So, a male-bodied person with a female gender identity- The decision making to start cross-sex hormones is somewhat dependent on whether or not they've been on blocker medications before, or whether they've stopped those blocker medications, they can still afford them or not. Ideally, we would like to have young people on both blockers to suppress their endogenous hormones. So, in the case a transgender girl, we want to suppress the production of testosterone, and add on estrogen to feminize that person's body. The first steps would be getting baseline laboratory values, to make sure using estrogen in this person would be safe and wouldn't compromise their health. It's not uncommon for male-bodied kids with female identities to have come out as gay. If the gender issue was not unveiled in childhood, they may get into puberty, and get into high school, and have a stepping-stone period where they come out as gay if they are attracted to men. There are some transgender women who are attracted to women, and want to partner with women. So, that is again- It underscores the importance of using mental health therapists in our treatment team so that young people can learn how to talk about their experience, and learn how to approach intimate partnerships, and adjust as a female and assimilating into their female role.