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Transition Considerations for Transgender Patients

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Abstract

A relatively new but growing group of youth transferring from pediatric to adult endocrine care includes transgender and gender-expansive children and youth, particularly as related to gender-affirming hormonal treatments. This chapter identifies the developmental and psychosocial considerations, treatment and screening issues, health service practices designed to ensure sensitive medical care of this vulnerable population, and specific care considerations as these youth transition from pediatric to adult endocrine programs. It concludes with providing key additional resources to facilitate optimal transition in care for these young adults.

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Notes

  1. 1.

    Note. The word “transition” has another meaning when referring to transgender people. It refers to the individual process transgender individuals go through, a social, legal, medical, and/or surgical processes with the goal of self-actualization as it relates to one’s gender identity and body. The authors will use “gender transition” throughout to refer to this process.

References

  1. Grant JM, Mottet L, Tanis J, Harrison J, Herman J, Keisling M. Injustice at every turn: a report of the national transgender discrimination survey. Washington, DC: National Center for Transgender Equality and National Gay and Lesbian Task Force; 2011.

    Google Scholar 

  2. Cohen-Kettenis PT, van Goozen SH. Pubertal delay as an aid in diagnosis and treatment of a transsexual adolescent. Eur Child Adolesc Psychiatry. 1998;7(4):246–8.

    Article  CAS  PubMed  Google Scholar 

  3. Keo-Meier C, Ehrensaft D, editors. The gender affirmative model: supporting transgender and gender expansive children. Washington, DC: American Psychological Association; 2018.

    Google Scholar 

  4. Ehrensaft D. The gender creative child: pathways for nurturing and supporting children who live outside gender boxes. New York: The Experiment; 2016.

    Google Scholar 

  5. Kohlberg L. A cognitive-developmental analysis of children’s sex-role concepts and attitudes. In: Maccoby EE, editor. The development of sex differences. Stanford: Stanford University Press; 1966.

    Google Scholar 

  6. Stoller RJ. Presentations of gender. New Haven: Yale University Press; 1985.

    Google Scholar 

  7. Tyson P. Review of the book psychogenesis: the early development of gender identity, by E. R. Moberly. Psychoanal Q. 1986;55:691–3.

    Google Scholar 

  8. Fast I. Gender identity: a differentiation model. Hillsdale: Analytic Press; 1984.

    Google Scholar 

  9. Fast I. Aspects of core gender identity. Psychoanal Dialogues. 1999;9(5):633–61. https://doi.org/10.1080/10481889909539349.

    Article  Google Scholar 

  10. Ehrensaft D. Gender born, gender made: raising healthy gender-nonconforming children. New York: The Experiment; 2011.

    Google Scholar 

  11. Alegría CA. Gender nonconforming and transgender children/youth: family, community, and implications for practice. J Am Assoc Nurse Pract. 2016;28(10):521–7. https://doi.org/10.1002/2327-6924.12363.

    Article  PubMed  Google Scholar 

  12. McLemore A-M. When the moon was ours: a novel. New York: A Thomas Dunne Book for St. Martin’s Griffin; 2016.

    Google Scholar 

  13. Testa RJ, Habarth J, Peta J, Balsam K, Bockting W. Development of the gender minority stress and resilience measure. Psychol Sex Orientat Gend Divers. 2015;2(1):65–77. https://doi.org/10.1037/sgd0000081.

    Article  Google Scholar 

  14. World Professional Association for Transgender Health. (2011). Standards of care for the health of transsexual, transgender, and gender nonconforming people. World Professional Association for Transgender Health.

    Google Scholar 

  15. Deutsch MB, editor. Guidelines for the primary and gender-affirming care of transgender and gender nonbinary people. 2nd ed. San Francisco: Center of Excellence for Transgender Health; 2016. Retrieved from http://transhealth.ucsf.edu/trans?page=guidelines-home.

    Google Scholar 

  16. Olson-Kennedy J, Rosenthal SM, Hastings J, Wesp L. Health considerations for gender non-conforming children and transgender adolescents. In: Deutsch MB, editor. Guidelines for the primary and gender-affirming care of transgender and gender nonbinary people. 2nd ed. San Francisco: Center of Excellence for Transgender Health; 2016. Retrieved from http://transhealth.ucsf.edu/trans?page=guidelines-youth.

    Google Scholar 

  17. Rosenthal SM. Approach to the patient: transgender youth: endocrine considerations. J Clin Endocrinol Metab. 2014;99(12):4379–89.

    Article  CAS  PubMed  Google Scholar 

  18. Vance S, Ehrensaft D, Rosenthal SM. Psychological and medical care of gender nonconforming youth. Pediatrics. 2014;134(6):1184–92. https://doi.org/10.1542/peds.2014-0772.

