The minimum age to start hormone replacement therapy (HRT) can vary depending on several factors. However, most doctors recommend waiting until at least age 16 to consider HRT for transgender youth.
Key Factors In Determining Minimum Age
There are a few key factors doctors consider when determining if a young person is ready to start HRT:
- Pubertal development - If puberty has already begun, doctors may prescribe puberty-blocking hormones first to pause development before starting HRT. This provides more time for gender exploration without progressing further into unwanted pubertal changes.
- Mental health evaluation - Thorough mental health assessments are recommended to ensure the adolescent has gender dysphoria and fully understands the social, psychological and medical impact of HRT.
- Informed consent - The teen must demonstrate the intellectual maturity and clarity to understand HRT effects and give informed consent to treatment. Their parents/guardians also typically provide consent.
- Readiness for therapy - The young person must be developmentally ready to start feminizing/masculinizing hormone therapy and commit to regular provider visits for monitoring and support.
Minimum Ages
- The Endocrine Society clinical practice guidelines recommend:
- Age 16 for starting feminizing/masculinizing sex hormone therapy
- Potentially age 14-15 in special circumstances when mental health professional, parent/guardian and physician agree
- WPATH standards also suggest:
- Age 16 for starting HRT but as early as age 14 in select cases
So while
16 is the general minimum age, HRT may be suitable even earlier following thorough assessment of individual factors like pubertal stage, mental health, informed consent and appropriate setting/support system.
Hormone Therapy Process for Transgender Youth
The process for a transgender adolescent to begin HRT often includes:
- Counseling - To explore gender identity and expression before confirming gender dysphoria diagnosis
- Puberty blockers - From onset of puberty to pause physical changes if desired
- Mental health evaluation - Assessing readiness for hormone therapy
- Medical exams & lab work - To establish baselines before starting hormones
- Informed consent - Discussing what bodily changes to expect from HRT and needing the adolescent’s consent
- Treatment plan - Creating a customized game plan for feminizing or masculinizing hormone dosages, timing, delivery method and ongoing medical monitoring
- Follow-up care - Regular visits with the care team to assess hormone effects, make dosage adjustments as needed, provide counseling support and monitor overall health
The process is tailored to the unique needs of each patient based on factors like their age, pubertal stage, mental health considerations, existing medical conditions and family preferences. Close provider coordination is maintained between the pediatrician, endocrinologist, mental health professional and/or transgender health specialist guiding the medical transition.
Harmony Hormone Clinic Therapy Clinic provides individualized transition care for transgender and nonbinary adolescents as well as adults. Contact us today to schedule your first appointment!
