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系统评价:促性腺激素释放激素类似物在性别不一致青少年中的青春期抑制作用。

Systematic Review: Puberty suppression with GnRH analogues in adolescents with gender incongruity.

机构信息

Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Morumbi, São Paulo, SP, 05652-900, Brazil.

出版信息

J Endocrinol Invest. 2021 Jun;44(6):1151-1158. doi: 10.1007/s40618-020-01449-5. Epub 2020 Oct 28.

Abstract

CONTEXT

Gender incongruence is defined as disharmony between assigned gender and gender identity. Several interventions are liable in this case including genital affirming surgery among other surgical interventions such as harmonization, and also the use of gonadotropin-releasing hormone agonists (GnRHa) for gonadal shielding. This aids in preventing the development of secondary sexual characteristics related to the genetic sex.

OBJECTIVE

Systematically review the treatment of gender incongruity with GnRHa analogues.

DATA SOURCES

The data source of this research is from Pubmed-Medline and Embase.

STUDY SELECTION

Articles published between 2009 and 2019 which studied transgender adolescents treated with GnRHa were carefully selected.

DATA EXTRACTION

Were extracted: design, sample size, study context, targeted subjects of intervention, outcome measures, and results.

RESULTS

Eleven studies were included. The use of GnRHa seems to be well tolerated by the studied population. When started in pubertal transition, it was associated with a more distinct resemblance to body shape than to the affirmed sex. In addition to preventing the irreversible phenotypic changes that occur in cross-hormonal therapy, the use of GnRHa can equally contribute to the mental health of these adolescents.

LIMITATION

There are few consistent studies on the use of GnRHa for gender incongruence.

CONCLUSION

As the population of transgender children and adolescents grows, they acquire knowledge and greater access to the various forms and stages of treatment for sex reassignment. The medical community needs to be adequately prepared to better serve this population and offer the safest resources available.

摘要

背景

性别不一致被定义为分配性别与性别认同之间的不和谐。在这种情况下,有几种干预措施,包括生殖器肯定手术,以及其他手术干预,如协调,以及使用促性腺激素释放激素激动剂(GnRHa)进行性腺屏蔽。这有助于防止与遗传性别相关的第二性征的发育。

目的

系统审查使用 GnRHa 类似物治疗性别不一致。

数据来源

本研究的数据来源是 Pubmed-Medline 和 Embase。

研究选择

仔细选择了 2009 年至 2019 年期间发表的研究 transgender 青少年接受 GnRHa 治疗的文章。

数据提取

提取了设计、样本量、研究背景、干预目标对象、结果测量和结果。

结果

纳入了 11 项研究。GnRHa 的使用似乎被研究人群很好地耐受。当在青春期过渡开始时使用时,它与身体形状的相似性比与肯定的性别更明显。除了防止在跨激素治疗中发生的不可逆转的表型变化外,GnRHa 的使用同样有助于这些青少年的心理健康。

局限性

关于 GnRHa 用于性别不一致的研究很少有一致性。

结论

随着 transgender 儿童和青少年人口的增长,他们获得了更多的知识,并且更容易获得性别重置的各种形式和阶段的治疗。医疗界需要做好充分准备,为这一人群提供最好的、可用的资源。

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