Gender incongruence and gender dysphoria in childhood and adolescence-current insights in diagnostics, management, and follow-up.
Hedi L Claahsen-van der GrintenChris VerhaakThomas SteensmaTim MiddelbergJoep RoeffenDaniel KlinkPublished in: European journal of pediatrics (2020)
Gender incongruence (GI) is defined as a condition in which the gender identity of a person does not align with the gender assigned at birth. Awareness and more social acceptance have paved the way for early medical intervention about two decades ago and are now part of good clinical practice although much robust data is lacking. Medical and mental treatment in adolescents with GI is complex and is recommended to take place within a team of mental health professionals, psychiatrists, endocrinologists, and other healthcare providers. 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. However to optimize treatment regimens, long-term follow-up and additional studies are still needed. What is known • The prevalence of gender dysphoria increased significantly in the past years and can lead to significant complaints and burdens especially during puberty. • Pubertal suppression and gender-affirmed treatment can be effectively used in adolescence with gender dysphoria. What is new • Transgender mental and medical healthcare is a long-lasting process during which not only the child/adolescent with GI but also their parents/family have to be counseled in making choices about their social, medical, and legal transitions. • There are an increasing number of transgender persons defining as nonbinary. Therefore, an individualized approach by an experienced team is necessary.
Keyphrases
- mental health
- healthcare
- young adults
- randomized controlled trial
- depressive symptoms
- clinical practice
- type diabetes
- physical activity
- machine learning
- pregnant women
- dna methylation
- risk factors
- palliative care
- health insurance
- human immunodeficiency virus
- skeletal muscle
- quality improvement
- replacement therapy
- copy number
- big data
- deep learning
- artificial intelligence
- electronic health record
- hiv testing
- antiretroviral therapy