Abstract
During the last 10 years, the Dutch protocol that comprises medical intervention in the management of gender dysphoria in adolescents has appeared to be safe and efficient. Using GnRH analogs, physiologic pubertal development is suppressed. From the age of 16 years, cross-sex steroids are added to the GnRH analog to induce the pubertal sex characteristics of the desired sex.
Side effects of the GnRH analog treatment are conceivable in the areas of growth, bone development, metabolism, and brain development. Up until now, however, we have not observed major side effects. On the contrary, with respect to growth, when medical intervention is started early in puberty, we are able to manipulate growth in a way that final adult height is more appropriate for the desired sex.
Currently, before the treatment is started to suppress puberty (with GnRH analogs) or to induce puberty (with cross-sex hormones), the treatment guidelines suggest to medical professionals that adolescents should have reached a certain pubertal stage, as well as a certain age. Because of the current positive outcomes, protocols may permit an earlier start to puberty suppression and induction of cross-sex secondary sex characteristics. This would result in a more typically timed physiologic pubertal development in adolescents with gender dysphoria.
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de Waal, H.A.Dv. (2014). Early Medical Intervention in Adolescents with Gender Dysphoria. In: Kreukels, B., Steensma, T., de Vries, A. (eds) Gender Dysphoria and Disorders of Sex Development. Focus on Sexuality Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-7441-8_10
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DOI: https://doi.org/10.1007/978-1-4614-7441-8_10
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