Skip to main content

Advertisement

SpringerLink
Log in

Care of the Transgender Child and Adolescent

  • Care for the Transgender Patient (C Unger, Section Editor)
  • Published:
Current Obstetrics and Gynecology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Transgender and gender non-conforming individuals are becoming increasingly visible in our society. Because they turn to physicians for assistance in transitioning as well as for their routine health care, it is important that gynecologists be knowledgeable resources and advocates.

Recent Findings

Updates on emerging long-term outcomes following early treatment of transgender adolescents are reviewed. Current guidelines for puberty suppression and gender-affirming hormone therapy are outlined. We emphasize providing a welcoming clinical environment and continued awareness of the mental healthcare challenges of transgender youth.

Summary

Care of the transgender child and adolescent is a growing and changing field. This paper offers a basic resource for current guidelines and recent evidence. Long-term data is minimal and we expect this literature to continue to expand.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. Conron KJ, Scott G, Stowell GS, et al. Transgender health in Massachusetts: results from a household probability sample of adults. Am J Public Health. 2012;102(1):118–22.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Clark TC, Lucassen MFG, Bullen P, et al. The health and well-being of transgender high school students: results from the New Zealand Adolescent Health Survery (Youth ’12). J Adolesc Health. 2014;55:93–9.

    Article  PubMed  Google Scholar 

  3. Harrison J, Grant J, Herman JL. A gender not listed here: genderqueers, gender rebels, and otherwise in the National Transgender Discrimination Survey. LGBTQ Policy Journal at the Harvard Kennedy School. 2011–2012: (2):13–24

  4. •• Olsen-Kennedy J, Rosenthal SM, Hastings J, et al. Health considerations for gender non-conforming children and transgender adolescents. In: Duetsch MB, editor. Guidelines for the primary and gender-affirming care of transgender and gender nonbinary people 2nd Edition 2016. Center of Excellence for Transgender Health, Department of Family and Community Medicine, University of California, San Francisco. Available at: www.transhealth.ucsf.edu/guidelines. Accessed 1 Feb 2017. Comprehensive and up to date resource for all aspects of healthcare for transgender patients.

  5. Affirmative Care for Transgender and Gender Non-Conforming People: Best Practices for Front-Line Health Care Staff. Updated Fall 2016. Available at: http://www.lgbthealtheducation.org/wp-content/uploads/2016/12/Affirmative-Care-for-Transgender-and-Gender-Non-conforming-People-Best-Practices-for-Front-line-Health-Care-Staff.pdf. Accessed 28 Jan 2017.

  6. •• Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA. Endocrine treatment of transsexual persons: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2009;94(9):3132–54. Current complete guidelines for the care of transgender patients. Updated guidelines anticipated in 2018.

    Article  CAS  PubMed  Google Scholar 

  7. De vries ALC, Noens ILJ, Cohen-Kettenis PT, et al. Autism spectrum disorders in gender dysphoric children and adolescents. J Autism Dev Discord. 2010;40(8):930–6.

    Article  Google Scholar 

  8. Steensma TD, McGuire JK, Kreukels BPC. Factors associated with desistance and persistence of childhood gender dysphoria: a quantitative follow up study. J Am Acad Child Adolesc Psychiatry. 2013;52:582–90.

    Article  PubMed  Google Scholar 

  9. Conant E. I am nine years old. National Geographic Special Issue: Gender Revolution. 2017;231(1):30–47.

  10. Olson KR, Durwood L, DeMeules M, et al. Mental health of transgender children who are supported in their identities. Pediatrics. 2015;137(3):1–9.

  11. Taylor JE, Miller BT, and Gray KD. The mechanism responsible for the physiologic gonadotropin surge in females treated with gonadotropin-releasing hormone (GnRH) antagonist. Fertil Steril. 2010;93(5):1668-75.

  12. Rosenthal S. Approach to the patient: transgender youth: endocrine consideration. J Clin Endocrinol Metab. 2014;99(12):4379–89.

  13. de Vries ALC, McGuire JK, Steensma TD, et al. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. 2014;134(4):696–704.

  14. Agostino H, Di Meglio G. Low-dose oral contraceptives in adolescents: how low can you go? J Pediatri Adolesc Gynecol. 2010;23(4):195–201.

  15. Golden NH, Abrams SA. Optimizing bone health in children and adolescents. Pediatrics. 2014;134(4):1229-43.

  16. Rosenberg MJ, Meyers A, Roy V. Efficacy, cycle control, and side effects of low- and lower-dose oral contraceptives: a randomized trial of 20mcg and 35mcg estrogen preparations. Contraception. 1999;60(6):321-329.

  17. Depot medroxyprogesterone acetate and bone effects. ACOG Committee Opinion No. 602 American College of Obstetricians and Gynecologists. Available at: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Depot-Medroxyprogesterone-Acetate-and-Bone-Effects. Accessed 28 Jan 2017.

  18. Nelson A, Apter D, Hauck B, et al. Two low-dose levonorgestrel intrauterine contraceptive systems: a randomized control trial. Obstet Gynecol. 2016;122(6):1205–13.

  19. Nahata L, Tishelman AC, Caltabellotta NM, Quinn GP. Low fertility preservation utilization among transgender youth. J Adolesc Health. 2017. doi: 10.1016/j.jadohealth.2016.12.012.

  20. Light AD, Obedin-Maliver J, Sevelius JM, Kerns JL. Transgender men who experienced pregnancy after female-to-male gender transitioning. Obstet Gynecol. 2014;124(6):1120–7.

  21. Olie V, Canonico M, Scarabin PY. Risk of venous thromboemolism with oral vs. transdermal estrogen therapy among postmenopausal women. Curr Opin Hematol. 2010;17(5):457-63.

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric and Adolescent Gynecology, MedStar Washington Hospital Center and Children’s National Medical Center, 110 Irving St NW, Ste 5B39, Washington, DC, 20010, USA

    Kylie Fowler & Veronica Gomez-Lobo

Authors
  1. Kylie Fowler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Veronica Gomez-Lobo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kylie Fowler.

Ethics declarations

Conflict of Interest

Kylie Fowler and Veronica Gomez-Lobo declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Care for the Transgender Patient

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fowler, K., Gomez-Lobo, V. Care of the Transgender Child and Adolescent. Curr Obstet Gynecol Rep 6, 156–162 (2017). https://doi.org/10.1007/s13669-017-0206-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13669-017-0206-2

Keywords

Search

Navigation