Advertisement

Reviews in Endocrine and Metabolic Disorders

, Volume 19, Issue 3, pp 227–230 | Cite as

Transgender medicine- transitioning transgender children to adulthood

  • Jessica AbramowitzEmail author
Article

Abstract

There has been an increasing prevalence of individuals presenting for treatment of gender dysphoria over the past several years. This growing population includes transgender children referred to pediatric clinics. Transgender children meeting diagnostic criteria for gender dysphoria, with supportive mental health care, may be treated with gonadotropin releasing hormone (GnRH) agonists and cross sex hormones. The treatment for these children requires ongoing maintenance and monitoring and therefore follow-up in the adult care setting. As is the case with other conditions that require long term treatment, these youth need a formal transition from pediatric to adult clinical care. The period of transition of care is critical and if not executed properly exposes the adolescent to risks of complications, and loss of follow-up. The proper clinical transfer is especially important for transgender youth in the setting of increased psychosocial and mental health issues. The transition of care for transgender adolescents has not been formally studied but given a growing population seeking treatment for gender dysphoria, it will need to be systematically assessed to determine the best outcomes to measure.

Keywords

Transgender medicine Transitions of care Cross sex hormones Transgender youth 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC; 2013.Google Scholar
  2. 2.
    Ruble DN, Martin CL, Berenbaum SA. Gender development, in Handbook of child psychology. In: Eisenberg N, editor. Social, emotional, and personality development. Hoboken: John Wiley & Sons; 2006. p. 858–932.Google Scholar
  3. 3.
    Herman JL, Flores AR, Brown TN, Wilson BD, Conron K. Age of individuals who identify as trangender in the United States. 2017. Available from: https://williamsinstitute.law.ucla.edu/research/transgender-issues/new-estimates-show-that-150000-youth-ages-13-to-17-identify-as-transgender-in-the-us/. Accessed July 2018.
  4. 4.
    Coleman E, Bockting W, Botzer M, et al. Standards of care for the health of transsexual, transgender and gender-nonconforming peple version 7. Int J Transgenderism. 2012;13:165–232.CrossRefGoogle Scholar
  5. 5.
    Hembree WC, Cohen-Kettenis PT, Gooren L, Hannema SE, Meyer WJ, Murad MH, et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: an Endocrine Society* clinical practice guideline. J Clin Endocrinol Metab. 2017;102:3869–903.CrossRefGoogle Scholar
  6. 6.
    Chew, D, et al. Hormonal Treatment in Young People With Gender Dysphoria: A Systematic Review. Pediatrics, 2018; 141(4).CrossRefGoogle Scholar
  7. 7.
    de Vries AL, et al. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. 2014;134(4):696–704.CrossRefGoogle Scholar
  8. 8.
    Russell ST, Pollitt AM, Li G, Grossman AH. Chosen name use is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth. J Adolesc Health. 2018.Google Scholar
  9. 9.
    Arcelus J, Bouman WP, van den Noortgate W, Claes L, Witcomb G, Fernandez-Aranda F. Systematic review and meta-analysis of prevalence studies in transsexualism. Eur Psychiatry. 2015;30(6):807–15.CrossRefGoogle Scholar
  10. 10.
    Zucker KJ. Epidemiology of gender dysphoria and transgender identity. Sex Health. 2017;14(5):404–11.CrossRefGoogle Scholar
  11. 11.
    Wiepjes CM, Nota NM, de Blok CJM, Klaver M, de Vries ALC, Wensing-Kruger SA, et al. The Amsterdam cohort of gender dysphoria study (1972-2015): trends in prevalence, treatment, and regrets. J Sex Med. 2018;15:582–90.CrossRefGoogle Scholar
  12. 12.
    Spack NP, Edwards-Leeper L, Feldman HA, Leibowitz S, Mandel F, Diamond DA, et al. Children and adolescents with gender identity disorder referred to a pediatric medical center. Pediatrics. 2012;129(3):418–25.CrossRefGoogle Scholar
  13. 13.
    Chen M, Fuqua J, Eugster EA. Characteristics of referrals for gender dysphoria over a 13-year period. J Adolesc Health. 2016;58(3):369–71.CrossRefGoogle Scholar
  14. 14.
    Aitken M, Steensma TD, Blanchard R, VanderLaan DP, Wood H, Fuentes A, et al. Evidence for an altered sex ratio in clinic-referred adolescents with gender dysphoria. J Sex Med. 2015;12(3):756–63.CrossRefGoogle Scholar
