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I parsed that as their criteria excluded children for whom hormone therapy was not being considered. If hormone therapy is not considered until puberty has begun, and most kids at the stage where hormone therapy is considered have mature gametes, then that's the pop we care about
FWIW, it's exceedingly dofficult to figure out what clinicians are actually doing, the guidelines that call for Tanner stage 2 development do *not* indicate mature gametes, and many of these kids are rendering themselves infertile for life. I'm really uncomfortable with this.
AFAICT, spermarche occurs at variable Tanner stages, but often not prior to Tanner stage 3; menarche is typically at Tanner stage 4. I keep trying to not throw myself back into this because there is absolutely nothing for me to gain here, but it is what it is.
Truth be told, there is one correct answer, Kelsey, and you already have it.
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