The role of the pediatrician in the management of the child and adolescent with gender dysphoria (original) (raw)
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Gender dysphoria in children and adolescents – a disease far from pediatric practice?
Romanian Journal of Pediatrics
Gender dysphoria in children and adolescentsa disease far from pediatric practice? assist. prof. mirela silvia iancu 1,2 , lecturer ana-maria davitoiu 1,2 , md, phd, assist. prof. sorina chindris 1,2 , lecturer iulia florentina tincu 1,2 , md, phd, assoc. prof. monica livia Gheorghiu 1,3 , md, phd,
Gender Dysphoria in the Pediatric Population: Initial Experience of a Transdisciplinary Group
Revista Urología Colombiana / Colombian Urology Journal, 2021
Introduction Although there is an increasing experience in the management of transgender individuals, this has not been thoroughly explored in children. The need to establish a comprehensive and transdisciplinary management is of critical importance. In order to solve this issue, we want to report the results of a cohort of individuals with gender dysphoria (GD) seen by our transdisciplinary group from a social and clinical and health access perspective. Methods A 10-year retrospective case series of all patients that had been seen by our transdisciplinary team was reviewed. The main demographic characteristics were described, as well as impact variables in terms of diagnosis and treatment of these individuals. A social description of each individual was described. Frequency, distribution, and central tendency measures were evaluated for data presentation. IBM SPSS Statistics for Windows, version 24.0 (IBM Corp, Armonk, NY) software was used. Results Four cases of GD were included. ...
Medical treatment in gender dysphoric adolescents endorsed by SIAMS–SIE–SIEDP–ONIG
Journal of Endocrinological Investigation, 2014
Purpose Despite international guidelines being available, not all gender clinics are able to face gender dysphoric (GD) youth population needs specifically. This is particularly true in Italy. Centers offering specialized support are relatively few and a commonly accepted Italian approach to GD youth has still not been defined. The aim of the present Position Statement is to develop and adhere to Italian guidelines for treatment of GD adolescents, in line with the ''Dutch Approach'', the Endocrine Society (ES), and the World Professional Association for Transgender Health (WPATH) guidelines. Methods An in-depth brainstorming on the application of International guidelines in the Italian context was performed by several dedicated professionals. Results A staged approach, combining psychological support as well as medical intervention is suggested. In the first phase, individuals requesting medical help will undergo a psycho-diagnostic procedure to assess GD; for eligible adolescents, pubertal suppression should be made available (extended diagnostic phase). Finally, from the age of 16 years, cross-sex hormonal therapy can be added, and from the age of 18 years, surgical sex reassignment can eventually be performed. Conclusions The current inadequacy of Italian services offering specialized support for GD youth may lead to negative consequences. Omitting or delaying treatment is The Italian GnRH analogs ONIG study group:
In the Center of Expertise on Gender Dysphoria at the VU University Medical Center in Amsterdam, a structured assessment and treatment protocol for adolescents with atypical gender identities is used. This multidimensional approach includes specific phases: psychological assessment, medical evaluation, possible psychotherapy, gonadotropin-releasing hormone (GnRH) analogues and cross-sex hormone therapy, which are differentiated according to age and specific requirements of each individual case. Recently, a collaborative study called AGIR (Adolescent Gender Identity Research) has been proposed by the Dutch clinic to allow international and cross-clinic comparisons with regards to referral background and psychological functioning, and to evaluate the treatment of gender dysphoric adolescents. An extensive assessment and timely treatment of adolescents with gender dysphoria seems essential to support the process of awareness and structuring of the dimensions of sexual identity, to prevent frequent associated psychopathologies and to improve quality of life by promoting more adequate psychosocial adaptation. Currently, transgender health care in Italy is characterized by isolated practitioners. Thus, it is particularly important to create specialised services that use a common protocol and that are coordinated at both the national and international levels in order to respond to the increasing number of requests in this age group.
Gender Dysphoria in Adolescents
Çocuk dergisi, 2022
Doğumda genetik ve biyolojik olarak belirlenmiş cinsiyet ile cinsiyet kimliğinin uyuşmaması cinsiyet disforisi (cinsiyet hoşnutsuzluğu) olarak tanımlanmaktadır. Çocukluk yaşlarından itibaren görülmekle beraber sekonder seks karakterlerinin geliştiği ergenlik döneminde bu tablo ağırlaşmaktadır. Bu nedenle DSM-V tanı kriterleri ile birey değerlendirilmeli gerekli tıbbi onamlar alındıktan sonra geri dönüşümlü bir tedavi olan GnRH agonistleri ile önce puberte baskılanmalı ve tıbbi endikasyon konulan hastalarda bir sonraki aşama olan istenen cinsiyet yönünde puberte indüksiyonu uygulanmalıdır. Daha sonraki aşamada ise uygun vakalarda cinsiyet değiştirici ameliyatlar yapılmaktadır. Bu ameliyatlar tam olarak geri dönüşümsüz olup uygun endikasyonlar açısından çok titiz davranılmalı ve operasyon kararı için acele edilmemelidir. Bu konuda tam bir konsensus sağlanmalıdır. Ameliyat kararı alınan hastalar için operasyon öncesinde doğurganlık ile ilgili tüm seçenekler ayrıntıları ile sunulmalıdır. Tüm bunların yanında sağlıklı nesillerin devamı açısından cinsel disforisi olan ergenleri yaftalamaktan kaçınılmalı ve bu bireylere tedavinin her aşamasında eşlik eden psikopatolojik durumlar nedeniyle psikolojik destek sağlanmalıdır.
This paper deals with the diagnostic, ethical, legal, and pharmacological treatment of gender dysphoria in adolescents and children.