Second year follow up: Gender variant young adolescents accessing physical interventions

Puberty suppression treatment may be conceptualised as a first step in a staged approach in the process towards gender affirmation (Coleman et. al., 2012). Its function is to relieve the distress caused by the development of... [ view full abstract ]

Puberty suppression treatment may be conceptualised as a first step in a staged approach in the process towards gender affirmation (Coleman et. al., 2012). Its function is to relieve the distress caused by the development of secondary sex characteristics, and to provide young people a space to consider their wishes regarding further transitioning. Published evidence shows the efficacy of this approach (Delemarre-van de Waal & Cohen-Kettenis, 2006; de Vries et. al., 2010 ;2014, Kreukels et. al., 2011). Dutch adolescents (age range 12-18y) who started on puberty suppression treatment were assessed pre-treatment (T0) and were followed up after an average of nearly 2 years (1.88 years), shortly before starting CSH treatment (T1) (De Vries et. al., 2010).
Research regarding puberty suppression treatment has not been repeated with any other cohort of GD adolescents. GIDS & UCLH are conducting a longitudinal study of young people who have started puberty suppression treatment under the age of 15, following them up yearly. Although we have used the same baseline measure (T0), the T1 measure in this research project was timed after 1 year on puberty suppression treatment, and our T2 after 2 years on puberty suppression.

Our aim is to review the second year follow-up data from the longitudinal research study for young people who commenced puberty suppression treatment under the age of 15. Firstly, we will report at what stage of physical... [ view full abstract ]

Our aim is to review the second year follow-up data from the longitudinal research study for young people who commenced puberty suppression treatment under the age of 15. Firstly, we will report at what stage of physical intervention all 44 participants are at; some may have been on puberty suppression treatment alone for 2 years, whereas others may have started on gender affirmative hormone therapy when over the age of 16. Secondly, we will review how this cohort of young people is functioning after accessing physical interventions for 2 years.

Stage of treatment at T2 will be retrieved from the research database, which is being kept to track the participant’s pathways. To evaluate young people’s functioning, we will be analysing their questionnaire data which... [ view full abstract ]

Stage of treatment at T2 will be retrieved from the research database, which is being kept to track the participant’s pathways. To evaluate young people’s functioning, we will be analysing their questionnaire data which assesses psychological functioning, body image, feelings of gender dysphoria and quality of life. All data will be analysed in SPSS. By using Repeated Measures we will also assess if there were any changes found over time (compared to data collected at T0 and T1). In addition, we will investigate if any differences emerge associated with assigned gender at birth or stage of physical treatment.

Psychological functioning is assessed with the Youth Self Report (completed by the young person) and the Child Behavioural Checklist (parent report). Body image and satisfaction about specific body parts is measured with the... [ view full abstract ]

Psychological functioning is assessed with the Youth Self Report (completed by the young person) and the Child Behavioural Checklist (parent report). Body image and satisfaction about specific body parts is measured with the Body Image Scale. Feelings of gender dysphoria are assessed with the Utrecht Gender Dysphoria Scale, The Recalled Childhood Gender Identity and the Gender Identity Interview. Quality of life is assessed with the Kidscreen 52.

44 young people, 24 assigned boys and 20 assigned girls, participated in this research study and have been assessed yearly since they have started receiving physical interventions. T0 is our baseline measurement; before start... [ view full abstract ]

44 young people, 24 assigned boys and 20 assigned girls, participated in this research study and have been assessed yearly since they have started receiving physical interventions. T0 is our baseline measurement; before start of treatment (Mean age = 12.99); at T1 all 44 young people have been on puberty suppression treatment for 1 year (Mean age = 13.70); at T2, all young people have been accessing physical interventions for 2 years. At this time point, we see that N=30 young people have been receiving puberty suppression treatment alone for 2 years, whereas N=14 sixteen plus year-olds have started CSH treatment. We will report if any changes were found over time in psychological functioning, body image and feelings of GD, compared to their data at T0 and T1. In addition, we will investigate if any differences were found between assigned gender at birth or if any differences were found between the young people who have accessed either puberty suppression for 2 years or the ones who have started on CSH at time 2.

Research evidence reporting on the effects of physical interventions in young people is limited and annual reports on the effects of physical interventions have not been undertaken. In particular there is no evidence base for... [ view full abstract ]

Research evidence reporting on the effects of physical interventions in young people is limited and annual reports on the effects of physical interventions have not been undertaken. In particular there is no evidence base for a cohort of young people who started accessing puberty suppression under the age of 15. In view of the fact that this is a widely used treatment an annual review of the effect that physical interventions has on young people with GD provides an important addition to the evidence base. This data will add to our understanding of the respective impact on psychological functioning and gender dysphoria of puberty suppression alone and puberty suppression and gender affirming hormones.
Possible differences between accessing puberty suppression treatment for 2 years and start accessing CSH treatment and which effect this has had on young people’s psychological functioning, body image and feelings of GD. It is important to keep in mind the differences in participants’ ages and the differences in assigned gender at birth when interpreting this data.