Endocrine Abstracts

An increasing number of transgender adolescents seek hormone treatment because they wish to align their body with their gender identity in order to reduce gender dysphoria. Medical care for adolescents should be offered by a multidisciplinary team, including mental health professionals as well as medical specialists. First a psychological and clinical assessment is performed, followed by counselling about medical treatment options and alternatives and their benefits and risks. The possible impact of treatment on fertility and options for fertility preservation are important topics in counselling. Several treatment options exist to suppress sex hormones and to induce sex characteristics consistent with gender identity. Care should be tailored to the specific needs of the adolescent. Current guidelines on hormone treatment and treatment monitoring will be reviewed. The transition from paediatric to adult care is an important phase to ensure adolescents receive appropriate long-term follow-up. This phase also requires attention to topics such as education, employment, relationships and sexual functioning. Transgender care, especially for adolescents, has become the subject of political and societal debate. Reviews have concluded there is a lack of high-quality evidence in this area. An increasing body of outcome data of hormonal treatment for transgender adolescents is available from observational studies, including data on mental health, development of secondary sex characteristics, growth and adult height, body composition, bone mineral accrual, and treatment continuation/discontinuation. However, long-term data are still limited. Therefore care is ideally combined with collection of data for research purposes.