Clinical Management of Youth with Gender Dysphoria in Vancouver

Characteristics of Adolescents Referred to a Gender Clinic: Are Youth Seen Now Different from Those in Initial Reports?

“…Depression, dysthymia, or depressive symptoms have been found in 12–64% of adolescents with gender dysphoria, with most studies reporting this number to be around 30% [1, 2, 6, 7, 12-20]. Adolescents with gender dysphoria have also been found to have elevated rates of suicide attempts (9–30%), self-harm (13–53%), and eating disorders (2–16%) [1, 2, 6, 7, 16-21]. In addition to the above, a recent study found that adolescents with gender dysphoria also had a co-occurring history of psychosocial and psychological vulnerability [22].…”

“…In 2015, Olson et al [20] described their Los Angeles cohort of 101 individuals, seen between February 2011 and June 2013. Also in 2015, Khatchadourian et al [2] described a cohort of 84 patients in Vancouver, seen between 1998 and 2011. However, some recent studies have suggested different demographics among transgender youth than were previously described [1, 2, 20].…”

“…Also in 2015, Khatchadourian et al [2] described a cohort of 84 patients in Vancouver, seen between 1998 and 2011. However, some recent studies have suggested different demographics among transgender youth than were previously described [1, 2, 20]. For instance, some have suggested a trend toward more individuals assigned female at birth (AFAB, or female to male) now seeking care than those assigned male at birth (AMAB, male to female) [8, 24].…”

Ethics in Child and Youth Care Practice With Transgender Youth

“…Gender affirming medical care interventions available for youth include pubertal suppression and hormone therapy (de Vries & Cohen-Kettenis, 2012). Pubertal suppression is a fully reversible intervention that blocks the sex hormones that the body naturally produces in order to temporarily stop secondary sex characteristic development, while hormone therapy is a partially reversible intervention through which hormones that produce desired secondary sex characteristics are provided (de Vries et al, 2014;Khatchadourian, Amed, & Metzger, 2014). Some youth go on to have gender affirming surgeries, typically once they reach the age of majority (Coleman et al, 2012).…”

“…However, recent studies have also highlighted the crucial roles of family support and gender affirming medical care in the overall wellbeing of trans youth (Bernal & Coolhart, 2012;de Vries et al, 2014;Khatchadourian, Amed, & Metzger, 2014;Olson, Forbes, & Belzer, 2011;Ryan et al, 2010). In one recent study, trans youth who had access to pubertal suppression and hormone therapy, and who went on to have gender affirming surgery as young adults, reported psychosocial outcomes very similar to their cisgender peers (de Vries et al, 2014).…”