Clinical Management of Youth with Gender Dysphoria in Vancouver

The retrospective chart review of 84 youth with gender dysphoria treated at BC Children's Hospital between 1998 and 2011 found that cross-sex hormones were prescribed to 75% of patients, with a median age at initiation of 17.3 years for FtM and 17.9 years for MtF individuals. Gonadotropin-releasing hormone analog (GnRHa) treatment was given to 32% of patients. Minor complications from testosterone treatment in FtM patients included severe acne, androgenic alopecia, dyslipidemia, and mood swings, but no severe complications were reported with either testosterone or estrogen treatment. Three FtM patients temporarily stopped hormone treatment due to psychiatric issues or distress over androgenic alopecia. The study noted a decrease in suicide attempts from 12% to 5% after clinic visits and suggested that early treatment with puberty blockers or cross-sex hormones could alleviate emotional problems and suicidality in transgender youth. However, it emphasized the need for long-term follow-up studies to assess the safety of these treatments.