Well, here's a good study that I just stumbled upon today that shows exactly why I do this and how I do it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5344188/

Basically for transgender men, I keep them on blockers or delay them as long as possible from starting testosterone until they literally can't stand it anymore if they want to be taller. This keeps their long bone growth plates open. I always shoot an x-ray of these before starting a kid on hormone therapy to see if they would benefit from this. If they are already closed, there's no point to do this.

When it comes to transgender girls, I again shoot the x-ray and see if the plates are open or closed. If open, I will often pulse them with a higher dose of injectable estradiol for about 3 months to get the growth spurt effect and terminate the plates and then go back to using the normal low dose that would be common for a teenager to gradually escalate with.

I've gotten crap in various transgender doctor groups about doing this, because "ItS ExPeRiMenTAL!"

no it's not. Literally nothing I do is experimental. Ever. It has all been done on cisgender people and I just read, clone things from other branches of medicine, and adapt them to transgender people.

I get really really tired of hearing this narrative about how I am not evidence-based with my treatment or anything else. Ironically, if anything, I'm more evidence-based than other people because I actually read journal articles and other publications to continuously scrape data to figure out what the best choice is for my own individual patients.

Regardless this was a good example of this, and so I wanted to share it for the future when somebody tells me there's no evidence to be able to modulate the height of transgender kids. Something that later on causes them a great amount of dysphoria as adults.

Ps: this is how I produced four world record cats. I neutered them as young as possible, and then, fed them a ton of phosphorus and calcium containing food. Literally porcine bone meal was ground up and put into their food. Ample bone making supply of materials, no reason to close a growth plate, cats grow tall and grow long tails.