Puberty suppression in transgender children and adolescents

Simone Mahfouda; Julia K Moore; Aris Siafarikas; Florian D Zepf; Ashleigh Lin

doi:10.1016/S2213-8587(17)30099-2

Puberty suppression in transgender children and adolescents

Lancet Diabetes Endocrinol. 2017 Oct;5(10):816-826. doi: 10.1016/S2213-8587(17)30099-2. Epub 2017 May 22.

Authors

Simone Mahfouda¹, Julia K Moore², Aris Siafarikas³, Florian D Zepf⁴, Ashleigh Lin⁵

Affiliations

¹ Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia; Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
² Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia; Gender Diversity Service, Acute Child and Adolescent Mental Health Service, Child and Adolescent Health Service, Perth, WA, Australia.
³ Telethon Kids Institute, University of Western Australia, Perth, WA, Australia; Department of Endocrinology and Diabetes, Princess Margaret Hospital, Perth, WA, Australia; Division of Paediatrics and Child Health, School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia; Institute for Health Research, University of Notre Dame, Fremantle, WA, Australia.
⁴ Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia; Telethon Kids Institute, University of Western Australia, Perth, WA, Australia; Specialised Child and Adolescent Mental Health Services, Department of Health in Western Australia, Perth, WA, Australia. Electronic address: florian.zepf@uwa.edu.au.
⁵ Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.

PMID: 28546095
DOI: 10.1016/S2213-8587(17)30099-2

Abstract

The World Professional Association for Transgender Health's standards of care recommend suspending puberty, preferably with the use of gonadotropin-releasing hormone agonists, in certain gender non-conforming minors (aged under 18 years) who have undergone a psychiatric assessment and have reached at least Tanner stage II of puberty. This approach seeks to lessen the discordance between assigned natal sex and gender identity by temporarily halting the development of secondary sexual characteristics, essentially widening the temporal window for gender clarification. Despite promising preliminary evidence on the clinical utility of this approach, there is a dearth of research to inform evidence-based practice. In view of these challenges, we review the available empirical evidence on the cognitive, physical, and surgical implications of puberty suppression in gender-incongruent children and adolescents. We also explore the historical underpinnings and clinical impetus for suspending puberty in this population, and propose key research priorities.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Female
Gonadotropin-Releasing Hormone / agonists*
Humans
Male
Puberty / drug effects*
Transgender Persons / psychology*
Transsexualism / physiopathology
Transsexualism / psychology*
Transsexualism / therapy*
Treatment Outcome

Substances

Gonadotropin-Releasing Hormone