Statement on gender-affirmative approach to care from the pediatric endocrine society special interest group on transgender health

Purpose of review The purpose of this Position Statement is to emphasize the importance of an affirmative approach to the health care of transgender individuals, as well as to improve the understanding of the rights of transgender youth. Recent findings Transgender youth have optimal outcomes when affirmed in their gender identity, through support by their families and their environment, as well as appropriate mental health and medical care. Summary The Pediatric Endocrine Society Special Interest Group on Transgender Health joins other academic societies involved in the care of children and adolescents in supporting policies that promote a safe and accepting environment for gender nonconforming/transgender youth, as well as adequate mental health and medical care. This document provides a summary of relevant definitions, information and current literature on which the medical management and affirmative approach to care of transgender youth are based.

[1]  S. Stewart,et al.  Approach to Children and Adolescents with Gender Dysphoria , 2016, Pediatrics in Review.

[2]  K. Olson,et al.  Mental Health of Transgender Children Who Are Supported in Their Identities , 2016, Pediatrics.

[3]  S. Reisner,et al.  Laboratory-confirmed HIV and sexually transmitted infection seropositivity and risk behavior among sexually active transgender patients at an adolescent and young adult urban community health center , 2015, AIDS care.

[4]  S. Reisner,et al.  Mental health of transgender youth in care at an adolescent urban community health center: a matched retrospective cohort study. , 2015, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[5]  P. Cohen-Kettenis,et al.  More than two developmental pathways in children with gender dysphoria? , 2015, Journal of the American Academy of Child and Adolescent Psychiatry.

[6]  M. C. Smith.  Guidelines for psychological practice with transgender and gender nonconforming people. , 2015, The American psychologist.

[7]  Juno Obedin-Maliver,et al.  Transgender Men Who Experienced Pregnancy After Female-to-Male Gender Transitioning , 2014, Obstetrics and gynecology.

[8]  S. Rosenthal,et al.  Psychological and Medical Care of Gender Nonconforming Youth , 2014, Pediatrics.

[9]  A. D. de Vries,et al.  Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment , 2014, Pediatrics.

[10]  K. Mayer,et al.  Promoting the successful development of sexual and gender minority youths. , 2014, American journal of public health.

[11]  Sheree M. Schrager,et al.  Parental support and mental health among transgender adolescents. , 2013, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[12]  M. Meriggiola,et al.  Safety of hormonal treatment in transgenders , 2013, Current opinion in endocrinology, diabetes, and obesity.

[13]  L. Clark,et al.  The Gender Affirmative Model: What We Know and What We Aim to Learn , 2013, Human Development.

[14]  David A Levine,et al.  Office-Based Care for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth , 2013, Pediatrics.

[15]  Kimberly A. S. Howard,et al.  Anxiety and depression in transgender individuals: the roles of transition status, loss, social support, and coping. , 2013, Journal of consulting and clinical psychology.

[16]  W. J. Meyer,et al.  Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7 , 2012 .

[17]  S. Mueller,et al.  Long-term evaluation of cross-sex hormone treatment in transsexual persons. , 2012, The journal of sexual medicine.

[18]  J. Drescher,et al.  Position Statement on Access to Care for Transgender and Gender Variant Individuals , 2012 .

[19]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[20]  A. D. de Vries,et al.  Puberty Suppression in Adolescents With Gender Identity Disorder: A Prospective Follow-Up Study: Puberty Suppression in Adolescents With GID , 2010 .

[21]  E. Giltay,et al.  A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones. , 2011, European journal of endocrinology.

[22]  P. Cohen-Kettenis,et al.  Gender Transitioning before Puberty? , 2011, Archives of sexual behavior.

[23]  P. Lichtenstein,et al.  Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden , 2011, PloS one.

[24]  R. Biemond,et al.  Desisting and persisting gender dysphoria after childhood: A qualitative follow-up study , 2011, Clinical child psychology and psychiatry.

[25]  J. Grant,et al.  Injustice at Every Turn: A Report of the National Transgender Discrimination Survey , 2011 .

[26]  O. Bodlund,et al.  A Five-Year Follow-Up Study of Swedish Adults with Gender Identity Disorder , 2010, Archives of sexual behavior.

[27]  V. Montori,et al.  Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. , 2009, The Journal of clinical endocrinology and metabolism.

[28]  A. Rogol,et al.  Consensus Statement on the Use of Gonadotropin-Releasing Hormone Analogs in Children , 2009, Pediatrics.

[29]  P. Cohen-Kettenis,et al.  Psychosexual outcome of gender-dysphoric children. , 2008, Journal of the American Academy of Child and Adolescent Psychiatry.

[30]  H. Delemarre-van de Waal,et al.  The treatment of adolescent transsexuals: changing insights. , 2008, The journal of sexual medicine.

[31]  F. Waldhauser,et al.  Long-term GnRH agonist treatment for female central precocious puberty does not impair reproductive function , 2006, Molecular and Cellular Endocrinology.

[32]  S. H. Goozen,et al.  Adolescents with gender identity disorder who were accepted or rejected for sex reassignment surgery: a prospective follow-up study. , 2001, Journal of the American Academy of Child and Adolescent Psychiatry.

[33]  J. Carel,et al.  Pharmacokinetics and Pharmacodynamics of GnRH Agonists: Clinical Implications in Pediatrics , 2000, Journal of pediatric endocrinology & metabolism : JPEM.

[34]  P. Cohen-Kettenis,et al.  Transsexualism: a review of etiology, diagnosis and treatment. , 1999, Journal of psychosomatic research.

[35]  S. H. Goozen,et al.  Sex reassignment of adolescent transsexuals: a follow-up study. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[36]  R. Clemons,et al.  Suppression of gonadotropin secretion by a long-acting gonadotropin-releasing hormone analog (leuprolide acetate, Lupron Depot) in children with precocious puberty. , 1989, The Journal of clinical endocrinology and metabolism.

[37]  M. Ross,et al.  Effects of adequacy of gender reassignment surgery on psychological adjustment: A follow-up of fourteen male-to-female patients , 1989, Archives of sexual behavior.

[38]  E. Nieschlag,et al.  Reversibility of long-term effects of GnRH agonist administration on testicular histology and sperm production in the nonhuman primate. , 1987, Journal of andrology.