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.
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Thanks. Changing my mind towards "the guidelines permit transition early enough that the tradeoff with fertility is in fact quite absolute; few transitions actually occur that early but that does not seem to be because guidelines discourage it". WIll email study authors re >=T2.
Curious why you think few transitions happen that early? Presumably not because of this study? I'm finding a number of clinical refs that argue for intervention as close to Tanner 2 as possible & having a hard time finding arguments in favor of delay. Fertility rarely discussed.
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The average age in the study was 15, which is part of why the T3 or later interpretation seems so likely to me. I think that even if the guidelines say ASAP, in practice wheels grind slowly, and as you observed many clinics do wait for T3.
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The study was conducted at a single pediatric facility. Is there a reason to think it's representative?
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