GENDER DYSPHORIA: A MEDICAL AND ETHICAL PERPLEXITY AS DISTINCT FROM REALITY AND THE RATIONAL APPROACH FOR MUSLIM YOUNG PEOPLE

This research investigated the prevalence of looked-after and adopted young people within a case file review of 185 young people referred to a UK gender identity development service over a 2-year period (1 April 2009 to 1 April 2011). Data were extracted from referral letters, clinical notes and clinician letters. Looked-after young people were found to represent 4.9% of referrals in this cohort, which is significantly higher than within the English general population (0.58%). Adopted young people represented 3.8% of referrals. In addition, the findings showed that looked-after young people were less likely to receive a diagnosis of gender dysphoria compared with young people living within their birth family. There were no statistically significant differences in the gender ratio or age of first gender dysphoric experience between groups. Looked-after and adopted young people were also not found to be experiencing greater impairment in overall functioning compared to other young people referred to the gender identity development service. In conclusion, there are a substantial proportion of referrals pertaining to looked-after or adopted young people, and it appears the referral route and process through the service may be distinct, particularly for looked-after young people. This may be understood by considering the possible complexities in the presentation of these groups, alongside the established higher levels of complexity generally for those experiencing feelings of gender dysphoria.

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Transgender adolescents and genital-alignment surgery: Is age restriction justified?

Clinical Ethics ◽

10.1177/1477750919845087 ◽

2019 ◽

Vol 14 (2) ◽

pp. 94-103

Author(s):

Edmund Horowicz

Keyword(s):

Young People ◽

Clinical Guidelines ◽

Gender Dysphoria ◽

Evidence Base ◽

Cultural Norms ◽

Evidence Based ◽

Professional Issues ◽

Standards Of Evidence ◽

Current Concerns ◽

Evidence Based Care

In the case of controversial interventions there is a need for clinical guidelines to be founded on ‘expert opinion’ and an evidence base, in order to minimise individual clinicians making subjective decisions influenced by bias or cultural norms. This paper considers international clinical guidelines that through recommendation effectively prohibit the provision of genital-alignment surgery for competent adolescents with gender dysphoria. I argue that although the rationale for this particular guideline is based on serious concerns, these need to be better understood to allow reconsideration of this unilateral prohibitive recommendation. I do not propose that genital-alignment surgery should be prima-facia provided for any adolescent with gender dysphoria. Instead I argue that by developing our understanding of the current concerns, we can allow guidelines to incorporate a margin of clinical discretion, to allow clinicians to provide genital-alignment surgery to some adolescents, where clinically appropriate. In facilitating this we can move towards establishing a solid evidence-base. The basis of this position is that clinical guidelines and medical practice should treat these young people with the same standards of evidence-based care as others who have less controversial conditions. Whilst this paper uses English law and UK professional regulation for context, many of the ethical, legal and professional issues highlighted are applicable to other jurisdictions.

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Gender dysphoria and the controversy over the Safe Schools program

Sexual Health ◽

10.1071/sh17014 ◽

2017 ◽

Vol 14 (5) ◽

pp. 417 ◽

Cited By ~ 1

Author(s):

Patrick Parkinson

Keyword(s):

Young People ◽

Gender Identity ◽

Gender Dysphoria ◽

Great Majority ◽

Social Engineering ◽

Medical Advice ◽

The Other ◽

Safe Schools ◽

Children And Young People ◽

And Gender

The Safe Schools program has attracted great controversy. On one end of the spectrum, it is defended as an anti-bullying program for young people who identify themselves as gay or lesbian, or have issues concerning their gender identity. On the other end of the spectrum, it is regarded as social engineering. This article seeks to promote a discussion of the way in which gender identity issues are addressed in the Safe Schools program. It is argued that the information in this program to Principals, teachers and young people is inaccurate and misleading. The program, as presently designed, may actually cause harm to children and young people who experience gender identity issues because it promotes gender transitioning without expert medical advice. The Safe Schools materials do not acknowledge that the great majority of children resolve gender dysphoria issues around the time of puberty. It may be much more difficult for a child to accept his or her gender at puberty if he or she has already changed name and gender identity in primary school. These deficits need to be addressed if the program is to continue.

