Abstract
For adolescents with gender dysphoria, puberty is an especially complicated time that may cause anxiety and distress, more so than what is typically experienced by cisgender adolescents. These physical and physiological changes can be addressed through medical interventions that are recognized by the World Professional Association of Transgender Health Standards of Care. Multidisciplinary teams that consist of psychologists, psychiatrists, pediatricians, social workers, advanced nurse specialists, and pediatric endocrinologists can guide families in the decision-making process around gender-affirming medical care. These exogenous interventions progress from most reversible to irreversible as an adolescent matures. This chapter aims to review pubertal stages for youth, to present the medical interventions recommended for adolescents who are experiencing gender dysphoria, and to comprehensively review the guidelines provided by the Endocrine Society and the World Professional Association for Transgender Health.
Keywords
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44(235):291.
Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child. 1970;45(239):13–23.
Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgenderism. 2012;13(4):165–232.
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(11):3869–903. https://doi.org/10.1210/jc.2017-01658.
Delemarre-van de Waal HA, Cohen-Kettenis PT. Clinical management of gender identity disorder in adolescents: a protocol on psychological and paediatric endocrinology aspects. Eur J Endocrinol. 2006;155(Suppl 1):S131–7.
Steensma TD, Kreukels BP, de Vries AL, Cohen-Kettenis PT. Gender identity development in adolescence. Horm Behav. 2013;64:288–97.
Cohen-Kettenis PT, Delemarre-van de Waal HA, Gooren LJ. The treatment of adolescent transsexuals: changing insights. J Sex Med. 2008;5(8):1892–7.
Wren B. Early physical intervention for young people with atypical gender identity development. Clin Child Psychol Psychiatry. 2000;5(2):220–31.
de Vries AL, McGuire JK, Steensma TD, Wagenaar EC, Doreleijers TA, Cohen-Kettenis PT. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. 2014;134(4):696–704. https://doi.org/10.1542/peds.2013-2958.
Lawrence AA. Factors associated with satisfaction or regret following male-to-female sex reassignment surgery. Arch Sex Behav. 2003;32(4):299–315.
Cohen-Kettenis PT, Schagen SEE, Steensma TD, de Vries AL, Delemarre-van de Waal HA. Puberty suppression in a gender-dysphoric adolescent: a 22-year follow-up. Arch Sex Behav. 2011;40:843–7. https://doi.org/10.1007/s10508-011-9758-9.
de Vries AL, Steensma TD, Doreleijers TA, Cohen-Kettenis PT. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J Sex Med. 2011;8(8):2276–83.
Leibowitz S, de Vries AL. Gender dysphoria in adolescence. Int Rev Psychiatry. 2016;28(1):21–35.
Staphorsius AS, Kreukels BP, Cohen-Kettenis PT, Veltman DJ, Burke SM, Schagen SE, et al. Puberty suppression and executive functioning: an fMRI-study in adolescents with gender dysphoria. Psychoneuroendocrinology. 2015;56:190–9.
Klink D, Caris M, Heijboer A, van Trotsenburg M, Rotteveel J. Bone mass in young adulthood following gonadotropin-releasing hormone analog treatment and cross-sex hormone treatment in adolescents with gender dysphoria. J Clin Endocrinol Metab. 2015;100:E270–5.
Nahata L, Chelvakumar G, Leibowitz S. Gender-affirming pharmacological interventions for youth with gender dysphoria: when treatment guidelines are not enough. Ann Pharmacotherapy. 2017;51(11):1023–32.
Altshuler AL, Hillard PJ. Menstrual suppression for adolescents. Curr Opin Obstet Gynecol. 2014;26:323–31.
Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA, Gooren LJ, Meyer WJIII, Spack NP, et al. Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2009;94(9):3132–54.
Steever J. Cross-gender hormone therapy in adolescents. Pediatr Ann. 2004;43(6):e138–44.
Klein C, Gorzalka BB. Continuing medical education: sexual functioning in transsexuals following hormone therapy and genital surgery: a review (CME). J Sex Med. 2009;6(11):2922–39.
Gijs L, van der Putten-Bierman E, De Cuypere G. Psychiatric comorbidity in adults with gender identity problems. In: Kreukels BPC, Steensma TD, de Vries AL, editors. Gender dysphoria and disorders of sex development: progress in care and knowledge. New York: Springer; 2014. p. 255–76.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Busa, S.M., Leibowitz, S., Janssen, A. (2018). Transgender Adolescents and the Gender-Affirming Interventions: Pubertal Suppression, Hormones, Surgery, and Other Pharmacological Interventions. In: Janssen, A., Leibowitz, S. (eds) Affirmative Mental Health Care for Transgender and Gender Diverse Youth. Springer, Cham. https://doi.org/10.1007/978-3-319-78307-9_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-78307-9_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-78306-2
Online ISBN: 978-3-319-78307-9
eBook Packages: MedicineMedicine (R0)