Young adult psychological outcome after puberty suppression and gender reassignment

Annelou L.C. De Vries, Jenifer K. McGuire, Thomas D. Steensma, Eva C.F. Wagenaar, Theo A.H. Doreleijers, Peggy T. Cohen-Kettenis

Research output: Contribution to journalArticlepeer-review

331 Scopus citations

Abstract

BACKGROUND: In recent years, puberty suppression by means of gonadotropin-releasing hormone analogs has become accepted in clinical management of adolescents who have gender dysphoria (GD). The current study is the first longer-term longitudinal evaluation of the effectiveness of this approach. METHODS: A total of 55 young transgender adults (22 transwomen and 33 transmen) who had received puberty suppression during adolescence were assessed 3 times: before the start of puberty suppression (mean age, 13.6 years), when cross-sex hormones were introduced (mean age, 16.7 years), and at least 1 year after gender reassignment surgery (mean age, 20.7 years). Psychological functioning (GD, body image, global functioning, depression, anxiety, emotional and behavioral problems) and objective (social and educational/professional functioning) and subjective (quality of life, satisfaction with life and happiness) well-being were investigated. RESULTS: After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Wellbeing was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being. CONCLUSIONS: A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, followed by cross-sex hormones and gender reassignment surgery, provides gender dysphoric youth who seek gender reassignment from early puberty on, the opportunity to develop into well-functioning young adults.

Original languageEnglish (US)
Pages (from-to)696-704
Number of pages9
JournalPediatrics
Volume134
Issue number4
DOIs
StatePublished - 2014

Keywords

  • Adolescents
  • Gender dysphoria
  • Longitudinal outcomes
  • Psychological functioning
  • Puberty suppression
  • Transgenderism

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