transition. In adolescents, however, puberty blocking agents [i.e. gonadotropin-releasing hormone agonist (GnRHa)] are the first-line treatment for younger persons entering puberty (Tanner stage ≥ G2/B2). GnRH agonists are also mentioned by some guidelines [3] to be used as routine gonadal axis suppression for all hormonally transitioning individuals. Many other agents have been mentioned as useful in GCHT depending on a person's transitional goals, although not unambiguously, and some with much controversy. These include, but are not limited to, cyproterone acetate and other progestins (e.g. medroxyprogesterone, lynestrenol), spironolactone, finasteride, or minoxidil. The SOC [1] and Endocrine Society CPG [2] specify