Division of Pediatric Endocrinology, Paedi Center for Specialized Pediatrics, Nicosia, Cyprus.
St George's, University London Medical Program at the University of Nicosia Medical School, Nicosia, Cyprus.
Hormones (Athens). 2020 Sep;19(3):267-276. doi: 10.1007/s42000-020-00174-1. Epub 2020 Feb 4.
Over the last decade, we have witnessed considerable progress in gender dysphoria (GD) terminology in an attempt to better describe the condition based on certain criteria. The ever-increasing social acceptance and destigmatization of children and adolescents with GD have resulted in an increased number of transgender individuals seeking endocrine care. In addition to terminology and diagnostic criteria, the tremendous progress of genetics and neuroimaging has enabled us to have a deeper understanding of the complex pathogenesis of GD. Although helpful guidelines for treatment with GnRH analogs and gender-affirming hormones have been proposed, several challenges and controversies still exist. In this article, the current knowledge about GD in adolescents is reviewed, with particular emphasis on terminology, clinical manifestations, and epidemiologic data. The neurobiological basis of the condition is presented, and both hormonal treatment and mental issues of transgender individuals are discussed. Undoubtedly, further research will optimize the diagnostic and therapeutic approach of children and adolescents with GD.
在过去的十年中,我们见证了性别焦虑症(GD)术语的重大进展,试图根据某些标准更好地描述这种情况。由于对患有 GD 的儿童和青少年的社会接受度和污名化程度不断提高,寻求内分泌治疗的跨性别者人数有所增加。除了术语和诊断标准外,遗传学和神经影像学的巨大进步使我们能够更深入地了解 GD 的复杂发病机制。尽管已经提出了 GnRH 类似物和性别肯定激素治疗的有用指南,但仍然存在一些挑战和争议。本文回顾了青少年 GD 的现有知识,特别强调术语、临床表现和流行病学数据。介绍了该病症的神经生物学基础,并讨论了激素治疗和跨性别者的心理问题。毫无疑问,进一步的研究将优化 GD 儿童和青少年的诊断和治疗方法。