"We noted a higher hormone continuation rate among TGD individuals who were younger than 18 years old at the time of first use of gender-affirming hormones compared with those who were aged 18 years and older when starting hormones. This has not been documented in previous studies. Parental support plays an important role in the mental health of TGD youth. A prior study of adults found that lack of family support for a TGD individual’s gender was associated with a history of discontinuing social or medical gender affirmation. Higher parental support may explain the higher continuation rate among patients who start gender-affirming hormones as minors compared with people who start as adults."