"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."
-
-
Replying to @KelseyTuoc
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.
1 reply 0 retweets 4 likes -
Replying to @webdevMason
Right, but "beyond Tanner stage 2" presumably means they're stage 3 or later? Agree that "in Tanner stage 2" wouldn't mean much but that's not what the paper says.
1 reply 0 retweets 0 likes -
Replying to @KelseyTuoc
I don't know. I read this as "inclusive of Tanner stages 2 and greater." Either way, not indicative of spermarche, though 3 is significantly higher likelihood than 2. Guidelines for suppression of puberty with blockers call for Tanner stage 2 at minimum, AFAB or AMAB.
1 reply 0 retweets 1 like -
Replying to @webdevMason @KelseyTuoc
> WPATH guidelines recommend Tanner stage 2 at minimum, but notes that some clinics may require stage 3-4 https://www.wpath.org/media/cms/Documents/SOC%20v7/Standards%20of%20Care_V7%20Full%20Book_English.pdf … > Endocrine Society recommends blockers at Tanner stage 2 https://endocrinenews.endocrine.org/blocking-puberty-in-transgender-youth/ … > UCSF says Tanner stage 2-3 is ideal https://transcare.ucsf.edu/guidelines/youth …
1 reply 0 retweets 4 likes -
Replying to @webdevMason
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.
1 reply 0 retweets 6 likes -
Replying to @KelseyTuoc
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.
1 reply 0 retweets 4 likes -
Replying to @webdevMason
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.
2 replies 0 retweets 2 likes -
Replying to @KelseyTuoc @webdevMason
(There's a general phenomenon in medicine where actual practitioners who've seen lots of patients are often behaving quite sensibly, especially if they cannot be sued for delaying, which afaik they cannot, even if the officially written rules would not be sensible as written.)
1 reply 0 retweets 1 like -
Replying to @KelseyTuoc @webdevMason
Between some evidence of average age of 15, evidence of 96% post-menarche, some confusion about whether 91% are T3, and those priors, I end up expecting most teens treated are in fact older than the min age in the guidelines. If I'm wrong re: 91% are T3 this will change.
1 reply 0 retweets 0 likes
Replying to @KelseyTuoc
...at a single pediatric facility.
6:22 PM - 8 Jul 2019
0 replies
0 retweets
0 likes
Loading seems to be taking a while.
Twitter may be over capacity or experiencing a momentary hiccup. Try again or visit Twitter Status for more information.