Medical management of transgender children and adolescents

Abstract

Transgender or gender incongruence (GI) persons identify themselves with a gender that is different from that correspondent to their birth sex. The demand for health services by families with transgender children or adolescents tends to increase. The prevalence of GI in children is unknown; however, it has been estimated to be > 1% in adolescents. Transgender persons are at increased risk of depression, suicide, illicit drug abuse, human immunodeficiency virus infection, and non-accidental injuries. The most accepted model for the care of transgender persons assumes that these adverse outcomes are the consequence of social margination rather than the GI condition itself. Social and physical gender transition seems to be effective in increasing the well-being of people with GI and reducing associated health risks. Mental health professionals can support the child in the process of social transition. The pediatric endocrinologist may offer puberty blockade and cross-sex induction of puberty. Surgical sex reassignment interventions are reserved for adults. Gender identity, gender expression, and sexual orientation are three relatively independent categories that can take any value, which is not necessarily binary (male/female) or fixed. Health professionals should be familiar with these concepts to offer the best resources available to optimize the well-being of each transgender child or adolescent with an individualized approach.

Adolescent Development of Biological Rhythms in Female Rats: Estradiol Dependence and Effects of Combined Contraceptives

“…The signal characteristics of rat CBT exhibit remarkable similarities to human peripheral temperature (See: Sanchez-Alavez et al, 2011 ; Shechter et al, 2011 ; Grant et al, 2020b ). Monitoring human peripheral temperature during adolescence could serve broad purposes – from personalizing health education based on self-collected data ( Eschler et al, 2019 ; Fowler et al, 2020 ), to adapting teaching style to an individual’s developmental phase ( Davidow et al, 2016 ; DePasque and Galván, 2017 ; Piekarski et al, 2017 ; Master et al, 2020 ), to enabling research into the impact of teen contraceptive use ( Martinez, 2015 ; Patseadou and Michala, 2017 ) or the process of gender transition ( Castilla-Peón, 2018 ; Strittmatter and Holtmann, 2020 ). Together, pubertal monitoring via continuous body temperature is worthy of further investigation in both animal models and human subject populations for its potential utility to individuals, researchers, families, and clinicians.…”

Adolescent Development of Biological Rhythms: Estradiol Dependence and Effects of Combined Contraceptives

“…The signal characteristics of rat CBT exhibit remarkable similarities to human peripheral temperature (See:(61,148,187)). Monitoring human peripheral temperature during adolescence could serve broad purposes – from personalizing health education based on self-collected data(188, 189), to adapting teaching style to an individual’s developmental phase(190–193), to enabling research into the impact of teen contraceptive use(194, 195) or the process of gender transition(196, 197). Together, pubertal monitoring via continuous body temperature is worthy of further investigation in both animal models and human subject populations for its potential utility to individuals, researchers, families, and clinicians.…”

Mental health of transgender children and adolescents: a systematic review

“…(3,63) These individuals maybe two times more likely to use cocaine, inhalants, or amphetamines, three times more likely to use tobacco at school, and two times more likely to abuse pain medications. (42) It is also noted that these adolescents are at risk for early alcohol consumption and early initiation of sexual intercourse from two to three times greater than cisgender adolescents (44,63), and also have a greater risk of developing overweight and obesity. (27,63) It was observed that transgenders aged between 6 and 23 years had a psychosocial health level significantly lower than cisgenders, and similar to that of (remove) young people with cerebral palsy.…”

“…The gender transition process associated with hormonal therapy with or without surgical intervention has been effective in decreasing suicide attempts, improving gender dysphoria and the quality of life of these individuals. (44) The study by Edwards-Leeper and Spack, demonstrates that biological boys seek medical intervention earlier than biological girls. Pubertal suppression can prevent emotional and psychological distress, in addition to allowing the clinician to assess how the teenager works when unwanted secondary sexual characteristics are suppressed.…”