Understanding Pediatric Patients Who Discontinue Gender-Affirming Hormonal Interventions

@article{Turban2018UnderstandingPP,
  title={Understanding Pediatric Patients Who Discontinue Gender-Affirming Hormonal Interventions},
  author={Jack L. Turban and Jeremi M. Carswell and Alex S. Keuroghlian},
  journal={JAMA Pediatrics},
  year={2018},
  volume={172},
  pages={903–904}
}
It is estimated that as many as 1% of American adolescents have a gender identity that is not congruent with their sex assigned at birth.1 Guidelines developed in the Netherlands and then adopted throughout the world allow clinicians to prevent physical changes of puberty with the use of gonadotropin-releasing hormone analogs (GnRHa) when the first signs of puberty have manifested, a point at which the patient’s dysphoria surrounding gender often intensifies. This may be followed with exogenous… 

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References

SHOWING 1-10 OF 10 REFERENCES

Insurance Coverage of Puberty Blocker Therapies for Transgender Youth

The most effective medications are the gonadotropin-releasing hormone (GnRH) agonist leuprolide injections or histrelin subcutaneous implant (Supprelin, Vantas; Endo Pharmaceuticals, Malvern, PA), and these have been recommended in both the Endocrine Society Guidelines and the World Professional Organization for Transgender Health Standards of Care.

Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment

A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, followed by cross-sex hormones and gender reassignment surgery, provides gender dysphoric youth who seekgender reassignment from early puberty on, the opportunity to develop into well-functioning young adults.

Research Review: Gender identity in youth: treatment paradigms and controversies

Background Pediatric gender identity has gained increased attention over the past several years in the popular media, political arena, and medical literature. This article reviews terminology in

Research Review: Gender identity in youth treatment paradigms and controversies

Emerging data suggest that patients' high rates of anxiety, depression, and suicidality appear to be improved with affirmative protocols, although future longitudinal data are needed.

Endocrine Treatment of Gender‐Dysphoric/Gender‐Incongruent Persons: An Endocrine Society* Clinical Practice Guideline

This evidence‐based guideline recommends treating gender‐dysphoric/gender‐incongruent adolescents who have entered puberty at Tanner Stage G2/B2 by suppression with gonadotropin‐releasing hormone agonists and recommends adding gender‐affirming hormones after a multidisciplinary team has confirmed the persistence of gender dysphoria/gender incongruence.

Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

This version of the SOC recognizes that treatment for gender dysphoria has become more individualized, and can be used to help patients consider the full range of health services open to them, in accordance with their clinical needs and goals for gender expression.

Poor peer relations predict parent- and self-reported behavioral and emotional problems of adolescents with gender dysphoria: a cross-national, cross-clinic comparative analysis

A measure of poor peer relations was the strongest predictor of CBCL and YSR behavioral and emotional problems in gender dysphoric adolescents.

Injustice at Every Turn: A Report of the National Transgender Discrimination Survey

Transgender and gender non-conforming people face rampant discrimination in every area of life: education, employment, family life, public accommodations, housing, health, police and jails, and ID

Zucker , K . Standards of care for the health of transsexual , transgender and gender non - conforming people , version 7

  • Int J Transgenderism
  • 2011