The American College of Obstetricians and Gynecologists Committee on Adolescent Health Care has issued a committee opinion with recommendations on care for transgender adolescents. Consensus guidelines support initiating medical therapy after an adolescent has an established diagnosis of transgender identity and had reached Tanner stage II development. ACOG recommendations and conclusions include:

• Obstetrician–gynecologists should understand gender identity and be able to treat transgender patients or refer them appropriately for medical and surgical therapeutic options.
• A patient with gender dysphoria may first present to a gynecologist; therefore, it is important for the clinician to be aware of this condition.
• Obstetrician–gynecologists can provide referrals as well as support and resources to young patients.
• It is important for obstetrician–gynecologists to be aware of the social and mental health risks for the transgender population.
• Transgender male adolescents have a uterus, ovaries, and breast tissue and, thus, can develop medical complications of gynecologic organs and also become pregnant.
• The need to discuss fertility preservation before initiation of cross-sex hormones is another important reason that obstetrician–gynecologists may be involved in the care of transgender adolescents.
• Like all patients, transgender adolescents should have a source for ongoing primary care.