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89 HISTOLOGICAL STUDY ON THE INFLUENCE OF PUBERTY SUPPRESSION AND HORMONAL TREATMENT ON DEVELOPING GERM CELLS 6 round spermatids, spermatocytes, or spermatogonia as most advanced germ cell type; and no possibilities for those with a complete absence of germ cells. Outcome was expressed as proportion with 95% confidence interval (95%CI) and compared between people who started medical treatment as an adult ( > 18 years) and those who started as adolescent in early-puberty (Tanner stage 2-3) or late-puberty (Tanner stage 4-5). 113 Since some categories contained no observations, we were not able to perform statistical tests. Therefore, differences between groups are shown in a figure. To assess the effect of cessation of GAHT prior to surgery, Fisher’s exact tests were used to compare outcome within each pubertal stage at initiation of medical treatment. The significance level was set at P < 0.05, and all tests were two-sided. Lastly, logistic regression analyses were performed to assess the association between the duration of medical treatment and the possibility for preservation of spermatozoa, as well as the possibility for preservation of spermatogonial stem cells. Since the duration of medical treatment prior to gGAS, as well as progress of spermatogenesis both might be dependent on the age at start of medical treatment, a correction was performed for this factor. Odds ratios (OR) with 95%CI were calculated. All statistical analyses were performed using STATA Statistical Software, version 15.1 (Statacorp, College Station, TX, USA). RESULTS Initially, 263 transgender women were selected for inclusion in the study cohort. A total of 35 individuals were excluded when, upon preparation for analysis of the orchiectomy specimens, it became evident that for these transgender women no tissue was stored at the Pathology department of Amsterdam UMC. Another 14 transgender women were excluded because no testicular parenchyma was encountered on the prepared slides. Therefore, the final cohort consisted of 214 transgender women divided into 6 subgroups (Figure 1).