13 year old born female trans male whose family is incredibly supportive, and the family is interested in learning more about hormone management. The patient has known for several years that something wasn’t right. He initially thought he was a female lesbian and told the family this about two years ago. About 1 year ago is when he came to the realization that he is actually transgender. He has been a patient with me for about 6 months and is incredibly shy, and speaks mostly through his parents. He has a very good relationship with them. They state there’s no sexual abuse history, and the patient is very reluctant to go to counseling and/or see other physicians (he’s just starting to “come around” to me.) As boarded in FM with very little endo in residency I’m unsure of the path for this, however, mental health is a huge part of my practice and I believe very important and I will be requiring this no matter the path forward.
What are the initial steps to take if he does become interested in hormone management?