Psychosocial health in adolescents and young adults with gender dysphoria before and after gender-affirming medical interventions: a descriptive study from the Hamburg Gender Identity Service

Becker-Hébly, Inga; Fahrenkrug, Saskia; Campion, Florentien; Richter‐Appelt, Hertha; Schulte‐Markwort, Michael; Barkmann, Claus

doi:10.1007/s00787-020-01640-2

Cited by 32 publications

(39 citation statements)

References 53 publications

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“…Improved psychological functioning, with follow-up outcomes comparable to the general population, has also been reported following use of PS ( 53 ) and GAH and/or gender-affirming surgery ( 47 , 49 ).…”

Section: Therapeutic Effects Of Hormonal Interventionmentioning

confidence: 82%

“…General psychological wellbeing, assessed using Youth Self Report ( 23 , 47 , 49-51 ), the Child behavior checklist ( 23 , 47 , 49 , 50 ), or the Children’s Global Assessment scale ( 47 , 50 , 53 ), significantly improved from baseline following PS alone in 3 studies ( 50 , 51 , 53 ) but was unchanged in another cohort, where notably, 57% were Tanner 4+ before PS ( 23 ).…”

Section: Therapeutic Effects Of Hormonal Interventionmentioning

confidence: 99%

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Approach to the Patient: Pharmacological Management of Trans and Gender-Diverse Adolescents

O’Connell

Nguyen

Ahler

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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Internationally, increasing numbers of children and adolescents with gender dysphoria are presenting for care. In response, gender affirming therapeutic interventions that seek to align bodily characteristics with an individual’s gender identity are more commonly being employed. Depending on a young person’s circumstances and goals, hormonal interventions may aim to achieve full pubertal suppression, modulation of endogenous pubertal sex hormone effects and/or development of secondary sex characteristics congruent with their affirmed gender. This is a relatively novel therapeutic area and, while short-term outcomes are encouraging, longer-term data from prospective longitudinal adolescent cohorts are still lacking, which may create clinical and ethical decision-making challenges. Here we review current treatment options, reported outcomes, and clinical challenges in the pharmacological management of trans and gender diverse adolescents.

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Section: Therapeutic Effects Of Hormonal Interventionmentioning

confidence: 82%

Section: Therapeutic Effects Of Hormonal Interventionmentioning

confidence: 99%

Approach to the Patient: Pharmacological Management of Trans and Gender-Diverse Adolescents

O’Connell

Nguyen

Ahler

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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Section: Körpermedizinische Behandlungen Im Jugendalterunclassified

“…Psychosoziale Unterstützung oder eine Unterdrückung der Pubertät durch GnRHa allein hatten in den bisher bestehenden Studien aus Amsterdam oder London jedoch einen geringeren Effekt 17 , 18 . Ähnlich war es auch in der bisher größten im Längsschnitt angelegten deutschen Studie aus Hamburg 18 . Jugendliche, die medizinisch-geschlechtsangleichende Interventionen erhielten (Hormone), aber vor allem jene, die eine vollständige soziale und medizinische Transition (inkl.…”

Section: Körpermedizinische Behandlungen Im Jugendalterunclassified

“…Gleichzeitig schienen nicht alle psychosozialen Probleme nach der Intervention gelöst zu sein: In der Gruppe jener Jugendlichen, die eine Hormonbehandlung erhalten hatten, unterschieden sich die Werte psychischer Auffälligkeiten zum Zeitpunkt der Nachuntersuchung nach durchschnittlich 2 Jahren immer noch signifikant von den Mittelwerten der deutschen/europäischen Norm. Somit unterstreicht diese Studie den dringenden Bedarf an weiterer Längsschnittforschung 18 .…”

Section: Körpermedizinische Behandlungen Im Jugendalterunclassified

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Transgender, Geschlechtsinkongruenz und Geschlechtsdysphorie bei Kindern und Jugendlichen

Richter‐Appelt¹,

Herrmann²,

Becker-Hébly³

2021

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Die öffentliche und mediale Präsenz des Themas „Transgender“ hat in den letzten Jahren deutlich zugenommen. Damit einhergehend nimmt die Anzahl der Kinder und Jugendlichen zu, die sich nicht ihrem körperlichen Geburtsgeschlecht entsprechend geschlechtstypisch verhalten bzw. erleben. Diese Tatsache wirft Fragen auf, denen auch Kinderärztinnen und -ärzte begegnen. In den letzten Jahren fand dabei ein Paradigmenwechsel rund um die Themen Transgender, Geschlechtsinkongruenz und Geschlechtsdysphorie statt.

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Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide

et al. 2023

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ImportanceGender-affirming care is a key clinical area that can benefit from implementation of patient-reported outcome measures (PROMs). Identifying barriers to and enablers of PROM implementation is needed to develop an evidence-based implementation strategy.ObjectiveTo identify (1) PROMs previously implemented for gender-affirming care and constructs measured, (2) how patients completed PROMs and how results were reported and used, and (3) barriers to and enablers of PROM implementation.Evidence ReviewIn this systematic review, PubMed, Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science were searched from inception to October 25, 2021, and updated on December 16, 2022. Gray literature was searched through gray literature database, online search engine, and targeted website searching. Inclusion criteria were (1) original articles of (2) a formally developed PROM or ad hoc instrument administered for gender-affirming care to (3) patients accessing gender-affirming care. The Critical Appraisal Skills Programme tool was used to evaluate quality of included studies. This review was registered on PROSPERO (CRD42021233080).FindingsIn total, 286 studies were included, representing 85 395 transgender and nonbinary patients from more than 30 countries. A total of 205 different PROMs were used in gender-affirming care. No studies described using an implementation science theory, model, or framework to support PROM deployment. Key barriers to PROM implementation included issues with evidence strength and quality of the PROM, engaging participants, and PROM complexity. Key enablers of PROM implementation included using PROMs validated for gender-affirming care, implementing PROMs able to be deployed online or in person, implementing PROMs that are shorter and reduce patient burden, engaging key stakeholders and participants as part of developing an implementation plan, and organizational climate.Conclusions and RelevanceIn this systematic review of barriers to and enablers of PROM implementation in gender-affirming care, PROM implementation was inconsistent and did not follow evidence-based approaches in implementation science. There was also a lack of patient input in creating implementation strategies, suggesting a need for patient-centered approaches to PROM implementation. Frameworks created from these results can be used to develop evidence-based PROM implementation initiatives for gender-affirming care and have potential generalizability for other clinical areas interested in implementing PROMs.

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Psychosocial health in adolescents and young adults with gender dysphoria before and after gender-affirming medical interventions: a descriptive study from the Hamburg Gender Identity Service

Cited by 32 publications

References 53 publications

Approach to the Patient: Pharmacological Management of Trans and Gender-Diverse Adolescents

Approach to the Patient: Pharmacological Management of Trans and Gender-Diverse Adolescents

Transgender, Geschlechtsinkongruenz und Geschlechtsdysphorie bei Kindern und Jugendlichen

Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide

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