Iris de Nie

92 C H A P T E R 6 In 10 transgender women (4.7%) some seminiferous tubules contained full spermatogenesis, all of whom had initiated medical treatment in Tanner stage 4 or higher and it occurred in both the group that had continued GAHT until gGAS and in the group that had discontinued four weeks prior to gGAS (Table 2, Figure 2E). Complete absence of germ cells was encountered in 15 transgender women (7.0%) (Figure 2A), all of whom had initiated medical treatment in adulthood. Also, mean Johnsen’s scores were lowest in the adult cohort. In the subgroup of transgender women who initiated medical treatment in Tanner stage 2 or 3, all specimens showed immature germ cells of which spermatogonia were most commonly observed (60-79%) (Figure 2B, C, and D). Supplementary Table 2 shows the Modified Johnsen’s score for each individual separately. Figure 2 . Orchiectomy specimens with their most advanced germ cell type. A. No germ cells present, B. Spermatogonia, C. Spermatocytes, D. Round spermatids, E. Spermatozoa. Arrows indicate most advanced germ cells. Bar represents 20µm.