Shumer Daniel E, Nokoff Natalie J, Spack Norman P
Division of Pediatric Endocrinology, Department of Pediatrics and Communicable Diseases, University of Michigan Health Systems, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5175, USA.
Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado School of Medicine, 13123 East 16th Avenue, Aurora, CO 80045, USA.
Adv Pediatr. 2016 Aug;63(1):79-102. doi: 10.1016/j.yapd.2016.04.018. Epub 2016 Jun 3.
Children and adolescents with gender dysphoria are presenting for medical attention at increasing rates. Standards of Care have been developed which outline appropriate mental health support and hormonal interventions for transgender youth. This article defines terminology related to gender identity, reviews the history of medical interventions for transgender persons, outlines what is known about gender identity development, and reviews mental health disparities faced by this patient population. We provide an overview of medical management options for transgender adolescents meeting diagnostic criteria for gender dysphoria including pubertal suppression, cross-sex hormones, longitudinal screening and anticipatory guidance. We describe current challenges in the field and provide information about how care is currently being provided in the US and Canada. We conclude with 5 brief case examples.
患有性别焦虑症的儿童和青少年寻求医疗关注的比例正在上升。已经制定了护理标准,概述了为跨性别青少年提供的适当心理健康支持和激素干预措施。本文定义了与性别认同相关的术语,回顾了跨性别者医疗干预的历史,概述了已知的性别认同发展情况,并回顾了这一患者群体所面临的心理健康差异。我们概述了符合性别焦虑症诊断标准的跨性别青少年的医疗管理选择,包括青春期抑制、跨性别激素、纵向筛查和预期指导。我们描述了该领域当前面临的挑战,并提供了有关美国和加拿大目前如何提供护理的信息。我们最后给出了5个简短的病例示例。