Treating Gender Dysphoria in Adolescents

Medically reviewed by Jennifer Richman on February 20, 2024. 

Gender dysphoria in adolescents is a serious medical concern that cannot be overlooked or ignored. Gender care for adolescents includes but is not limited to gender-affirming hormone therapy, pubertal hormone blockers, surgery, and psychosocial support. We are committed to fostering a community that is supportive of adolescent gender care. In this article, we give an overview of evidence-based gender-affirming healthcare options for adolescents and how surgery may fall into that.

Misconceptions:
Over the years, we have seen the spread of the scientifically baseless myth that gender-affirming care is not appropriate for adolescent patients who identify as transgender. Several misconceptions are fueled by limited understanding, misinformation, or biased beliefs. The risks and benefits of gender affirming mental health and medical care must be weighed in all patient populations, including adolescents. 

Evidence-Based Care:
Major medical organizations, including the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry, the Endocrine Society, the American Medical Association, the American Psychological Association and the American Psychiatric Association, agree that age-appropriate gender-affirming care is evidence-based and medically necessary. Data from more than a dozen studies of more than 30,000 transgender and gender-diverse young people, carried out over a decade, consistently show that access to gender-affirming care is associated with a reduction in rates of suicidality, depression and self-harming behavior. 

Providing Support:
We acknowledge that mental health risks may be severe for adolescents who are denied or delayed gender care. Adolescents and their parents or legal guardians should feel empowered to go through the informed consent process to make important decisions regarding the patient’s health and identity. A multidisciplinary approach including the opinions of the World Professional Association for Transgender Health (WPATH), mental health experts, and members of patients’ medical and psychological care teams has always been valued and utilized diligently at the GCC. 

While genital surgery is not available for minors in the United States, adolescents can consent to the surgical removal of breast tissue (“top surgery”) below the age of 18, providing they are able to fully understand the risks and benefits. To ensure the best outcomes for the patient, rigid protocols are in place which include consent from all legal guardians, as well as two letters from mental health professionals.

Conclusion:
It is crucial to understand that evidence-based gender-affirming care for adolescents involves providing comprehensive support and resources to help patients navigate their gender identity. The safety and well-being of the adolescent and family members are the primary priority. An individualized and multidisciplinary approach is essential in understanding their personal needs and providing the appropriate social, mental, and when necessary, medical or surgical interventions.