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Pediatric transgender

Nancy A Dodson, Miriam Langer
Primary care providers should have a general understanding of the medical care available to transgender youth throughout childhood and adolescence. Providers and parents should create an affirming environment for young people at every developmental stage, while ensuring thorough and thoughtful evaluations prior to any medical intervention. Transgender teens have unique reproductive health care needs. Transgender boys may seek suppression of menses, and they will need to pay particular attention to pregnancy prevention if they decide to undergo masculinizing hormonal treatment...
February 1, 2019: Pediatric Annals
Diane Chen, Victoria D Kolbuck, Megan E Sutter, Amy C Tishelman, Gwendolyn P Quinn, Leena Nahata
PURPOSE: Transgender individuals may experience impaired fertility due to gender-affirming hormonal interventions (e.g., pubertal suppression treatment and/or exogenous hormones). Clinical practice guidelines recommend providers discuss fertility implications and options for fertility preservation. The goal of this study was to examine fertility knowledge, practice behaviors, and perceived barriers to fertility care among multidisciplinary providers who care for transgender pediatric and/or adult patients...
February 2019: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Anna Neyman, John S Fuqua, Erica A Eugster
PURPOSE: The purpose of the study was to describe the novel use of bicalutamide in transgender youth. METHODS: This is a retrospective review of patients with gender dysphoria followed in the pediatric endocrine clinic at Riley Hospital for Children. RESULTS: Of 104 patients with gender dysphoria, 23 male-to-female adolescents received bicalutamide 50 mg daily as a second-line puberty blocker after insurance company denial of a gonadotropin-releasing hormone analog...
January 3, 2019: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Jane O'Bryan, Kimberly Leon, Carolyn Wolf-Gould, Melissa Scribani, Nancy Tallman, Anne Gadomski
Purpose: Significant knowledge gaps regarding outcomes of gender-affirming therapy in transgender (TG) and gender expansive (GE) youth impede an evidence-based approach to these patients. The Gender Wellness Center (GWC) Pediatric Patient Registry was established in 2017 to enable systematic, longitudinal research to describe the physical, mental, and quality-of-life outcomes of these youth. Methods: All TG/GE youth, ages 8-21 years, presenting to the GWC were recruited on site. Ten research questions guided the creation of data fields...
2018: Transgender Health
Heather L Flores, Azita Amiri
: Food insecurity affects people of all ages, in every area in which nurses work or volunteer. The U.S. Department of Agriculture describes food insecurity as the lack of "consistent, dependable access to adequate food for active, healthy living." The health effects of food insecurity include, but are not limited to, obesity, diabetes, hypertension, low birth weight, depression, and anxiety. Food insecurity is associated with single parenthood, low socioeconomic status, having three or more children, having low educational attainment, being a member of a racial or ethnic minority, renting a home, living in a city, and having a disabled household member...
January 2019: American Journal of Nursing
Danielle N Moyer, Kara J Connelly, Amy L Holley
Background Transgender and gender nonconforming (TGNC) youth are at higher risk for anxiety and depression than their peers. The referral rate for those seeking specialty medical care has rapidly increased in recent years. This paper examines the use of brief screening tools with clear cutoffs to assist physicians in rapidly identifying TGNC youth in acute distress. Methods A retrospective chart review was conducted for patients aged 11-18 years being treated in a pediatric endocrinology clinic for gender dysphoria...
December 11, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
Laura L Kimberly, Kelly McBride Folkers, Phoebe Friesen, Darren Sultan, Gwendolyn P Quinn, Alison Bateman-House, Brendan Parent, Craig Konnoth, Aron Janssen, Lesha D Shah, Rachel Bluebond-Langner, Caroline Salas-Humara
Transgender and gender-nonconforming (TGNC) youth who suffer from gender dysphoria are at a substantially elevated risk of numerous adverse physical and psychosocial outcomes compared with their cisgender peers. Innovative treatment options used to support and affirm an individual's preferred gender identity can help resolve gender dysphoria and avoid many negative sequelae of nontreatment. Yet, despite advances in these relatively novel treatment options, which appear to be highly effective in addressing gender dysphoria and mitigating associated adverse outcomes, ethical challenges abound in ensuring that young patients receive appropriate, safe, affordable treatment and that access to this treatment is fair and equitable...
December 2018: Pediatrics
Marie Reilly, Vanessa Desousa, Alexandra Garza-Flores, Ellen C Perrin
BACKGROUND: There is growing awareness and exposure in both the medical community and the lay media about the characteristics and complex needs of individuals who believe that their gender identity does not match their birth sex. Despite research and lay publications about teens with gender dysphoria and those who identify as transgender, little guidance is available regarding young (prepubertal) children with questions about their gender identity. Although many terms are used to describe these children, we have chosen to describe them as "gender nonconforming" (GNC)...
September 21, 2018: Journal of Developmental and Behavioral Pediatrics: JDBP
Gia Chodzen, Marco A Hidalgo, Diane Chen, Robert Garofalo
PURPOSE: Transgender and gender-nonconforming (TGNC) adolescents and young adults experience mental health problems, including anxiety and depression, at an elevated rate as compared to their cisgender counterparts. A growing literature suggests that vulnerability to psychiatric problems in TGNC individuals results from social discrimination and minority stress. METHODS: The sample consisted of adolescent TGNC patients (N = 109) who completed behavior health screening questionnaires as standard of care at their first clinical visit to an interdisciplinary gender program within a pediatric academic medical center in a metropolitan Midwestern city...
