Endocrine Abstracts

JOINT1001

Introduction: The worldwide trend of rising referrals of youths to gender clinics is widely discussed and observed in Poland as well. To our knowledge, there is no data presenting the medical and psychological status of gender dysphoric youth in Central Europe. Similarly, the data about the relation between the Gender Minority Stress (GMS) and health – both mental and somatic – is scant.

Aim: Here, the mental health diagnoses and endocrinological status based on steroid metabolome from 24-hr urinary collection are analysed in the context of minority status-related data.

Methods: This prospective study has examined consecutive series of children and adolescents diagnosed due to gender incongruence/dysphoria in accordance with WPATH SOC-8 in one university center between July/2017 and Sep/2024. Clinical and laboratory data was collected in unified medical records.

Results: The population consists of 269 participants (female: male at birth -230:39) with the mean/median age of diagnosis 15.8/16.1 years and the mean age of gender identity mismatch onset of 12 years. Mental health diagnoses among our patients include: mood disorders - 59.8%, anxiety disorders - 26.0%, adjustment disorders - 3.8%, psychotic disorders - 4.6%, conduct/disruptive disorders – 0.8%, substance use disorders - 2.3%, eating disorders - 12.6%, personality disorders – 9.6%, attention deficit hyperactivity disorder – 9.6%, autism spectrum disorders – 22.6%. Further statistical analyses have revealed that gender dysphoria is a positive predictor of a number of mental health diagnoses (P <0.05) and correlates positively with values of THF+allo-THF/THE (reflects 11ßHSD1 activity), α- and β-cortolone (cortisone metabolites) (P <0.05). Negative association was found between the age of gender incongruence onset and values of F/E (11ßHSD1 activity) and positive between the age of coming out to friends and relatives and values of tetrahydrocortisone (THE), tetrahydrocortisol (THF) and β-cortol (cortisol metabolite) (P <0.05). The results of the intergroup differences analysis have shown that adolescents who have parental acceptance of their minority status report lower intensity of gender dysphoria than those who have no parental support in this respect.

Conclusions: The analyses further indicate the significance of gender dysphoria alleviation for transgender and gender non-conforming adolescents’ mental health. Our results show that Gender Minority Stress (including gender dysphoria) influences the glucocorticoids balance, which indicates a need for further investigation.