Journal of Pediatric Care

Gender non-conforming children and transgender youth: Clinical considerations and perspective from the United States

Joint Event on 18^th International Conference on Pediatrics Health & 2^nd Edition of International Conference on Adolescent Health & Medicine
August 06-07, 2018 Madrid, Spain

Johanna Olson Kennedy

Children�s Hospital Los Angeles, USA

Posters & Accepted Abstracts: J Pediatr Care

DOI: 10.21767/2471-805X-C3-012

Abstract

Transgender youth are those who experience incongruence between their assigned sex at birth, and their gender identity. Ongoing distress that results in an impairment of function about this incongruence is termed gender dysphoria. In order to help alleviate this distress, many transgender youth require physical changes to their bodies in order to bring them into closer alignment with their internal gender identity. Historically, most transgender individuals seeking medical interventions (hormones and/or surgery) for gender transition have and still continue to access care in adulthood. The past decade has witnessed an unprecedented number of transgender youth presenting for care at gender centers throughout the world, with the average age of referral getting younger each year. In response to this groundswell, the care of gender non-conforming and transgender youth has become a topic of great interest over the past decade. The evolution of professional communities moving from pathologizing transgender experience to a thoughtful discussion about improving the health and well-being of transgender individuals is long overdue. The development of adult male (larnyngeal prominence, deepening of the voice, tall stature, etc.) or adult female (chest, menstruation, and short stature) secondary sexual characteristics often trigger specific body dysphoria for many transgender adolescents and adults. The use of medications for the purpose of suppressing endogenous puberty, and thus potentially bypassing the development of undesired secondary sexual characteristics altogether, is a relatively new strategy in the approach to treating gender-nonconforming youth. Primarily pioneered by a team of gender specialists in the Netherlands, suppression of puberty is becoming increasingly common in many gender clinics around the world. Increasingly, professional guidelines are acknowledging the importance of individualized care plans over protocols as appropriate and critical when working with gender diverse youth. The use of cross-sex, or gender affirming hormones for masculinization or feminization is a critical aspect of addressing gender dysphoria in most transgender individuals. Due to a lack of available data and long-term outcomes among youth who begin physical gender transition in adolescence, there is a lack of consensus among medical providers about timing, dosing, and care models for transgender youth. This workshop will cover the basic principles of gender dysphoria, the use of blockers to suppress endogenous puberty, and the use of gender affirming hormones in transgender adolescents. mental health and medical care for those youth desiring gender transition is still extremely rare, and often inadequate in most places around the United States. This program is a comprehensive, two day symposium designed for professionals interested in providing sensitive and competent mental health and medical care for gender non-conforming children, transgender youth and young adults. While primarily didactic in presentation, this symposium also includes case studies, and audience activities designed to highlight the challenges of caring for this population, and improve understanding of their needs.