Care of Transgender Persons

A healthy 19-year-old college student presents with the statement that he is transgender and wants to start hormone therapy. The sex recorded at birth was female, but he notes having identified as a boy for as long as he can remember. More recently, his treatment goals have become clearer, including a wish to begin medical treatment and to begin presenting as male. He has no medical or behavioral health concerns and takes no medications. How would you advise this patient?