  15. 15.
    Gortmaker SL, Sappenfield W. Chronic childhood disorders: prevalence and impact. Pediatr Clin N Am. 1984;31(1):3–18.CrossRefGoogle Scholar
  16. 16.
    Blum RW, Garell D, Hodgman CH, Jorissen TW, Okinow NA, Orr DP, et al. Transition from child-centered to adult health-care systems for adolescents with chronic conditions. A position paper of the Society for Adolescent Medicine. J Adolesc Health. 1993;14(7):570–6.CrossRefGoogle Scholar
  17. 17.
    Shaw TM, Delaet DE. Transition of adolescents to young adulthood for vulnerable populations. Pediatr Rev. 2010;31(12):497–504. quiz 505CrossRefGoogle Scholar
  18. 18.
    American Academy of Pediatrics, et al. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. 2011;128(1):182–200.CrossRefGoogle Scholar
  19. 19.
    Got Transition. 6 Core Elements of Health Care Transition 2.0. 3/27/18; Available from: http://www.gottransition.org/resourceGet.cfm?id=206.
  20. 20.
    Wright C, Steinway C, Jan S. The genesis of systems of care for transition to adulthood services: emerging models in primary and subspecialty care. Curr Opin Pediatr. 2018;30(2):303–10.CrossRefGoogle Scholar
  21. 21.
    De Pedro KT, et al. Substance use among transgender students in California public middle and high schools. J Sch Health. 2017;87(5):303–9.CrossRefGoogle Scholar
  22. 22.
    Becerra-Culqui, T.A., et al. Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers. Pediatrics, 2018;141(5).CrossRefGoogle Scholar
  23. 23.
    Sanchez NF, Sanchez JP, Danoff A. Health care utilization, barriers to care, and hormone usage among male-to-female transgender persons in new York City. Am J Public Health. 2009;99(4):713–9.CrossRefGoogle Scholar
  24. 24.
    Safer JD, Coleman E, Feldman J, Garofalo R, Hembree W, Radix A, et al. Barriers to healthcare for transgender individuals. Curr Opin Endocrinol Diabetes Obes. 2016;23(2):168–71.CrossRefGoogle Scholar
  25. 25.
    Arnett, JJ, Schwab J The Clark University poll of emerging adults: thriving, struggling, and hopeful. 2012; Available from: <clark-university-poll-emerging-adults-findings.pdf>.
  26. 26.
    Olson J, Schrager SM, Belzer M, Simons LK, Clark LF. Baseline physiologic and psychosocial characteristics of transgender youth seeking Care for Gender Dysphoria. J Adolesc Health. 2015;57(4):374–80.CrossRefGoogle Scholar
  27. 27.
    Strang JF, Kenworthy L, Dominska A, Sokoloff J, Kenealy LE, Berl M, et al. Increased gender variance in autism spectrum disorders and attention deficit hyperactivity disorder. Arch Sex Behav. 2014;43(8):1525–33.CrossRefGoogle Scholar
  28. 28.
    Heylens G, Aspeslagh L, Dierickx J, Baetens K, van Hoorde B, de Cuypere G, et al. The co-occurrence of gender dysphoria and autism Spectrum disorder in adults: an analysis of cross-sectional and clinical chart data. J Autism Dev Disord. 2018;48:2217–23.CrossRefGoogle Scholar
  29. 29.
    Bloom SR, Kuhlthau K, van Cleave J, Knapp AA, Newacheck P, Perrin JM. Health care transition for youth with special health care needs. J Adolesc Health. 2012;51(3):213–9.CrossRefGoogle Scholar
  30. 30.
    Hughto, JMW, Reisner SL, Kershaw TS, Altice FL, Biello KB, Mimiaga MJ, Garofalo R, Kuhns LM, Pachankis JE, A multisite, longitudinal study of risk factors for incarceration and impact on mental health and substance use among young transgender women in the USA. J Public Health (Oxf), 2018.Google Scholar
  31. 31.
    Rider, GN, et al. Health and care utilization of transgender and gender nonconforming youth: A population-based study. Pediatrics, 2018.Google Scholar
  32. 32.
    Clark, BA, et al. Primary care access and foregone care: a survey of transgender adolescents and young adults. Fam Pract, 2017.Google Scholar
  33. 33.
    Davis AM, Brown RF, Taylor JL, Epstein RA, McPheeters ML. Transition care for children with special health care needs. Pediatrics. 2014;134(5):900–8.CrossRefGoogle Scholar
  34. 34.
    Endocrine Society. Transitions of care. Available from: http://www.endocrinetransitions.org.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Internal Medicine, Division of Endocrinology and MetabolismUT Southwestern Medical CenterDallasUSA

Personalised recommendations