professionals may consider starting HRT earlier in certain cases, such as when a transgender teen is experiencing significant distress or has started puberty at a younger age.

It is important to note that HRT for transgender teens should only be initiated on an individual basis – after a thorough evaluation by a physician who is experienced and trained in transgender healthcare. This evaluation should include a comprehensive medical history, physical exam, and mental health evaluation, as well as informed consent from the teen and their parent or guardian.

SottoPelle® Method transgender HRT training has enabled physicians worldwide to help transgender adults and teens live their authentic lives with pellet therapy since the 1990’s. Our transgender HRT physician training offers doctors important tools to naturally, safely, and effectively provide consistent, individualized delivery of the hormones required for gender transition, aligning the teen patient’s sexual characteristics with their gender identity.

Physician HRT Dosing in Transgender Teens

As a physician, finding the right tools for teen transgender HRT dosing calculation is critical. Adolescents are typically smaller than adults – so ‘one-size-fits-all’ standard HRT pills and patches typically do not provide ideal dosages for these smaller patients.

Additionally, a teen body’s hormone production is much more erratic than an adult’s – often fluctuating wildly. Custom-compounded HRT allows for more precise control over hormone levels, which is particularly important for transgender youth who are in the midst of puberty and may require more frequent dose adjustments.

For these reasons, customized, individual HRT dosing is even more important in teens. SottoPelle® Method transgender HRT physician training educates doctors on the key factors involved in achieving optimal hormone ranges, while also providing the tools needed for individualized physician hormone dosing calculation.

The SottoPelle® Method takes the guesswork out of hormone dosing calculation for physicians treating transgender patients. Through our proprietary, patented, online Dosaggio™ hormone dosing calculator, physicians have the tools they need to help their transgender patients achieve optimal hormone levels to align their sexual characteristics with their identity.

Physician Transgender HRT Training for Teen Patients

Gender affirming HRT can be an important tool for helping transgender teens achieve a gender identity that matches their inner sense of self. Studies have definitively shown that starting HRT during the teenage years can have significant physical and psychological benefits, including the development of more masculine or feminine features and improved mental health.

While the optimal age for starting HRT is still being studied, medical professionals with experience and training in transgender HRT can help guide transgender teens and their families through the process of starting HRT safely and effectively.

SottoPelle® Method physician HRT training offers providers an individualized HRT protocol that is superior to one-size-fits-all HRT pills and patches for transgender patients. If you are a physician who is interested in learning more about customized HRT pellet therapy for your transgender patients, contact us today – we offer multiple online an in-person training options and have friendly staff on standby to assist you!

Physician Transgender HRT Training: 323.986.5100 (press 1)

  1. de Vries, A.L.C., Steensma, T.D., Doreleijers, T.A.H., & Cohen-Kettenis, P.T. (2011). Puberty suppression in adolescents with gender identity disorder: A prospective follow-up study. Journal of Sexual Medicine, 8(8), 2276-83.
  2. Olson, J., Schrager, S.M., Belzer, M., Simons, L.K., Clark, L.F. (2015). Baseline Physiologic and Psychosocial Characteristics of Transgender Youth Seeking Care for Gender Dysphoria. Journal of Adolescent Health, 57(4), 374-380.
  3. de Vries, A.L.C., McGuire, J.K., Steensma, T.D., Wagenaar, E.C.F., Doreleijers, T.A.H., & Cohen-Kettenis, P.T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics, 134(4), 696-704.

IMPORTANT DISCLAIMER: This article is provided as general information only and is not intended to be used as medical advice. While the benefits of hormone replacement are well documented through clinical research, we are not representing that hormone therapy is a “cure” for any disease. Only your treating physician can determine if hormone replacement may be a beneficial part of your healthcare regimen, based on your age, overall health, risk factors, and lifestyle.