The Lancet Diabetes and Endocrinology, Volume 5, October 2017,
The World Professional Association for Transgender Health's standards of care recommend suspending puberty, preferably with the use of gonadotropin-releasing hormone agonists, in certain gender non-conforming minors (aged under 18 years) who have undergone a psychiatric assessment and have reached at least Tanner stage II of puberty. This approach seeks to lessen the discordance between assigned natal sex and gender identity by temporarily halting the development of secondary sexual characteristics, essentially widening the temporal window for gender clarification. Despite promising preliminary evidence on the clinical utility of this approach, there is a dearth of research to inform evidence-based practice. In view of these challenges, we review the available empirical evidence on the cognitive, physical, and surgical implications of puberty suppression in gender-incongruent children and adolescents. We also explore the historical underpinnings and clinical impetus for suspending puberty in this population, and propose key research priorities.
Adolescent; Agonists; Bone Development; Child; Clinical Decision Making; Cognitive Development; Comorbidity; Distress Syndrome; Drug Effect; Estradiol Cipionate; Estradiol Valerate; Face Surgery; Fear; Female; Female To Male Transgender; Fertility; Functional Disease; Gender Dysphoria; Gender Identity; Gonadorelin; Gonadorelin Agonist; Gonadotropin-Releasing Hormone; Hair Removal; Human; Humans; Hypothalamus Hypophysis Gonad System; Larynx Surgery; Life Satisfaction; Male; Male To Female Transgender; Mastectomy; Orchiectomy; Pathophysiology; Physical Appearance; Precocious Puberty; Prevalence; Priority Journal; Psychological Well-being; Psychology; Psychotherapy; Puberty; Review; Salpingooophorectomy; Sexual Counseling; Sexual Development; Social Competence; Social Interaction; Social Rejection; Spironolactone; Stigma; Testosterone; Transgender; Transgender Persons; Transsexualism; Treatment Outcome; Voice Change; Watchful Waiting; Global