Butler Gary, Adu-Gyamfi Kirpal, Clarkson Kerry, El Khairi Ranna, Kleczewski Sara, Roberts Alice, Segal Terry Y, Yogamanoharan Karththeepan, Alvi Sabah, Amin Nadia, Carruthers Paul, Dover Stacey, Eastman Joanna, Mushtaq Talat, Masic Una, Carmichael Polly
Department of Paediatric and Adolescent Endocrinology, University College London Hospitals NHS Foundation Trust, London, UK
UCL Great Ormond Street Institute of Child Health, London, UK.
Arch Dis Child. 2022 Oct 19;107(11):1018-1022. doi: 10.1136/archdischild-2022-324302.
The destination of transgender and gender variant young people referred by the National Health Service (NHS) Gender Identity Development Service (GIDS) to, and discharged from the two English paediatric endocrine liaison clinics is not known.
1151 young people referred after full assessment by the GIDS; 827 to University College London Hospital since 2008; 324 to Leeds Children's Hospital since 2013. Discharge categorisation was by agreed criteria. Eleven emigrated and 51 self-discharged. 1089 had known outcomes.
999/1089 (91.7%) continued identifying as gender variant. 867/999 (86.8%) were discharged to adult gender identity clinics (GICs). 166/867 (19.1%) of these were <16 years and 701/867 (80.9%) ≥16 years at initial endocrine referral. No sex differences were seen. 38/999 (3.8%) opted for non-NHS services.90/1089 ceased identifying as gender variant. In 32/1089 (2.9%), this was subsequent to their first clinic appointment.58/1089 (5.3%) stopped treatment either with the gonadotropin releasing hormone analogue (GnRHa) or gender-affirming hormones (GAH) and reverted to their birth gender: <16 years (20/217; 9.2%); ≥16 years (38/872; 4.4%).Subdividing further, 16/217 (7.4%) <16 years ceased GnRHa and 4/217 (1.8%) after GAH. Of those ≥16 years, 33/872 (3.8%) ceased GnRHa and 5/872 (0.6%) GAH.
At discharge, 91.7% continued as transgender or gender variant, 86.8% sought ongoing care through NHS GICs. 2.9% ceased identifying as transgender after an initial consultation prior to any endocrine intervention and 5.3% stopped treatment either with GnRHa or GAH, a higher proportion in the <16 year compared with the ≥16 year groups.
英国国家医疗服务体系（NHS）性别认同发展服务机构（GIDS）转介至两家英国儿科内分泌联络诊所并从诊所出院的跨性别和性别多样化青少年的去向不明。
1151名经GIDS全面评估后被转介的青少年；自2008年起有827名转介至伦敦大学学院医院；自2013年起有324名转介至利兹儿童医院。出院分类依据商定标准。11人移民，51人自行出院。1089人有已知结局。
1089人中，999人（91.7%）继续认定为性别多样化。999人中，867人（86.8%）出院后前往成人性别认同诊所（GIC）。其中，166人（19.1%）在初次内分泌转诊时年龄小于16岁，701人（80.9%）年龄大于等于16岁。未见性别差异。999人中，38人（3.8%）选择非NHS服务。1089人中，90人不再认定为性别多样化。其中，32人（2.9%）是在首次门诊预约后不再认定。1089人中，58人（5.3%）停止使用促性腺激素释放激素类似物（GnRHa）或性别确认激素（GAH）治疗，恢复其出生时的性别：年龄小于16岁组（20/217；9.2%）；年龄大于等于16岁组（38/872；4.4%）。进一步细分，年龄小于16岁组中，16人（7.4%）停止使用GnRHa，4人（1.8%）停止使用GAH。年龄大于等于16岁组中，33人（3.8%）停止使用GnRHa，5人（0.6%）停止使用GAH。
出院时，91.7%的人继续保持跨性别或性别多样化，86.8%的人通过NHS的GIC寻求持续护理。2.9%的人在初次咨询后、任何内分泌干预之前不再认定为跨性别，5.3%的人停止使用GnRHa或GAH治疗，年龄小于16岁组的比例高于年龄大于等于16岁组。