September 18, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Jason Rafferty
As a traditionally underserved population that faces numerous health disparities, youth who identify as transgender and gender diverse (TGD) and their families are increasingly presenting to pediatric providers for education, care, and referrals. The need for more formal training, standardized treatment, and research on safety and medical outcomes often leaves providers feeling ill equipped to support and care for patients that identify as TGD and families. In this policy statement, we review relevant concepts and challenges and provide suggestions for pediatric providers that are focused on promoting the health and positive development of youth that identify as TGD while eliminating discrimination and stigma...
October 2018: Pediatrics
Jessica Abramowitz
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...
September 2018: Reviews in Endocrine & Metabolic Disorders
Brayden N Kameg, Donna G Nativio
BACKGROUND AND PURPOSE: Primary care providers who encounter children are often the first line of contact for individuals with gender dysphoria, which occurs when sex assigned at birth is incongruent with one's true, expressed sexual identity. Because those with untreated gender dysphoria are at risk of a variety of negative outcomes, including mood symptomatology, suicidality, substance use disorders, and other psychosocial risk factors, it is critical that health care providers are adept in the provision of holistic, patient-centered care...
September 2018: Journal of the American Association of Nurse Practitioners
Leena Nahata, Lisa T Campo-Engelstein, Amy Tishelman, Gwendolyn P Quinn, John D Lantos
In this article, we discuss a case in which a 16-year-old birth-assigned male came out to her parents as transgender. She is referred to the gender management program at a large pediatric academic center to discuss hormone therapy. She was initially evaluated by a psychiatrist, diagnosed with gender dysphoria and anxiety, and treated with medication and psychotherapy. When her anxiety was well controlled and she met eligibility and readiness criteria, she was referred to 1 of 2 pediatric endocrinologists in the gender management program to discuss hormone therapy...
September 2018: Pediatrics
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No abstract text is available yet for this article.
August 2018: Pediatrics
Diane Chen, Laura Edwards-Leeper, Terry Stancin, Amy Tishelman
Growing numbers of transgender and gender-nonconforming (TGNC) youth are presenting for medical and mental health care, and increasingly, pediatric psychologists are being called upon to serve as critical members of interdisciplinary care teams. In this commentary, we present information on TGNC youth in three distinct developmental cohorts: prepubescent TGNC children, peripubertal TGNC youth, and pubertal TGNC adolescents. First, we describe the social, medical, and/or surgical treatments available to each cohort of youth...
March 2018: Clinical Practice in Pediatric Psychology
Parisa Salehi, Sara A Divall, Julia M Crouch, Rebecca A Hopkinson, Leah Kroon, Jennifer Lawrence, Benjamin S Wilfond, David J Inwards-Breland
Care of transgender and gender diverse youth is complex and requires a multidisciplinary approach. Many transgender patients and providers feel the limited availability of affirming, knowledgeable professionals is a barrier to obtaining care. Such care can be provided through a clinic with providers from different disciplines who are trained in the unique care of transgender youth. In this paper, we discuss the care guidelines for transgender youth and the unresolved challenges that need to be addressed during the development of a transgender clinic...
April 2018: Pediatric Endocrinology Reviews: PER
Carla Marisa Lopez, Daniel Solomon, Susan D Boulware, Emily R Christison-Lagay
BACKGROUND: The objective of the study was to identify national trends in the utilization of histrelin acetate implants among transgender children in the United States. METHODS: We analyzed demographic, diagnostic and treatment data from 2004 to 2016 on the use of histrelin acetate reported to the Pediatric Health Information System (PHIS) to determine the temporal trends in its use for transgender-related billing diagnoses, e.g. "gender identity disorder"...
June 27, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
María Fernanda Castilla-Peón
Transgender or gender nonconforming (GN) persons identify themselves with a gender which 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 GN 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 injury. 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...
2018: Boletín Médico del Hospital Infantil de México
Yuanshu Zou, Rhonda Szczesniak, Alexis Teeters, Lee Ann E Conard, Daniel H Grossoehme
PURPOSE: To quantify HRQOL of TGN patients using the PedsQL 4.0 generic core scales, and to compare reported HRQOL of TGN adolescents with published data from comparison populations. METHODS: Transgender children and adolescents (N = 142; 68% natal females) ages 6-23 years (M = 15.9, SD = 3.7) attending an outpatient clinic for TGN care at an academic pediatric hospital and caregivers of children and adolescents (N = 95) completed the PedsQL 4.0 generic core scales...
August 2018: Quality of Life Research
Deirdre A Shires, Ashley Schnaar, Maureen D Connolly, Daphna Stroumsa
Little is known about general pediatricians' experience and knowledge regarding the care of transgender youth. We surveyed N =50 general pediatricians practicing in an integrated Midwest health system. Few respondents had participated in medical management care for transgender patients, but one-third were willing to do so if training opportunities were made available. Notably, <60% of respondents were comfortable providing routine care for transgender youth. At a minimum, pediatricians need the training to feel capable of providing routine care for transgender pediatric patients...
2017: Transgender Health
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