Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts, USA.
Horm Res Paediatr. 2022;95(5):405-414. doi: 10.1159/000524030. Epub 2022 Mar 10.
Clinicians of all disciplines, including pediatric endocrinologists, are likely to encounter transgender and gender-diverse (TGD) young people in their practice regardless of whether they specialize in gender-affirming medical care. Because of this, it is important to be aware of the ways in which medical professionals can affirm these individuals. Although gender-affirming therapy should always include affirmation including proper use of names and pronouns, the transition journey will look different for each patient. The gender-affirming care of TGD young people may include both medical and nonmedical interventions (e.g., social transition). Therapies utilized for medical gender transition such as gonadotropin-releasing hormone agonists and/or gender-affirming hormones have implications for growth, bone health, cardiovascular health, and fertility, although these impacts are not yet completely understood. This review provides an overview of the care of transgender young people as well as a summary of what is known about the outcomes of these therapies. Clinicians should advise TGD young people and their families of the known and unknown risks and work together with patients to decide upon a treatment and follow-up regimen that aligns with their individual gender affirmation and health goals.
所有学科的临床医生,包括儿科内分泌学家,都可能在实践中遇到跨性别和性别多样化(TGD)的年轻人,无论他们是否专门从事性别肯定的医疗护理。因此,了解医疗专业人员可以肯定这些人的方式非常重要。尽管性别肯定治疗应始终包括肯定,包括正确使用姓名和代词,但每个患者的过渡旅程都将不同。TGD 年轻人的性别肯定护理可能包括医疗和非医疗干预措施(例如,社会过渡)。用于医学性别过渡的治疗方法,如促性腺激素释放激素激动剂和/或性别肯定激素,对生长、骨骼健康、心血管健康和生育能力都有影响,尽管这些影响尚未完全了解。这篇综述提供了对跨性别年轻人护理的概述,以及对这些治疗方法结果的已知和未知风险的总结。临床医生应向 TGD 年轻人及其家人告知已知和未知的风险,并与患者合作,决定与他们的个人性别肯定和健康目标一致的治疗和随访方案。