117 Trajectories of adolescents treated with gonadotropin‑releasing hormone analogues for gender dysphoria 6 identified. Because of this deterioration of his general condition, he wished to discontinue treatment with GnRHa after 2.4 years. He gradually recovered over the next two years. He subsequently started lynestrenol and testosterone treatment. The last adolescent had stopped GnRHa because his parents were unable to regularly collect medication from the pharmacy and take him to appointments for the injections. He subsequently started lynestrenol to suppress menses; he is not eligible yet for testosterone treatment. The five others (3.5%) no longer wished gender-affirming medical treatment (GAMT). One adolescent had been very distressed about breast development at the start of GnRHa. She later thought that she might want to live as a woman without breasts. She did not want to live as a boy and did not wish testosterone treatment and decided to discontinue GnRHa although she dreaded breast development and menstruation. Another adolescent had concurrent psychosocial problems interfering with the exploration of gender identity and did not currently wish treatment. When looking back on treatment with GnRHa this individual said: “The decision to stop GnRHa to my mind was made by the gender team, because they did not think gender dysphoria was the right diagnosis. I do still feel like a man, but for me it is okay to be just me instead of a he or a she, so for now I do not want any further treatment.” - Interview with an adolescent assigned female sex at birth, age 16 years One adolescent felt more in between man and woman and therefore did not wish to continue treatment: “At the moment, I feel more like ‘I am’ instead of ‘I am a woman’ or ‘I am a man’.” - Interview with an adolescent assigned female sex at birth, age 16 years Another individual made a social transition while using GnRHa and shortly afterward decided to discontinue treatment. He indicated that he had fallen in love with a girl and had never had such feelings, which made him question his gender identity. At subsequent visits, he indicated that he was happy living as a man. The last adolescent stated: “After using GnRHa for the first time, I could feel who I was without the female hormones, this gave me peace of mind to think about my future. It was an inner feeling that said I am a woman.” - Interview with an adolescent assigned female sex at birth, age 18 years