Table 1.

Diagnostic criteria for treatment with puberty suppression for adolescents

Adolescents are eligible for treatment with puberty suppression if:
The adolescent has demonstrated an intense and long-lasting pattern of gender dysphoria or gender nonconformity (whether expressed or suppressed)
The gender dysphoria emerged or worsened with puberty’s onset
Any concurrent psychological, social, and/or medical issues that could interfere with the treatment (for example, that may compromise compliance with the treatment) have been addressed, such that the functioning and situation of the adolescent are stable enough to start the treatment
The adolescent is having sufficient mental capacity to give informed consent to the treatment
The adolescent and/or parent(s)/other caretaker(s) (depending on the adolescent’s age and local laws) has/have given informed consent after being informed about the effects of the treatment and fertility preservation options
The parent(s)/other caretaker(s) is/are involved and supporting the adolescent throughout the treatment process
A pediatric endocrinologist or other clinician with experience in the assessment of puberty agrees with the indication of the health care provider to start puberty suppressing treatment
The adolescent’s puberty has started (Tanner stage ≥ G2/B2)
The adolescent has no medical contraindications to treatment with puberty suppression