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Pediatrics. 2018 Apr;141(4). pii: e20173742. doi: 10.1542/peds.2017-3742. Epub 2018 Mar 7.

Hormonal Treatment in Young People With Gender Dysphoria: A Systematic Review.

Chew D1, Anderson J2, Williams K1,3,4, May T1,3,4,5, Pang K6,3,4,7,8.

Author information

1
Departments of Pediatrics and.
2
Discipline of Paediatrics, Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, Australia.
3
Murdoch Children's Research Institute, Parkville, Australia.
4
The Royal Children's Hospital, Melbourne, Australia.
5
School of Psychology, Deakin University, Burwood, Australia; and.
6
Departments of Pediatrics and ken.pang@mcri.edu.au.
7
Psychiatry, Melbourne Medical School, University of Melbourne, Parkville, Australia.
8
Inflammation Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Abstract

CONTEXT:

Hormonal interventions are being increasingly used to treat young people with gender dysphoria, but their effects in this population have not been systematically reviewed before.

OBJECTIVE:

To review evidence for the physical, psychosocial, and cognitive effects of gonadotropin-releasing hormone analogs (GnRHa), gender-affirming hormones, antiandrogens, and progestins on transgender adolescents.

DATA SOURCES:

We searched Medline, Embase, and PubMed databases from January 1, 1946, to June 10, 2017.

STUDY SELECTION:

We selected primary studies in which researchers examined the hormonal treatment of transgender adolescents and assessed their psychosocial, cognitive, and/or physical effects.

DATA EXTRACTION:

Two authors independently screened studies for inclusion and extracted data from eligible articles using a standardized recording form.

RESULTS:

Thirteen studies met our inclusion criteria, in which researchers examined GnRHas (n = 9), estrogen (n = 3), testosterone (n = 5), antiandrogen (cyproterone acetate) (n = 1), and progestin (lynestrenol) (n = 1). Most treatments successfully achieved their intended physical effects, with GnRHas and cyproterone acetate suppressing sex hormones and estrogen or testosterone causing feminization or masculinization of secondary sex characteristics. GnRHa treatment was associated with improvement across multiple measures of psychological functioning but not gender dysphoria itself, whereas the psychosocial effects of gender-affirming hormones in transgender youth have not yet been adequately assessed.

LIMITATIONS:

There are few studies in this field and they have all been observational.

CONCLUSIONS:

Low-quality evidence suggests that hormonal treatments for transgender adolescents can achieve their intended physical effects, but evidence regarding their psychosocial and cognitive impact are generally lacking. Future research to address these knowledge gaps and improve understanding of the long-term effects of these treatments is required.

PMID:
29514975
DOI:
10.1542/peds.2017-3742

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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