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Pediatr Clin North Am. 2015 Aug;62(4):1001-16. doi: 10.1016/j.pcl.2015.04.013. Epub 2015 Jun 11.

Gender Variance and Dysphoria in Children and Adolescents.

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Division of Adolescent Medicine, Department of Pediatrics, Transgender Youth Clinic, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. Electronic address:
Pediatric Endocrine Outpatient Services, Pediatric Endocrinology, Child and Adolescent Gender Center, University of California, San Francisco, 513 Parnassus Avenue, Room S-672, Box 0434, San Francisco, CA 94143-0434, USA.


Gender variant and transgender youth are seeking medical care at younger ages. Pediatricians and other primary care physicians are often the first professionals who encounter such youth and their families. The goals of this article are to provide information on the epidemiology and natural history of gender variant and transgender youth, current clinical practice guidelines regarding the use of puberty blockers and cross-sex hormones for transgender youth, and limitations and challenges to optimal care.


Cross-sex hormones; Gender dysphoria; Gender identity; Gender variance; Pubertal blockers; Transgender youth

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