Delay provides kids and family much needed time.


SAN DIEGO Delaying puberty in kids who present with symptoms of gender dysphoria gives them much needed time and is thus helpful, even for children who will not persist with symptoms of gender dysphoria, said Jack Drescher, MD, who served as section editor of the gender dysphoria chapter of DSM-5 Task Force.

Drescher, who is a clinical professor of psychiatry at Columbia University College of Physicians and Surgeons, discussed controversies in the treatment of transgender teens and adolescents in a presentation at Psych Congress 2019.

Despite the attention given to transgender individuals around issues like bathroom use, Drescher said the number of children and adolescents with gender dysphoria is small, “less than 1% of the general pediatric population, and the children and adolescents who present for treatment are a heterogeneous group.”

Moreover, the majority of children who present do not persist; “usually, they become what we term ‘desisters’ by adolescence or adulthood, meaning that they return to their natal gender identity. As adults they may be gay, but they are not transgender.”

A minority will persist with gender dysphoria and they will be transgender, he said.

“It is important to understand that we don’t know why this occurs,” he cautioned the audience, noting that much misinformation, especially information from sources online sources, can be confusing for both patients and clinicians. “But we need to remember that the Huff Post is not a peer-reviewed journal.”

Dreschcr noted that while there are various schools of thought about treating gender dysphoria in young kids from discouraging cross gender identification, to encouraging it, or simply doing nothing — there is agreement among all three that puberty should be delayed by administering “GnRH analogues to delay the sex steroid induced progression of body changes of puberty. Research suggests that suppressing those changes for several years appears safe.”

He said, however, that there is no evidence that delaying puberty will ultimately reduce the likelihood of a child persisting to a transgender individual.

It should, however, be noted that since 2012, “18 states, Washington, D.C., and Ontario, Canada have passed laws banning efforts to change minors’ sexual orientation or gender identity.”

 

Written by Peggy Peck, Editor-in-Chief, BreakingMED, is a service of @Point of Care, LLC, which provides daily medical news reports curated to serve the unique needs of busy physicians and other healthcare professionals.