54 Chapter 3 It is important to give voice to the gender dysphoric adolescents themselves, hearing their views on topics like gender, autonomy, and best interests, when discussing the use of PS in GD. As professionals publish their pleas for or against this treatment it only seems fair to add the views of those involved, the adolescents themselves, to the literature. This is important because otherwise professionals act upon assumptions on the adolescents’ views, rather than on the actual considerations and opinions of the adolescents. This is illustrated by the fact that the adolescents seem to have more concerns about lowering age limits than professionals. In order to advance the ethical debate, we need to continue discussing the various themes based on research data in addition to mere opinions. If not based on empirical data, ideas on GD treatment may diverge even more, which eventually may lead to (even more) inconsistencies between the approaches recommended by clinicians across different centres. There are strengths and weaknesses to the present study. The qualitative nature of the study made it possible to find out, in depth, the ways in which the adolescents think or feel about specific topics. Nevertheless, the considerations explicated in this study are solely from a relatively small sample of adolescents from the treatment team in Leiden, the Netherlands. The considerations of adolescents are likely to be different in other adolescents and in other countries or other clinics. Furthermore, all adolescents, except for one, started treatment with PS when they were older than 12, at an average age of 15 years and 10 months. This could have had an effect on the way these adolescents think about the current age limit of 12 years of age. These adolescents were never confronted with this limit which possibly did not make them feel the urge to lower the current age limit. It calls for studies among a larger group of adolescents who started treatment at younger ages and adolescents who were not treated with PS at all. Furthermore the adolescents in our study come from a society with a relatively high acceptance of transgender individuals (Keuzenkamp & Kuyper, 2013).Studies in other countries should be done, not only to investigate differences between minors that had different treatment regimens but also to investigate the relationship between their views and the culture they live in. Until more research data become available, the optimal timing of treatment for GD will remain unclear (Olson-Kennedy et al., 2016).