Clinical management of children and adolescents with gender dysphoria in Israel

To describe characteristics at presentation and treatment of children and adolescents with gender dysphoria in Israel. [ view full abstract ]

To describe characteristics at presentation and treatment of children and adolescents with gender dysphoria in Israel.

A retrospective chart review of 40 children and adolescents (< 18 years) with the diagnosis of gender dysphoria followed at a tertiary children hospital from February 2013 to September 2016. [ view full abstract ]

A retrospective chart review of 40 children and adolescents (< 18 years) with the diagnosis of gender dysphoria followed at a tertiary children hospital from February 2013 to September 2016.

The gender dysphoria referrals rate increased since the establishment of the clinic by 8 folds. No severe side effects were recorded in patients treated with Gonadotropin-releasing hormone analog and testosterone or estrogen. [ view full abstract ]

The gender dysphoria referrals rate increased since the establishment of the clinic by 8 folds. No severe side effects were recorded in patients treated with Gonadotropin-releasing hormone analog and testosterone or estrogen.

Of the 40 patients, 11 (28%) identified as female-to-male (FtM), 29 (72%) as male-to-female (MtF). The gender dysphoria population increased since the establishment of the clinic from 1-2 new referrals to 16 new referrals per... [ view full abstract ]

Of the 40 patients, 11 (28%) identified as female-to-male (FtM), 29 (72%) as male-to-female (MtF). The gender dysphoria population increased since the establishment of the clinic from 1-2 new referrals to 16 new referrals per 6 months. Median age at referral was 14.9±3.1 years (range 4.58-18.3 years). At time of referral, 78% have completed their sexual maturation in their biological gender. Gonadotropin-releasing hormone analog treatment was initiated in 29 (73%) patients at a mean age of 16.1±1.5 years. Cross-sex hormones were initiated in 19 (48%) patients at a mean age of 16.8±1.1 years. No severe side effects were recorded in patients treated with Gonadotropin-releasing hormone analog and testosterone or estrogen. One MtF patient underwent genital sex reassignment surgery at age 18.16 years. One FtM patient underwent mastectomy at age 18.25 years.

After establishment of a multidisciplinary childhood and adolescent gender dysphoria clinic, referral rate to the clinic increased fivefold. Treatment with gonadotropin-releasing hormone analog and/or cross-sex hormones, in... [ view full abstract ]

After establishment of a multidisciplinary childhood and adolescent gender dysphoria clinic, referral rate to the clinic increased fivefold. Treatment with gonadotropin-releasing hormone analog and/or cross-sex hormones, in collaboration with transgender-competent mental health professionals, is an intervention that appears to be appropriate in carefully selected youth with gender dysphoria. Long-term follow-up studies are needed to determine the safety and efficiency of these treatments in this age group.