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Gender Dysphoria in Children and Young People

Child and Adolescent Mental Health ◽

10.4324/9781003083139-25 ◽

2021 ◽

pp. 165-172

Author(s):

Hannah Stynes ◽

Martin McColl ◽

Ellis Kennedy

Keyword(s):

Young People ◽

Gender Dysphoria ◽

Children And Young People

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

Yearbook of Paediatric Endocrinology ◽

10.1530/ey.15.6.6 ◽

2018 ◽

Author(s):

Chew D ◽

Anderson J ◽

Williams K ◽

May T ◽

Pang K

Keyword(s):

Systematic Review ◽

Young People ◽

Gender Dysphoria ◽

Hormonal Treatment

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

PEDIATRICS ◽

10.1542/peds.2017-3742 ◽

2018 ◽

Vol 141 (4) ◽

pp. e20173742 ◽

Cited By ~ 30

Author(s):

Denise Chew ◽

Jemma Anderson ◽

Katrina Williams ◽

Tamara May ◽

Kenneth Pang

Keyword(s):

Systematic Review ◽

Young People ◽

Gender Dysphoria ◽

Hormonal Treatment

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Internalizing and Externalizing Behaviors in a Group of Young People with Gender Dysphoria

International Journal of Transgenderism ◽

10.1080/15532739.2013.822340 ◽

2013 ◽

Vol 14 (3) ◽

pp. 105-112 ◽

Cited By ~ 14

Author(s):

Elin Skagerberg ◽

Sarah Davidson ◽

Polly Carmichael

Keyword(s):

Young People ◽

Gender Dysphoria ◽

Externalizing Behaviors ◽

Internalizing And Externalizing Behaviors ◽

Internalizing And Externalizing

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Perspectives on fertility preservation and parenthood among transgender youth and their parents

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-316080 ◽

2019 ◽

Vol 104 (8) ◽

pp. 739-744 ◽

Cited By ~ 11

Author(s):

Lyne Noelle Chiniara ◽

Christine Viner ◽

Mark Palmert ◽

Herbert Bonifacio

Keyword(s):

Young People ◽

Fertility Preservation ◽

Gender Dysphoria ◽

Good Health ◽

Large Majority ◽

Cross Sectional ◽

Alternative Strategies ◽

Biological Child ◽

Future Fertility ◽

Over Time

ObjectiveThe aim of this study was to investigate the views of young people (YP) with gender dysphoria and their parents concerning fertility preservation and reproductive and life priorities.DesignA cross-sectional questionnaire-based study assessed knowledge of potential effects of treatments for gender dysphoria on fertility, current and future life priorities and preferences regarding future fertility/parenting options among YP and parents.ResultsA total of 79 YP (81% assigned female at birth [AFAB], 19% assigned male at birth [AMAB], aged 12–18 years, 68% between ages 16 years and 18 years) and 73 parents participated. The top current life priority for YP among eight options was being in good health; the least important priority was having children. Anticipated life priorities 10 years from now were ranked similarly. Parents’ rankings paralleled the YP responses; however, parents ranked having children as a significantly higher priority for AFAB compared with AMAB YP in 10 years. The majority of YP (66% AFAB, 67% AMAB) want to be a parent in the future. However, most do not envision having a biological child. A large majority (72% AFAB, 80% AMAB) were open to adoption. None of the YP surveyed pursued fertility preservation.ConclusionFertility is a low current and future life priority for transgender YP. The majority of YP wish to become parents but are open to alternative strategies for building a family. These data may explain in part the reported low rates of fertility preservation among this population. Further studies are needed to assess if life priorities change over time.

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Levels of physical activity and barriers to sport participation in young people with gender dysphoria

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0007 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Misha Gilani ◽

Peri Wallach ◽

Andreas Kyriakou

Keyword(s):

Physical Activity ◽

Young People ◽

Gender Dysphoria ◽

Sport Participation ◽

Gnrh Analogue ◽

Societal Change ◽

Paediatric Endocrinology ◽

High Motivation ◽

Gonadotrophin Releasing Hormone ◽

Motivation Level

Abstract Objectives To determine the levels of physical activity (PA) in young people with gender dysphoria (GD) and help identify factors which deter participation. Methods Fifty-six young people who attended paediatric endocrinology because of GD, June to October 2019, and were on treatment with gonadotrophin-releasing hormone (GnRH) analogue were approached to participate in a survey. Results A total of 55 young people (98%) responded to the survey. Thirty-eight (69%) participated in PA for >1 h/week. Thirty-two (58%) reported high motivation level for exercise. Those had median age of 15.9 years (10.7, 18.7) at the time of survey, and 13.6 years (9.7, 17.6) at start of GnRH analogue compared to 16.7 years (13.9, 18.5) (p, 0.047) and 15.4 years (11.2, 18.0) (p, 0.009) of the 23 (42%) who reported low motivation. Forty-one (74.5%) reported barriers when accessing PA, such as not being as good as others (75%), revealing sports clothing (73%) and not satisfied with body image (47%). Those were older (16.4 years [10.9, 18.7] vs. 14.7 years [10.7, 18.4] [p, 0.011]) at the time of survey and at start of GnRH analogue (14.9 years [9.7, 18.0] vs. 12.5 years [10.6, 15.2] [p, 0.0001]) than those 14 (25.5%) who reported facing no barriers. Twelve (85.7%) of those reporting no barriers stated high motivation levels compared to 20 (48.8%) of those reporting barriers (p, 0.026). Conclusions Strategies aimed at improving participation are twofold: first to improve motivation, especially in post-pubertal young people, and secondly to achieve societal change to help eliminate barriers.

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