Nicos Skordis1,2, Gary Butler3,4,5, Martine C de Vries6,7, Katharina Main8, Sabine E Hannema7. 1. Division of Pediatric Endocrinology, Paedi Center for Specialized Pediatrics, Nicosia, Cyprus, nskordis@cytanet.com.cy. 2. University of Nicosia Medical School, Nicosia, Cyprus, nskordis@cytanet.com.cy. 3. Department of Paediatric and Adolescent Endocrinology, University College London Hospitals, London, United Kingdom. 4. UCL Great Ormond Street Institute of Child Health, London, United Kingdom. 5. UK Gender Identity Development Service, Tavistock and Portman NHS Trust, London, United Kingdom. 6. Department of Medical Ethics and Health Law, Leiden University Medical Centre, Leiden, The Netherlands. 7. Department of Paediatrics, Leiden University Medical Centre, Leiden, The Netherlands. 8. Department of Growth and Reproduction and EDMaRC, Rigshospitalet, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark.
Abstract
BACKGROUND/AIMS: Increasing numbers of children and adolescents seek medical care because they experience incongruence between their physical sex and their gender identity. METHODS: The ESPE working group on gender dysphoria (GD) undertook a survey to investigate the structure and the type of medical care in centers that offer specialist care for transgender adolescents. RESULTS: The personnel of each center varied from country to country, and a nationally organized network or plan for managing GD did not exist in all centers. The majority of young people were transitioning from female to male, and the number of new referrals increased remarkably during the past 3 years. Almost all centers follow the guidelines issued by the Endocrine Society and World Professional Association for Transgender Health. GnRH analogues were used as the initial treatment in the majority of the centers. The age from which adolescents are treated with gender-affirming hormones varied between centers. Several legal restrictions that concern or influence the treatment of children and adolescents with GD were finally addressed. CONCLUSION: This first international survey examining the variations in availability and provisions of services for children and adolescents with GD serves as a starting block for further dialogue and future studies.
BACKGROUND/AIMS: Increasing numbers of children and adolescents seek medical care because they experience incongruence between their physical sex and their gender identity. METHODS: The ESPE working group on gender dysphoria (GD) undertook a survey to investigate the structure and the type of medical care in centers that offer specialist care for transgender adolescents. RESULTS: The personnel of each center varied from country to country, and a nationally organized network or plan for managing GD did not exist in all centers. The majority of young people were transitioning from female to male, and the number of new referrals increased remarkably during the past 3 years. Almost all centers follow the guidelines issued by the Endocrine Society and World Professional Association for Transgender Health. GnRH analogues were used as the initial treatment in the majority of the centers. The age from which adolescents are treated with gender-affirming hormones varied between centers. Several legal restrictions that concern or influence the treatment of children and adolescents with GD were finally addressed. CONCLUSION: This first international survey examining the variations in availability and provisions of services for children and adolescents with GD serves as a starting block for further dialogue and future studies.
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