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The interventions can either include suppression of testosterone and introduction of estrogen, or suppression of estrogen and introduction of testosterone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This review article focuses on the psychosocial experiences of youth who have completed their endogenous puberty and are now requesting one of these two forms of gender\u2010affirming hormonal treatment. We investigate the comparative profiles of these two subgroups of transgender\/gender\u2010expansive youth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Review of research data, established standards of care and practice guidelines, and clinical observations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Differences and similarities are noted and discussed in several realms: gender\u2010related experiences prior to receiving hormonal treatment; the relationship between the physical changes and psychological experiences that accompany the introduction of testosterone or suppression of testosterone with replacement with estrogen; the intrapersonal and interpersonal implications of the treatment; considerations of fertility preservation for future family building; the role of the family in the decision\u2010making process prior to starting a course of hormone therapy; and the capacity of youth to make informed decisions about these partially irreversible medical interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Medical providers who offer gender\u2010affirming hormonal care to youth should work with the family and allied professionals to assure that the youth's gender health is enhanced, barriers to care are removed, and mental health risks are reduced, whether the T is coming out or going in.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The cohort of youth who come to medical providers after completing puberty, and request gender\u2010affirming hormones in the form of increases or reductions in T have a great deal in common, and also extensive variation among them.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13055","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T17:02:59Z","timestamp":1622221379000},"page":"1698-1706","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Take the T out, put the T in: Gender\u2010affirming hormones in youth"],"prefix":"10.1111","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2708-6310","authenticated-orcid":false,"given":"Diane","family":"Ehrensaft","sequence":"first","affiliation":[{"name":"Child and Adolescent Gender Center University of California San Francisco  5633 Ocean View Drive Oakland California 94618 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy C.","family":"Tishelman","sequence":"additional","affiliation":[{"name":"Department of Psychology and Neuroscience Boston College  140 Commonwealth Avenue Chestnut Hill MA 02467 United 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