Department of Pediatric and Adolescent Gynecology, the Department of Endocrinology and Diabetes, and the Department of Adolescent Medicine, the Royal Children's Hospital Melbourne, and the Murdoch Children's Research Institute, Parkville, and the Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia.
Obstet Gynecol. 2023 Nov 1;142(5):1096-1104. doi: 10.1097/AOG.0000000000005317. Epub 2023 Aug 10.
To investigate the prevalence, nature, and effectiveness of menstrual suppression in transgender and gender-diverse (TGD) adolescents, and to explore whether there is an association between menstrual suppression and mental health in this population.
A cross-sectional study was performed of TGD adolescents assigned female at birth attending their first appointment at a specialist pediatric gender service between February 2017 and December 2021. Demographic and mental health data were collected using a questionnaire at the time of first visit, and information regarding menstrual suppression at this time was retrieved from the medical record.
A total of 530 TGD individuals were included; 131 (24.7%) were on menstrual suppression at their initial visit, mainly to help alleviate gender dysphoria. Combined oral contraceptive pills were the most common agent used (n=61, 46.6%), followed by norethindrone (n=39, 29.8%) and intramuscular medroxyprogesterone (n=19, 14.5%). Rates of effectiveness (in stopping menstruation) and patient satisfaction were high. Among the 399 individuals not on menstrual suppression, there was strong interest in starting this treatment. No differences in the risk of gender dysphoria, depression, or anxiety were observed between those who were receiving menstrual suppression and those who were not.
Effectiveness of and satisfaction with menstrual suppression were high in TGD adolescents receiving this treatment. These findings support the routine exploration and management of menstrual health in TGD adolescents. However, menstrual suppression was not associated with any difference in gender dysphoria, depression, or anxiety symptoms in this cross-sectional study, and longitudinal studies are required to better investigate this.
调查跨性别和性别多样化（TGD）青少年中月经抑制的流行率、性质和效果，并探讨在该人群中，月经抑制与心理健康之间是否存在关联。
对 2017 年 2 月至 2021 年 12 月期间在专门的儿科性别服务机构首次就诊的出生时被指定为女性的 TGD 青少年进行了一项横断面研究。在首次就诊时使用问卷收集人口统计学和心理健康数据，并从病历中检索此时的月经抑制信息。
共纳入 530 名 TGD 个体；131 名（24.7%）在首次就诊时正在进行月经抑制，主要是为了缓解性别焦虑。最常用的联合口服避孕药（n=61，46.6%），其次是炔诺酮（n=39，29.8%）和肌肉注射醋酸甲羟孕酮（n=19，14.5%）。有效性（停止月经）和患者满意度均很高。在未进行月经抑制的 399 名个体中，强烈希望开始这种治疗。在接受月经抑制和未接受月经抑制的个体之间，性别焦虑、抑郁或焦虑的风险没有差异。
在接受这种治疗的 TGD 青少年中，月经抑制的有效性和满意度均很高。这些发现支持在 TGD 青少年中常规探索和管理月经健康。然而，在这项横断面研究中，月经抑制与性别焦虑、抑郁或焦虑症状之间没有差异，需要进行纵向研究以更好地研究这一点。
