Caring for the transgender adolescent and young adult: Current concepts of an evolving process in the 21st century

Agana, Marisha; Greydanus, Donald E.; Indyk, Justin A.; Calles, Joseph L.; Kushner, Jennifer; Leibowitz, Scott; Chelvakumar, Gayathri; Cabral, Maria Demma

doi:10.1016/j.disamonth.2019.07.004

Cited by 34 publications

(23 citation statements)

References 349 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The interpretation of GV varies between professionals: some consider it a form of subjective distress due to a structural aspect of identity, persistent in most cases after puberty, others, a secondary result of family dynamics, or an issue connected to homosexuality. The consideration of GV as a form of subjective distress of an individual toward his or her gender is in line with the DSM-5 diagnosis and consistent with recent research (Agana et al, 2019).…”

Section: Discussionsupporting

confidence: 85%

“…As already mentioned, a lack of network between services and professionals emerged. This may result in a difficulty for transgender youth to access proper care, which in turn could lead to negative consequences under many aspects: it may result in an increased distress related to a lack of understanding (e.g., Fisher et al, 2017); it may delay the access to hormonal treatment, which scientific literature proved to be beneficial for both physical and mental health (e.g., Priest, 2019); and it may intensify the isolation GV youth experience, since specialized centers often offer the possibility to attend support groups meetings and work usually in network with schools (e.g., Agana et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Caring for gender diverse children and adolescents in Italy: A mixed-method investigation of clinicians’ knowledge and approach to clinical practice

Fortunato

Giovanardi

Mirabella

et al. 2020

Clin Child Psychol Psychiatry

View full text Add to dashboard Cite

Introduction: In today’s Italy, gender diversity has assumed a remarkable resonance and visibility in both scientific and popular literature, which has facilitated the development of studies regarding treatments and support for children and adolescents with gender-related issues. Aim: the aim of this study was to conduct a preliminary evaluation of how Italian clinicians (psychologists and pediatricians) perceive gender variant children and adolescents, evaluating their approach to clinical practice. Methods: An online questionnaire directed to clinicians regarding their experience with, and perceptions of, gender variant children and adolescents was used for the first part of the research. In the second part of this study, Consensual Qualitative Research (CQR) methodology was applied to semi-structured interviews aimed at investigating clinicians’ approach to clinical practice. Results: Professionals reported 374 cases, including 200 children (aged 2–11 years) and 174 adolescents (aged 12–19 years); a total of 10 interviews were conducted with professionals. Conclusion: This study highlights the increase of gender variant children and adolescents seen by professionals, but also the poor awareness of Italian professionals about gender diversity and their care, as well as an absence of a network model of intervention.

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Caring for gender diverse children and adolescents in Italy: A mixed-method investigation of clinicians’ knowledge and approach to clinical practice

Fortunato

Giovanardi

Mirabella

et al. 2020

Clin Child Psychol Psychiatry

View full text Add to dashboard Cite

show abstract

“…Detailed examinations for GD should be conducted by mental health professionals (MHPs) [12] who have su cient training and experience in assessing related mental health conditions and are willing to participate in the ongoing care throughout the endocrine transition [1,4,12]. In the case of our patient, the endocrinologist and oncologistgynecologist should be included in the diagnostic process due to the hormonal disorders and recurrent ovarian tumor [3,13].…”

Section: Discussionmentioning

confidence: 99%

Gender Dysphoria disrupting the course of treatment of a recurrent Juvenile Granulosa Cell Tumor in an adolescent female - a case report.

