Endocr Pract. 2020 Apr;26(4):423-428. doi: 10.4158/EP-2019-0418. Epub 2020 Feb 11.
To describe patient characteristics at presentation, management, and fertility preservation rates among a cohort of Israeli children and adolescents with gender dysphoria (GD). We performed a retrospective chart review of 106 consecutive children and adolescents with GD (<18 years) referred to and followed at the multidisciplinary Israeli Pediatric Gender Dysphoria Clinic from March 2013 through December 2018. Of the 106 patients, 10 were prepubertal (9 prepubertal transgender females), and 96 were pubertal (38 pubertal transgender females). The GD population increased 11-fold since the establishment of our clinic in 2013. The subject's median age at referral was 15.5 years (range, 4.6 to 18 years). At the time of referral, 91 (95%) of the pubertal group had completed sexual maturation in their assigned gender at birth. Thirteen (13.5%) patients had attempted suicide, and 11 (11.5%) reported having had suicidal thoughts. Fourteen (45%) pubertal transgender females and 3 (6.5%) pubertal transgender males completed fertility preservation. Gonadotropin-releasing hormone analog treatment was prescribed in 77 (80%) patients at a mean age of 15.9 ± 1.6 years. Gender-affirming hormones were prescribed in 61 (64%) patients at a mean age of 16.5 ± 1.3 years. No severe side effects were recorded. Two (2%) of the pubertal group expressed regret about medical treatment. Children and adolescents with GD are presenting for medical attention at increasing rates. Israeli adolescents with GD have high fertility preservation rates, perhaps attributable to cultural perspectives. Taking advantage of the option to preserve fertility can be achieved when proper counseling is both available and promoted by medical personnel. = gender-affirming hormone; = gender dysphoria; = gonadotropin-releasing hormone analog; = mental health professional.
描述一组以色列性别焦虑症（GD）儿童和青少年患者就诊时的患者特征、治疗方法和生育保存率。我们对 2013 年 3 月至 2018 年 12 月期间在以色列儿科性别发育障碍多学科诊所就诊和随访的 106 例连续 GD （年龄＜18 岁）儿童和青少年进行了回顾性病历审查。106 例患者中，10 例为青春期前（9 例青春期前 transgender 女性），96 例为青春期（38 例青春期 transgender 女性）。自 2013 年我们的诊所成立以来，GD 人群增加了 11 倍。就诊时，青春期组患者的中位年龄为 15.5 岁（范围，4.6-18 岁）。转诊时，91 例（95%）青春期组患者在出生时已完成其分配性别的性成熟。13 例（13.5%）患者曾试图自杀，11 例（11.5%）曾有自杀念头。14 例（45%）青春期 transgender 女性和 3 例（6.5%）青春期 transgender 男性完成了生育保存。77 例（80%）患者在平均年龄 15.9±1.6 岁时接受了促性腺激素释放激素类似物治疗。61 例（64%）患者在平均年龄 16.5±1.3 岁时接受了性别肯定激素治疗。未记录到严重副作用。青春期组中有 2 例（2%）对医疗治疗表示后悔。越来越多的 GD 儿童和青少年寻求医疗关注。以色列 GD 青少年的生育保存率较高，这可能归因于文化观点。利用适当的咨询和医疗人员的宣传，可以实现保留生育能力的选择。
