Hormonal Treatment in Young People With Gender Dysphoria: A Systematic Review
| Autor: | Tamara May, Ken C Pang, Denise Chew, Katrina Williams, Jemma Anderson |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Gender dysphoria
Male Adolescent Databases Factual medicine.drug_class Hormone Replacement Therapy Population Psychological intervention 030209 endocrinology & metabolism Context (language use) Antiandrogen 03 medical and health sciences Young Adult 0302 clinical medicine Hormone replacement therapy (female-to-male) Transgender Medicine Humans 030212 general & internal medicine education Gender Dysphoria education.field_of_study business.industry medicine.disease Treatment Outcome Pediatrics Perinatology and Child Health Female business Psychosocial Progestin Clinical psychology |
| Zdroj: | Pediatrics. 141(4) |
| ISSN: | 1098-4275 |
| Popis: | CONTEXT: Hormonal interventions are being increasingly used to treat young people with gender dysphoria, but their effects in this population have not been systematically reviewed before. OBJECTIVE: To review evidence for the physical, psychosocial, and cognitive effects of gonadotropin-releasing hormone analogs (GnRHa), gender-affirming hormones, antiandrogens, and progestins on transgender adolescents. DATA SOURCES: We searched Medline, Embase, and PubMed databases from January 1, 1946, to June 10, 2017. STUDY SELECTION: We selected primary studies in which researchers examined the hormonal treatment of transgender adolescents and assessed their psychosocial, cognitive, and/or physical effects. DATA EXTRACTION: Two authors independently screened studies for inclusion and extracted data from eligible articles using a standardized recording form. RESULTS: Thirteen studies met our inclusion criteria, in which researchers examined GnRHas (n = 9), estrogen (n = 3), testosterone (n = 5), antiandrogen (cyproterone acetate) (n = 1), and progestin (lynestrenol) (n = 1). Most treatments successfully achieved their intended physical effects, with GnRHas and cyproterone acetate suppressing sex hormones and estrogen or testosterone causing feminization or masculinization of secondary sex characteristics. GnRHa treatment was associated with improvement across multiple measures of psychological functioning but not gender dysphoria itself, whereas the psychosocial effects of gender-affirming hormones in transgender youth have not yet been adequately assessed. LIMITATIONS: There are few studies in this field and they have all been observational. CONCLUSIONS: Low-quality evidence suggests that hormonal treatments for transgender adolescents can achieve their intended physical effects, but evidence regarding their psychosocial and cognitive impact are generally lacking. Future research to address these knowledge gaps and improve understanding of the long-term effects of these treatments is required. |
| Databáze: | OpenAIRE |
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