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Pediatr Clin North Am. 2016 Dec;63(6):1121-1135. doi: 10.1016/j.pcl.2016.07.011. Epub 2016 Oct 14.

What the Primary Care Pediatrician Needs to Know About Gender Incongruence and Gender Dysphoria in Children and Adolescents.

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Department of Child and Adolescent Psychiatry, VU University Medical Center, Room 1y130, PO Box 7057, 1007 MB Amsterdam, The Netherlands. Electronic address:
Division of Endocrinology, Department of Pediatrics, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
Department of Medical Psychology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.


The recognition and acknowledgment that gender identity and birth-assigned sex may be incongruent in children and adolescents have evolved in recent decades. Transgender care for children and adolescents has developed and is now more widely available. Controversies exist, however, around clinical management of gender dysphoria and gender incongruence in children and adolescents. Clinical guidelines are consensus based and research evidence is limited. Puberty suppression as part of clinical management has become a valuable element of adolescent transgender care, but long-term evidence of success is limited. These uncertainties should be weighed against the risk of harming a transgender adolescent when medical intervention is denied.


Adolescents; Children; Gender dysphoria; Gender incongruence; Gender variance; Transgender care

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