Improving Our Understanding of Medical Decision-Making Competence in Puberty Suppression.

  title={Improving Our Understanding of Medical Decision-Making Competence in Puberty Suppression.},
  author={Neal D. Hoffman and Elizabeth Meller Alderman},
In this issue of Pediatrics, Vrouenraets et al present findings on an important study assessing transgender adolescents’ medical decision-making competence (MDC) to give informed consent for starting puberty suppression (PS) among a sample of youth receiving care at 2 specialized gender identity clinics in the Netherlands. This study has significance for 2 important reasons: (1) PS has gained increased use in care for transgender adolescents; and (2) recent legislation in several US states, as… 



Assessing Medical Decision-Making Competence in Transgender Youth.

Transgender adolescents' medical decision-making competence (MDC) to give IC for starting PS in a structured, replicable way is examined in a validated semistructured interview.

Timing of Puberty Suppression and Surgical Options for Transgender Youth

PS reduces the development of sex characteristics in transgender adolescents, and transgender men may not need to undergo mastectomy, whereas transgender women may require an alternative to penile inversion vaginoplasty.

Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents

This policy statement reviews relevant concepts and challenges and provides suggestions for pediatric providers that are focused on promoting the health and positive development of youth that identify as TGD while eliminating discrimination and stigma.

Informed Consent in Decision-Making in Pediatric Practice

This technical report, which accompanies the policy statement “Informed Consent in Decision-Making in Pediatric Practice” was written to provide a broader background on the nature of informed consent, surrogate decision-making in pediatric practice, information on child and adolescent decision- making, and special issues in adolescent informed consent.

Long-term Puberty Suppression for a Nonbinary Teenager

Ethics Rounds analyzes a case that raised issues about prolonged pubertal suppression for a patient with a nonbinary gender, and examines whether the benefits outweigh the risks.

Trends in the use of puberty blockers among transgender children in the United States

Utilization of histrelin acetate implants among transgender children has increased dramatically and White non-Hispanic patients are more likely to be White when compared to the larger cohort of patients being treated with histrel in acetate for central precocious puberty (CPP), thus identifying a potential racial disparity in access to medically appropriate transgender care.

Medically assisted gender affirmation: when children and parents disagree

This discussion approaches this parent–child disagreement in a manner that prioritises the developing autonomy of transgender youth in the decision-making process surrounding medically assisted gender affirmation.

The Amsterdam Cohort of Gender Dysphoria Study (1972-2015): Trends in Prevalence, Treatment, and Regrets.

The Legal Authority of Mature Minors to Consent to General Medical Treatment

The underlying differences between medical ethics and law are discussed, the most current legal rules governing adolescent decision-making authority in general medical settings are set out, and a comprehensive analysis of both statutory and common law demonstrates that in such settings, parental consent continues to be required by most jurisdictions.

The adolescent alone : decision making in health care in the United States

Ethics Guidelines for Health Care Providers on Treating 'Adolescents Alone' Jeffrey Blustein, Nancy Dubler and Carol Levine, and Ethics Guidelines by Antisocial Adolescents: Defining the 'Least Bad' Option Michael Pawel.