The treatment of adolescent transsexuals: changing insights.

@article{CohenKettenis2008TheTO,
  title={The treatment of adolescent transsexuals: changing insights.},
  author={Peggy T Cohen-Kettenis and Henriette A. Delemarre-van de Waal and Louis J Gooren},
  journal={The journal of sexual medicine},
  year={2008},
  volume={5 8},
  pages={
          1892-7
        }
}
INTRODUCTION Treatment of individuals with gender identity disorder (GID) has in medicine nearly always met with a great deal of skepticism. Professionals largely follow the Standards of Care of the World Professional Association for Transgender Health. For adolescents, specific guidelines have also been issued by the British Royal College of Psychiatrists. AIM To describe the stepwise changes in treatment policy which, in recent years, have been made by the team of the Gender Identity Clinic… 
Ethical conflicts over the management of transsexual adolescents--report of two cases.
TLDR
"harm reduction" is proposed as a means of coping with this dilemma in some cases of juvenile transsexuals who resorted to prostitution to afford hormonal medications when treatment was denied because of age criteria.
MANAGEMENT OF ENDOCRINE DISEASE: Approach to the management of children and adolescents with Gender Dysphoria.
TLDR
The current standards of care for transgender children and adolescents are reviewed with particular emphasis on disparities among countries and short to medium-term outcomes and ethical considerations regarding categorization of gender dysphoria, timing of treatment initiation, infertility, and how to deal with the long-term consequences are highlighted.
Endocrine Care of Transgender Children and Adolescents
The medical approach to transgender children and adolescents is outlined by the World Professional Association for Transgender Health and the Endocrine Society. All treatment considerations must be
Review of World Professional Association for Transgender Health's Standards of Care for Children and Adolescents with Gender Identity Disorder: A Need for Change?
ABSTRACT With the upcoming seventh edition of the Standards of Care (SOC), this article addresses various relevant aspects of the assessment and treatment of gender-dysphoric children and
Challenges in the care of transgender and gender-diverse youth: an endocrinologist’s view
TLDR
Although the relative paucity of outcomes data raises concerns, the stance of not intervening until more is known is not a neutral option, and large observational studies evaluating current models of care are necessary and are now underway.
Transgender Medicine is a Significant Part of Paediatric Endocrinology
Paediatric transgender individuals are reported, as adults, to be disproportionately affected by barriers to care, mental health problems, suicide, violence, discrimination, poverty, and HIV compared
How young is too young: ethical concerns in genital surgery of the transgender MTF adolescent.
INTRODUCTION During the last decade, the age of youths presenting for gender confirmation has steadily fallen. Transgender adolescents are being treated with gonadotropin-releasing hormone analogues
Gender incongruence and gender dysphoria in childhood and adolescence—current insights in diagnostics, management, and follow-up
TLDR
The somatic treatment generally consists of the use of GnRH analogues to prevent the progression of biological puberty and subsequently gender-affirming hormonal treatment to develop sex characteristics of the self-identified gender and surgical procedures.
...
...

References

SHOWING 1-10 OF 39 REFERENCES
Clinical management of gender identity disorder in adolescents: a protocol on psychological and paediatric endocrinology aspects
TLDR
Preliminary findings suggest that a decrease in height velocity and bone maturation occurs, and GnRHa treatment appears to be an important contribution to the clinical management of gender identity disorder in transsexual adolescents.
Sex reassignment of adolescent transsexuals: a follow-up study.
TLDR
Starting the sex reassignment procedure before adulthood results in favorable postoperative functioning, provided that careful diagnosis takes place in a specialized gender team and that the criteria for starting the procedure early are stringent.
Sex reassignment surgery: A study of 141 dutch transsexuals
TLDR
It is concluded that there is no reason to doubt the therapeutic effect of sex reassignment surgery and that more attention ought to be paid to psychosocial guidance in addition to medical guidance.
Pubertal delay as an aid in diagnosis and treatment of a transsexual adolescent
TLDR
A postoperative follow-up case-study of a female-to-male transsexual who was treated with a combination of an LHRH agonist and psychotherapy at age 13, and subsequently underwent sex reassignment at 18.
The psychoanalyst and the transsexual patient.
  • C. Chiland
  • Psychology
    The International journal of psycho-analysis
  • 2000
TLDR
It is concluded that transsexualism is a narcissistic disorder in which the constitution of the self has been profoundly impaired and that it is only since analysis have embarked on the treatment of non-neurotic patients that the condition has become accessible to psychoanalytic psychotherapy or indeed to psychoanalysis.
The Feasibility of Endocrine Interventions in Juvenile Transsexuals
A large number of adult transsexuals recall that their gender dysphoria started early in life, well before puberty. They remember puberty with abhorence, since the hormones of puberty precisely
Transgenderism and Intersexuality in Childhood and Adolescence: Making Choices
Series Editor's Introduction - Alan E. Kazdin Preface Acknowledgments List of Abbreviations 1. Typical Sexual Differentiation General Terminology Sexual Differentiation Development of Gender Identity
Adolescents with gender identity disorder who were accepted or rejected for sex reassignment surgery: a prospective follow-up study.
TLDR
Careful diagnosis and strict criteria are necessary and sufficient to justify hormone treatment in adolescent transsexuals and the high levels of psychopathology found in this group justify the decision to not start hormone treatment too soon or too easily.
Sex reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals.
TLDR
The results substantiate previous conclusions that sex reassignment is effective and clinicians need to be alert for non-homosexual male-to-females with unfavourable psychological functioning and physical appearance and inconsistent gender dysphoria reports, as these are risk factors for dropping out and poor post-operative results.
A sex difference in the human brain and its relation to transsexuality
TLDR
This study is the first to show a female brain structure in genetically male transsexuals and supports the hypothesis that gender identity develops as a result of an interaction between the developing brain and sex hormones.
...
...