To treat or not to treat: puberty suppression in childhood-onset gender dysphoria

To treat or not to treat: puberty suppression in childhood-onset gender dysphoria

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KEY POINTS * Puberty suppression using gonadotropin-releasing hormone analogues is prescribed to relieve the distress associated with pubertal development in adolescents with gender


dysphoria, in order to provide time for further exploration * Treating prepubertal individuals with gender dysphoria is particularly controversial owing to their unstable pattern of gender


variance compared with gender-dysphoric adolescents and adults * The absence of robust data in support of or against the use of puberty suppression in childhood-onset gender dysphoria has


led to inconsistencies between health-care pathways across different centres * The paucity of evidence of the effect of puberty suppression on health-related outcome measures calls for


studies that might help to advance the evidence-based debate on risks and benefits * Despite a limited number of studies, the existing literature supports puberty suppression as an early,


sufficiently safe, and preventive treatment for gender dysphoria in childhood and adolescence ABSTRACT Puberty suppression using gonadotropin-releasing-hormone analogues (GnRHa) has become


increasingly accepted as an intervention during the early stages of puberty (Tanner stage 2–3) in individuals with clear signs of childhood-onset gender dysphoria. However, lowering the age


threshold for using medical intervention for children with gender dysphoria is still a matter of contention, and is more controversial than treating the condition in adolescents and adults,


as children with gender dysphoria are more likely to express an unstable pattern of gender variance. Furthermore, concerns have been expressed regarding the risks of puberty suppression,


which are poorly understood, and the child's ability to make decisions and provide informed consent. However, even if the limited data available mean that it is not possible to make a


conclusive treatment recommendation, some safety criteria for puberty suppression can be identified and applied. Access through your institution Buy or subscribe This is a preview of


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HORMONE ANALOGS TREATMENT IN GIRLS WITH CENTRAL PRECOCIOUS PUBERTY AND EARLY FAST PUBERTY Article 07 November 2023 EFFECT OF GONADOTROPIN-RELEASING HORMONE AGONIST MONOTHERAPY AND


COMBINATION THERAPY WITH GROWTH HORMONE ON FINAL ADULT HEIGHT IN GIRLS WITH CENTRAL PRECOCIOUS PUBERTY Article Open access 23 January 2023 TESTOSTERONE THERAPY IN CHILDREN AND ADOLESCENTS:


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references ACKNOWLEDGEMENTS Authors would like to thank all patients and colleagues met during their years of clinical research activity. A special thank goes to the Gender Unit at the


University of Bari, Italy, and the Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust, United Kingdom. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Gender


Identity Development Service, Tavistock and Portman NHS Foundation Trust, Tavistock Centre, 120 Belsize Lane, London, NW3 5BA, UK Rosalia Costa & Polly Carmichael * Department of


Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK Marco Colizzi Authors * Rosalia Costa View


author publications You can also search for this author inPubMed Google Scholar * Polly Carmichael View author publications You can also search for this author inPubMed Google Scholar *


Marco Colizzi View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS R.C. and M.C. researched data for the article, and wrote the manuscript. All


authors made substantial contributions to discussions of content and reviewed and edited the manuscript before submission. CORRESPONDING AUTHOR Correspondence to Rosalia Costa. ETHICS


DECLARATIONS COMPETING INTERESTS The authors declare no competing financial interests. POWERPOINT SLIDES POWERPOINT SLIDE FOR FIG. 1 RIGHTS AND PERMISSIONS Reprints and permissions ABOUT


THIS ARTICLE CITE THIS ARTICLE Costa, R., Carmichael, P. & Colizzi, M. To treat or not to treat: puberty suppression in childhood-onset gender dysphoria. _Nat Rev Urol_ 13, 456–462


(2016). https://doi.org/10.1038/nrurol.2016.128 Download citation * Published: 19 July 2016 * Issue Date: August 2016 * DOI: https://doi.org/10.1038/nrurol.2016.128 SHARE THIS ARTICLE Anyone


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