We now describe 6 patients (including P13) with SIR (2 with type B IR, 2 with pathogenic INSR variants, 1 with a pathogenic variant in TBC1D4, and 1 with acquired partial lipodystrophy associated with juvenile dermatomyositis) who received GnRH analogue therapy for management of hyperandrogenism (Table 4). The gene discussed is TBC1D4; the disease is hyperandrogenism.