Purpose: Approximately half of transgender or gender diverse youth identify as gender nonbinary (not entirely or exclusively male or female). This study aimed to explore the views and practices of Australian clinicians working with transgender or gender diverse young people regarding puberty suppression for nonbinary youth, including requests for ongoing puberty suppression into adulthood.
Methods: Individual semistructured key informant interviews were conducted with 14 clinicians (medical and mental health) in Australia to explore their practices, views, and decision-making regarding puberty suppression for nonbinary youth. Transcripts were analyzed using inductive content analysis.
Results: Requests for puberty suppression from nonbinary young people are occurring, with 12 of 14 clinicians reporting they have received such requests. Although all clinicians were prepared to support short-term puberty suppression for nonbinary youth, clinicians diverged in their preparedness to support long-term puberty suppression. Clinicians expressed concerns in relation to risks, resource allocation, and medicalization. Some clinicians required nonbinary young people to choose a masculinizing or feminizing puberty. Some clinicians also put forward arguments in favor of long-term puberty suppression, including potential psychosocial harm of discontinuing puberty suppression, respect for autonomy, equity, and harm minimization. Clinicians also highlighted practical challenges of obtaining long-term puberty suppression in the adult setting.
Conclusions: The decision of whether to provide puberty suppression, particularly long-term, to a nonbinary young person is both ethically and clinically complex. There is currently a diversity of practice in this area, and evidence-based ethical guidelines and outcome data could promote more informed decision-making and support clinicians working in this complex area.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jadohealth.2020.09.028 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical Manifestations and Challenges in Adolescent and Adult Females With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.
J Clin Endocrinol Metab
January 2025
Department of Women's and Children's Health, Karolinska Institutet, SE-171 76 Stockholm, Sweden.
Classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency (CAH) is a rare genetic condition that results in cortisol deficiency and excess production of adrenal androgens. While the introduction of newborn screening for CAH has reduced morbidity and mortality, management of CAH remains challenging. Lifelong treatment with glucocorticoids is required to replace the endogenous cortisol deficiency and reduce excess adrenal androgens.
View Article and Find Full Text PDFHypothalamic SIRT1-mediated regulation of the hormonal trigger of ovulation and its repression in energy deficit.
Metabolism
December 2024
Instituto Maimónides de Investigación Biomédica de Cordoba (IMIBIC), Department of Cell Biology, Physiology and Immunology, University of Cordoba; and Hospital Universitario Reina Sofia, Cordoba, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain. Electronic address:
Female reproduction is highly sensitive to body energy stores; persistent energy deficit, as seen in anorexia or strenuous exercise, is known to suppress ovulation via ill-defined mechanisms. We report herein that hypothalamic SIRT1, a key component of the epigenetic machinery that links nutritional status and puberty onset via modulation of Kiss1, plays a critical role in the control of the preovulatory surge of gonadotropins, i.e.
View Article and Find Full Text PDFExogenous estradiol impacts anxiety-like behavior of juvenile male and female Siberian hamsters in a dose-dependent manner.
Horm Behav
January 2025
Department of Psychology, University at Buffalo, SUNY, Buffalo, NY, USA; Neuroscience Program, University at Buffalo, SUNY, Buffalo, NY, USA; Evolution, Ecology, and Behavior Program, University at Buffalo, SUNY, NY, USA.
Anxiety is among the most prevalent mental health issues in children. While it is well established that gonadal steroids influence anxiety-like behavior in adulthood, a potential role in prepubertal juveniles has been overlooked because it is commonly thought that the gonads are quiescent during the juvenile period. However, the juvenile gonads secrete measurable amounts of steroids, and we have recently found that prepubertal ovariectomy decreases anxiety-like behavior of juvenile Siberian hamsters in the light/dark box test.
View Article and Find Full Text PDFTreatment trajectories among children and adolescents referred to the Norwegian National Center for Gender Incongruence.
Acta Paediatr
December 2024
Division of Paediatric and Adolescent Medicine, Department of Child and Adolescent Mental Health in Hospitals, Oslo University Hospital, Oslo, Norway.
Aim: We aimed to describe treatment trajectories, detransition and mortality rate among children and adolescents referred to the Norwegian National Center for Gender Incongruence (NCGI).
Methods: The cohort included all 1258 persons under 18 years at referral to the NCGI from 2000 to 2020. Trajectories were registered until end of 2023.
Menstrual management in transgender and gender diverse individuals: psychiatric and psychosocial considerations.
Front Psychiatry
October 2024
Department of Psychiatry, New York University, New York, NY, United States.
Transgender and gender-diverse (TGD) menstruators are individuals assigned female at birth (AFAB)*, who retain the capacity to menstruate and have a gender identity that differs from their natal sex. Reports indicate up to 1.6 million individuals in the US identify as TGD.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!