Kwiatkowska

Kułak

Wertel

2020

Preprint

View full text Add to dashboard Cite

Background: We present a case an adolescent female patient with Gender Dysphoria (GD) who was diagnosed with a recurrent ovarian neoplasm - Juvenile Granulosa Cell Tumor (JGCT).Case presentation: A 17-year-old female patient presented multiple endocrine pathologies and a recurrent JGCT. During the surgery qualification process, the patient admitted to identifying herself as a male. The patient described being uncomfortable with her body and with the expected roles of her assigned gender. Due to that, the patient requested a total hysterectomy with a bilateral salpingo-oophorectomy. As a minor, she required parent permission, which was not granted. The patient underwent several specialist consultations, after which she agreed for unilateral removal of tumor-changed pathologies and additional hormonal, psychological, and psychiatric diagnostics.Conclusion: To the best of our knowledge, this is the first detailed report of co-occurrence of GD spectrum disorders and JGCT in an adolescent female. This case contains many therapeutic and ethical problems regarding both physical and mental health. It should be noted that adolescents with the GD spectrum rarely develop persistent transsexuality. Modulations from developmental psychology, psychotherapy, family dynamics, hormonal treatment, and the removal of JGCT in the presented case may have potential therapeutic implications for GD.

show abstract

“…The aim of treatment was to suppress gonadotropins and sex hormones to near pre-pubertal levels. [13] Continued regular attendance for psychological support and therapy throughout the study was a precondition of GnRHa prescription. In addition local psychological services provided support for co-occuring difficulties for participants as required.…”

Section: The Treatmentmentioning

confidence: 99%

“…[5] There are limited data on the outcomes of pubertal suppression in the treatment of young people with GD. [3, 13] A recent systematic review included data on the physical and mental health outcomes of pubertal suppression using GnRHa in over 500 young people. [4] Longer-term follow-up data on pubertal suppression in GD are limited to individuals from four cohorts.…”

Section: Introductionmentioning

confidence: 99%

Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK

Carmichael

Butler

Masic

et al. 2020

Preprint

View full text Add to dashboard Cite

Background In adolescents with severe and persistent gender dysphoria (GD), gonadotropin releasing hormone analogues (GnRHa) are used from early/middle puberty with the aim of delaying irreversible and unwanted pubertal body changes. Evidence of outcomes of pubertal suppression in GD is limited. Methods We undertook an uncontrolled prospective observational study of GnRHa as monotherapy in 44 12-15 year olds with persistent and severe GD. Prespecified analyses were limited to key outcomes: bone mineral content (BMC) and bone mineral density (BMD); Child Behaviour CheckList (CBCL) total t-score; Youth Self-Report (YSR) total t-score; CBCL and YSR self-harm indices; at 12, 24 and 36 months. Semistructured interviews were conducted on GnRHa. Results 44 patients had data at 12 months follow-up, 24 at 24 months and 14 at 36 months. All had normal karyotype and endocrinology consistent with birth-registered sex. All achieved suppression of gonadotropins by 6 months. At the end of the study one ceased GnRHa and 43 (98%) elected to start cross-sex hormones. There was no change from baseline in spine BMD at 12 months nor in hip BMD at 24 and 36 months, but at 24 months lumbar spine BMC and BMD were higher than at baseline (BMC +6.0 (95% CI: 4.0, 7.9); BMD +0.05 (0.03, 0.07)). There were no changes from baseline to 12 or 24 months in CBCL or YSR total t-scores or for CBCL or YSR self-harm indices, nor for CBCL total t-score or self-harm index at 36 months. Most participants reported positive or a mixture of positive and negative life changes on GnRHa. Anticipated adverse events were common. Conclusions Overall patient experience of changes on GnRHa treatment was positive. We identified no changes in psychological function. Changes in BMD were consistent with suppression of growth. Larger and longer-term prospective studies using a range of designs are needed to more fully quantify the benefits and harms of pubertal suppression in GD.

show abstract

Caring for the transgender adolescent and young adult: Current concepts of an evolving process in the 21st century

Cited by 34 publications

References 349 publications

Caring for gender diverse children and adolescents in Italy: A mixed-method investigation of clinicians’ knowledge and approach to clinical practice

Caring for gender diverse children and adolescents in Italy: A mixed-method investigation of clinicians’ knowledge and approach to clinical practice

Gender Dysphoria disrupting the course of treatment of a recurrent Juvenile Granulosa Cell Tumor in an adolescent female - a case report.

Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK

Contact Info

Product

Resources

About