Based on Australian Standards of Care and Treatment Guidelines for trans and gender diverse children and adolescents.
Gender-affirming hormones have been shown to improve mental health and wellbeing outcomes in trans and gender diverse adolescents, significantly ameliorating harms such as depression, anxiety, and suicidality when provided as part of supportive, gender affirming care.
Injections
Early puberty
- Start Sustanon or testosterone enanthate 0.5mL (125mg) IM every 3 weeks for Tanner stage 2-4 on suppression.
- After 6 months, increase to 1mL (250mg) IM every 3 weeks.
- Once at 250mg every 3 weeks, the GnRHa puberty blocker can usually be stopped.
- Consider long-acting testosterone undecanoate (e.g. Nebido or Reandron) IM every 8–12 weeks for long-term.
Late puberty
- Use a graded approach as above or start long-acting testosterone undecanoate (e.g. Nebido or Reandron) from the outset.
Gels
Topical testosterone: Testogel 12.5mg/pump, increasing from 1–2 pumps daily every three months until the age of 14 and then 3-4 pumps after the age of 14.