A Critical Review of Clinical Practice Guidelines for Care of Transgender and Gender Diverse Children and Youth for Use by Primary Care Practitioners

Ziegler, Erin; Charnish, Erin; Carroll, Benjamin; Layman-Pleet, Leah

doi:10.1089/trgh.2020.0185

Cited by 5 publications

(18 citation statements)

References 53 publications

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“…Only studies that look at adult patients (those aged 18 years and older) will be included because guidelines for hormone therapy differ between adults and children or adolescents. 1,24 Guidelines for hormone therapy for adults typically include testosterone for transgender males and estrogen with an antiandrogen for transgender women. 2,11 Medical support for children and youth can often involve puberty suppression.…”

Section: Inclusion Criteria Populationmentioning

confidence: 99%

“…Medical support for children and youth can often involve puberty suppression. Although in some cases it is done in primary care, many children and youth still access this care from specialists 24,25…”

Section: Inclusion Criteriamentioning

confidence: 99%

“…Although in some cases it is done in primary care, many children and youth still access this care from specialists. 24,25 Transgender adults who seek primary care services can include transgender patients, trans men, trans masculine, trans masc, trans women, trans feminine, male-to-female (MTF), female-to-male (FTM), assigned male at birth (AMAB), assigned female at birth (AFAB), non-binary, gender queer, and gender diverse people who access primary care.…”

Section: Inclusion Criteria Populationmentioning

confidence: 99%

“…Physicians or nurse practitioners providing hormone therapy or puberty blockers to only children or youth will be excluded. Only studies that look at adult patients (those aged 18 years and older) will be included because guidelines for hormone therapy differ between adults and children or adolescents 1,24. Guidelines for hormone therapy for adults typically include testosterone for transgender males and estrogen with an antiandrogen for transgender women 2,11.…”

Section: Inclusion Criteriamentioning

confidence: 99%

See 3 more Smart Citations

Barriers and facilitators for accessing and prescribing hormone therapy in primary care for transgender adults: a scoping review protocol

Ziegler

Mills

Lee

et al. 2022

JBI Evidence Synthesis

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Objective: The objective of this scoping review is to understand the extent and type of evidence in relation to barriers and facilitators experienced by transgender adults in accessing hormone therapy. It will also explore the experiences of primary care practitioners in prescribing hormone therapy in primary care. Introduction: Providing care to transgender patients is a rapidly growing area of primary care. Despite the existence of clinical practice guidelines that support the prescription of gender-affirming hormone therapy in primary care, only a small number of primary care providers are offering this care. This review will seek to advance research on this topic by examining the barriers and facilitators of hormone prescription for transgender adults in primary care. Inclusion criteria: This review will consider research on primary care practitioners who prescribe hormone therapy to transgender adults. It will also focus on transgender adults who seek hormone therapy in primary care. Only studies that examine barriers and facilitators in primary care will be included. The review will include qualitative, quantitative, and mixed methods studies, in addition to systematic reviews and meta-analyses. Methods: The search will include MEDLINE, CINAHL, EmCare, and Nursing and Allied Health Premium. No date limits will be applied to the search. Only articles written in English will be eligible for inclusion. Articles will be reviewed and data extracted by 2 independent reviewers. The results of the extracted data will be presented in a narrative summary with accompanying tables.

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Section: Inclusion Criteria Populationmentioning

confidence: 99%

Section: Inclusion Criteriamentioning

confidence: 99%

Section: Inclusion Criteria Populationmentioning

confidence: 99%

Section: Inclusion Criteriamentioning

confidence: 99%

See 2 more Smart Citations

Barriers and facilitators for accessing and prescribing hormone therapy in primary care for transgender adults: a scoping review protocol

Ziegler

Mills

Lee

et al. 2022

JBI Evidence Synthesis

Self Cite

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“…Several clinical guidelines exist to inform care provision for this population 12 13. Recent systematic reviews have identified and appraised guidelines for transgender care, raising concerns about their quality 12–14.…”

Section: Introductionmentioning

confidence: 99%

Clinical guidelines for children and adolescents experiencing gender dysphoria or incongruence: a systematic review of guideline quality (part 1)

Taylor,

Hall,

Heathcote

et al. 2024

Arch Dis Child

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BackgroundIncreasing numbers of children and adolescents experiencing gender dysphoria/incongruence are being referred to specialist gender services. There are various guidelines outlining approaches to the clinical care of these children and adolescents.AimTo examine the quality and development of published guidelines or clinical guidance containing recommendations for managing gender dysphoria/incongruence in children and/or adolescents (age 0-18). A separate paper reports the synthesis of guideline recommendations.MethodsA systematic review and narrative synthesis. Databases (Medline, Embase, CINAHL, PsycINFO, Web of Science) were searched to April 2022 and web-based searches and contact with international experts continued to December 2022, with results assessed independently by two reviewers. The Appraisal of Guidelines for Research and Evaluation tool was used to examine guideline quality.ResultsTwenty-three guidelines/clinical guidance publications (1998–2022) were identified (4 international, 3 regional and 16 national). The quality and methods reporting in these varied considerably. Few guidelines systematically reviewed empirical evidence, and links between evidence and recommendations were often unclear. Although most consulted with relevant stakeholders, including 10 which involved service users or user representatives, it was often unclear how this influenced recommendations and only two reported including children/adolescents and/or parents. Guidelines also lacked clarity about implementation. Two international guidelines (World Professional Association for Transgender Health and Endocrine Society) formed the basis for most other guidance, influencing their development and recommendations.ConclusionsMost clinical guidance for managing children/adolescents experiencing gender dysphoria/incongruence lacks an independent and evidence-based approach and information about how recommendations were developed. This should be considered when using these to inform service development and clinical practice.PROSPERO registration numberCRD42021289659.

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Ethically Navigating the Evolution of Gender Affirmation Surgery

2023

AMA Journal of Ethics

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A Critical Review of Clinical Practice Guidelines for Care of Transgender and Gender Diverse Children and Youth for Use by Primary Care Practitioners

Cited by 5 publications

References 53 publications

Barriers and facilitators for accessing and prescribing hormone therapy in primary care for transgender adults: a scoping review protocol

Barriers and facilitators for accessing and prescribing hormone therapy in primary care for transgender adults: a scoping review protocol

Clinical guidelines for children and adolescents experiencing gender dysphoria or incongruence: a systematic review of guideline quality (part 1)

Ethically Navigating the Evolution of Gender Affirmation Surgery

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