Case 1: Clitoromegaly, Oligomenorrhea, and Hirsutism in a 17-Year-Old Transgender Male

September 2024 in “ Pediatrics in Review ”

Saira Ahmed, John M. Oberlin, Barbara Bowsher

clitoromegaly oligomenorrhea hirsutism hyperandrogenism testosterone androstenedione virilizing tumors nonclassical congenital adrenal hyperplasia gender-affirming hormone treatment GAHT

TLDR Parental support and gender-affirming care are crucial for the mental health of transgender adolescents.

A 17-year-old transgender male presented with clitoromegaly, oligomenorrhea, and hirsutism, showing signs of hyperandrogenism despite not receiving gender-affirming hormone treatment (GAHT) due to parental non-acceptance. Elevated testosterone and androstenedione levels were noted, and tests ruled out virilizing tumors and nonclassical congenital adrenal hyperplasia. The case highlights the importance of parental support and ethical considerations in providing GAHT to minors, advising the patient to seek GAHT from a qualified physician and wait until age 18 for further treatment. Gender-affirming care is crucial for improving mental health outcomes in gender-diverse adolescents.

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