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“It is possible that over time physicians have become somewhat inured to the safety warnings,” said Dr. Mark Olfson, who was not involved with this study.

"Coming out about gender can be a challenging experience for adolescents," writes Dr. Rachel Lynn Golden. It leaves them vulnerable to be rejected for a part of their core sense of self.

“There’s been a mad rush on the part of desperate patients to seek care,” said Dr. Jeffrey A. Lieberman. “There is a considerable body of evidence that proves it really does work.”

“School dropout portends other bad outcomes, like the inability to gain employment, involvement in substance abuse and problems with the juvenile justice system,” said Dr. Laura Mufson.