Mason  🏃‍♂️ ✂️

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.

Have you found anything indicating that the 96% and 91% numbers are atypical?

Those numbers DO NOT indicate mature gametes!

"91% of transgender females had progressed beyond Tanner stage 2 and were offered an opportunity to bank sperm; 96% of transgender males were postmenarchal and were offered a referral to a reproductive endocrinologist at a nearby fertility practice."

Tanner stage 2 *is not* confirmatory or disconfirmatory for spermarche. Tanner stage 1 is literally "no signs of puberty," so it doesn't make sense to even consider sperm banking prior to stage 2. Postmenarchal AFAB patients are Tanner stage 4 & in a much better position.