I see some activists now saying perhaps teens should go straight onto cross sex hormones, so I'll note that the long term side effects of at least testosterone on females is known from transmen & Eastern bloc athletes. They include: 1/4

* liver cancer
* diabetes
* kidney disease https://twitter.com/WomensLibFront/status/1338715125226893314
* heart disease, including both atherosclerosis and heart
tissue damage
* ovarian cysts
* vaginal atrophy
* uterine atrophy leading to hysterectomy
* painful orgasm
* painful clitoromegaly
* infertility and miscarriage

2/4
* babies born with birth defects including blindness and
club feet
* violent mood swings, from euphoria to rage
* depression
* persistent hoarseness and vocal weakening
* acne
* baldness
* weight gain
* neurophysiological addiction

3/4
* and finally, it may increase the risk of dementia

Anything I've missed? This is all easily sourced from scholarly research and historical papers. I'm not sure many transmen are fully informed of these risks, but surely taking these drugs is, again, an adult decision.

4/4
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