Psychosocial Functioning in Transgender Youth after 2 Years of Hormones

Chen, Diane; Berona, Johnny; Chan, Yee-Ming; Ehrensaft, Diane; Garofalo, Robert; Hidalgo, Marco A.; Rosenthal, Stephen M.; Tishelman, Amy C.; Olson-Kennedy, Johanna

doi:10.1056/nejmoa2206297

Cited by 142 publications

(75 citation statements)

References 26 publications

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Section: Gender Affirmative Carementioning

confidence: 99%

“…43 The only study to look at longer term psychosocial outcomes reported significant improvements in depression, anxiety, positive affect, and life satisfaction following 2 years of GAH treatment and found that improvements in these domains were significantly associated with increasing appearance congruence. 44 Surgical interventions may include breast/chest surgery (eg, breast augmentation; mastectomy with chest contouring), genital surgery involving removal of undesired reproductive organs (eg, orchiectomy, hysterectomy, oophorectomy), or surgical construction of desired genital anatomy (eg, vaginoplasty, phalloplasty/metoidioplasty), and other non-genital, non-chest surgical interventions (eg, facial feminization surgery, tracheal shave). Most surgical interventions are offered only to adults, 10 but chest masculinization surgery is a notable exception available to adolescents experiencing significant and impairing chest dysphoria who desire chest surgery and have parental support and consent.…”

mentioning

confidence: 99%

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Gender Dysphoria: Optimizing Healthcare for Transgender and Gender Diverse Youth with a Multidisciplinary Approach

Coyne¹,

Yuodsnukis²,

Chen³

2023

NDT

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Transgender and gender diverse (TGD) youth and their families are seeking medical and mental health care at increasing rates. As the number of multidisciplinary pediatric gender programs expands, we consider the history and evidence base for gender affirmative care and highlight existing models of care that can flexibly accommodate the diverse needs of TGD youth and their families. Comprehensive multidisciplinary care includes both medical and mental health providers who work collaboratively with TGD youth and their caregivers to assess gender-related support needs and facilitate access to developmentally appropriate medical and mental health interventions. In addition to direct health-care services, multidisciplinary care for TGD youth and their families extends into community training, education, community outreach, nonmedical programming, and advocacy for TGD youth.

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Section: Gender Affirmative Carementioning

confidence: 99%

mentioning

confidence: 99%

Gender Dysphoria: Optimizing Healthcare for Transgender and Gender Diverse Youth with a Multidisciplinary Approach

Coyne¹,

Yuodsnukis²,

Chen³

2023

NDT

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“…The use of GnRH analogs and other hormonal therapies has significant psycho-social benefits for TGD youth and can significantly reduce distress and long-term morbidity from development of undesired secondary sex characteristics [6,20 ▪▪ ].…”

Section: Pubertal Suppression and Hormonal Therapiesmentioning

confidence: 99%

Emergency care considerations for transgender and gender diverse youth: a review to improve health trajectories

Lillemoe

Holmstrom

Sojar

2023

Current Opinion in Pediatrics

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Purpose of reviewTransgender and Gender Diverse (TGD) youth represent a growing subset of pediatric patients who are at increased risk for harmful health outcomes. Consideration of these risks during emergency encounters may decrease these undesired, sometimes fatal, adverse events. Recent findingsGender affirmative care of TGD youth is considered a basic healthcare right as noted by several academic societies including the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the American Psychological Association [1--3] (Table 1). Withholding gender affirmative care can lead to undesired health outcomes including but not limited to an increased incidence of mood disorders, self-injurious behavior, suicidal ideation, sexually transmitted diseases, and delayed presentations of treatable illness. TGD youth often access acute care settings, yet many feel apprehensive due to prior negative experiences or fear of discrimination. Practitioners are also often unaware as to how to effectively provide this type of healthcare.

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“… 188 Certain sociocultural and peer factors, including appearance incongruence and dissatisfaction, stress related to communicating one’s identity to others, and social pressure to look a certain way may also be exacerbated for certain individuals with these identities. 187 , 189 , 190 Importantly, SGM refers to a heterogeneous group of identities, and distinguishing between gender and sexual orientations is important when considering and assessing body image and disordered eating. 189 , 191 Transgender and gender diverse adolescents also may exhibit body image concerns and restrictive eating/weight-control behaviors that are related to the experience of gender dysphoria (eg, a transgender boy engaging in restrictive eating to prevent/reduce development of feminine body characteristics).…”

Section: Considerations For Using the Ede With Specific Adolescent Su...mentioning

confidence: 99%

Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents

Parker¹,

Lavender²,

Schvey³

et al. 2023

AHMT

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Approximately 35 years after its initial publication, the Eating Disorder Examination (EDE) remains one of the most widely used semi-structured interviews for assessing eating disorder diagnoses and symptomatology. Although the interview provides certain advantages over other common measurement approaches (ie, questionnaires), there are particular considerations regarding the EDE that warrant attention, including in its use with adolescents. The aims of this paper are therefore to: 1) provide a brief overview of the interview itself, as well as a description of its origin and underlying conceptual framework; 2) describe relevant factors for administering the interview with adolescents; 3) review potential limitations regarding use of the EDE with adolescents; 4) address considerations for using the EDE with pertinent subpopulations of adolescents who may experience distinct eating disorder symptoms and/or risk factors; and 5) discuss the integration of self-report questionnaires with the EDE. Advantages of using the EDE include the ability for interviewers to clarify complex concepts and mitigate inattentive responding, enhanced orientation to the interview timeframe to improve recall, increased diagnostic accuracy compared to questionnaires, and accounting for potentially salient external factors (eg, food/eating rules imposed by a parent/guardian). Limitations include more extensive training requirements, greater assessment burden, variable psychometric performance across subgroups, lack of items evaluating muscularity-oriented symptoms and avoidant/restrictive food intake disorder diagnostic criteria, and lack of explicit consideration for salient risk factors other than weight and shape concerns (eg, food insecurity).

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Psychosocial Functioning in Transgender Youth after 2 Years of Hormones

Cited by 142 publications

References 26 publications

Gender Dysphoria: Optimizing Healthcare for Transgender and Gender Diverse Youth with a Multidisciplinary Approach

Gender Dysphoria: Optimizing Healthcare for Transgender and Gender Diverse Youth with a Multidisciplinary Approach

Emergency care considerations for transgender and gender diverse youth: a review to improve health trajectories

Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents

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