    Article  PubMed  Google Scholar 

  19. Meier C, Fitzgerald K, Pardo S, Babcock J. The effects of hormonal gender affirmation treatment on mental health in female-to-male transsexuals. J Gay Lesbian Mental Health. 2011;15(3):281–99.

    Article  Google Scholar 

  20. Gómez-Gil E, Zubiaurre-Elorza L, Esteva I, Guillamon A, Godás T, Cruz Almaraz M, et al. Hormone-treated transsexuals report less social distress, anxiety and depression. Psychoneuroendocrinology. 2012;37(5):662–70.

    Article  PubMed  Google Scholar 

  21. Keo-Meier C, Herman L, Reisner SL, Pardo S, Sharp C, Babcock J. Testosterone treatment and MMPI–2 improvement in transgender men: a prospective controlled study. J Consult Clin Psychol. 2015;83:143–56.

    Article  PubMed  Google Scholar 

  22. James-Abra S, Tarasoff LA, Green D, Epstein R, Anderson S, Marvel S, Steele LS, Ross LE. Trans people’s experiences with assisted reproduction services: a qualitative study. Hum Reprod. 2015;30(6):1365–74. https://doi.org/10.1093/humrep/dev087ss.

    Article  CAS  PubMed  Google Scholar 

  23. Light AD, Obedin-Maliver J, Sevelius JM, Kerns JL. Transgender men who experience pregnancy after female-to-male gender transition. Obstet Gynecol. 2014;124(6):1120–7.

    Article  CAS  PubMed  Google Scholar 

  24. Brannstrom M, Johannesson L, et al. Live birth after uterine transplant. Lancet. 2015;385(9968):607–16. https://doi.org/10.1016/S0140-6736(14)61728-1.

    Article  PubMed  Google Scholar 

  25. Gamarel KE, Reisner SL, Laurenceau J-P, Tooru Nemoto T, Don Operario D. Gender minority stress, mental health, and relationship quality: a dyadic investigation of transgender women and their cisgender male partners. J Fam Psychol. 2014;28(4):437–47. https://doi.org/10.1037/a0037171.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Ryan C, Russell ST, Huebner D, Diaz R, Sanchez J. Family acceptance in adolescence and the health of LGBT young adults. J Child Adolesc Psychiatr Nurs. 2010;23(4):205–13. https://doi.org/10.1111/j.1744-6171.2010.00246.x.

    Article  PubMed  Google Scholar 

  27. Travers R, Bauer G, Pyne J. Impacts of strong parental support for trans youth: a report prepared for Children’s Aid Society of Toronto and Delisle Youth Services. Trans Pulse. 2012;1–5. Retrieved from http://transpulseproject.ca/wp-content/uploads/2012/10/Impacts-of-Strong-Parental-Support-for-Trans-Youth-vFINAL.pdf.

  28. Reisner SL, Vetters R, Leclerc M, Zaslow S, Wolfrum S, Shumer D, Mimiaga MJ. Mental health of transgender youth in care at an adolescent urban community health center: a matched retrospective cohort study. J Adolesc Health. 2015;56(3):274–9. https://doi.org/10.1016/j.jadohealth.2014.10.264.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Substance Abuse and Mental Health Services Administration. A practitioner’s resource guide: helping families to support their LGBT children. HHS Publication No. PEP14-LGBTKIDS. Rockville: Substance Abuse and Mental Health Services Administration; 2014.

    Google Scholar 

  30. Hidalgo MA, Ehrensaft D, Tishelman AC, Clark LF, Garofalo R, Rosenthal SM, Spack NP, Olson J. The gender affirmative model: what we know and what we aim to learn. Hum Dev. 2013;56:285–90. https://doi.org/10.1159/000355235.

    Article  Google Scholar 

  31. Sherer I, Baum J, Ehrensaft D, Rosenthal SM. Gender nonconforming/gender expansive and transgender children and teens. Contemp Pediatr. 2015. Retrieved from contemporarypediatrics.modernmedicine.com.

  32. Joiner TE, Van Orden KA, Witte TK, Rudd MD. The interpersonal theory of suicide: guidance for working with suicidal clients. Washington, DC: American Psychological Association; 2009.

    Book  Google Scholar 

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Ehrensaft, D., Keo-Meier, C.L., Yuen, J. (2019). Transition Considerations for Transgender Patients. In: Lyons, S., Hilliard, M. (eds) Transitioning from Pediatric to Adult Care in Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-030-05045-0_10

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  • DOI: https://doi.org/10.1007/978-3-030-05045-0_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-05044-3

  • Online ISBN: 978-3-030-05045-0

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