"It seems quite possible that the reduced physical genital development that results from puberty suppression could inhibit the phenomenological experience and behaviors associated with sexual climax. In other words, while youth who undergo trans-affirmative treatment may have less genital tissue with which to experience sexual stimulation, their bodies and brains are likely capable of sexual climax though they may feel the experience less intensely due to reduced genital tissue. It is possible that individuals assigned as male and female at birth may experience these effects differently, as seems evident in research with people who experience transition as adults. Finally, it seems likely that learning plays a role in this process, though contrary to Bowers, it seems unlikely that it is the only factor involved. However, it seems quite important that future research examine the sexual health experiences of individuals who initiate trans affirmative treatment prior to adulthood."