First name
Linda
Middle name
A
Last name
Hawkins

Title

Transgender Youth Experiences with Implantable GnRH Agonists for Puberty Suppression.

Year of Publication

2022

Number of Pages

364-368

Date Published

08/2022

ISSN Number

2688-4887

Abstract

This descriptive study reports caregiver experiences with GnRH agonist implants among a cohort of youth followed in a pediatric hospital-based gender clinic. We administered a survey to 36 of 55 eligible caregivers ascertaining demographics and satisfaction, with a medical record review of any surgical complications. The overwhelming majority (97.1%) reported satisfaction with the procedure and would undergo the implant procedure again (94.4%). The most frequent challenges noted were about affordability (39.8%) and insurance denials (39.8%). Implantable GnRH agonist can be used successfully in pediatric patients with gender dysphoria. Future policy should seek to address concerns regarding insurance approval and reimbursement.

DOI

10.1089/trgh.2021.0006

Alternate Title

Transgend Health

PMID

36033209
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Title

Experience of Chest Dysphoria and Masculinizing Chest Surgery in Transmasculine Youth.

Year of Publication

2021

Number of Pages

Date Published

2021 Feb 03

ISSN Number

1098-4275

Abstract

<p><strong>OBJECTIVES: </strong>Transmasculine individuals, those assigned female sex at birth but who identify as masculine, have high rates of suicidal behavior and often suffer from chest dysphoria (discomfort and distress from unwanted breast development). Growing numbers of transmasculine youth are pursuing definitive treatment with masculinizing chest surgery (MCS), and adult studies reveal marked benefits of MCS, although little is known about the impact of chest dysphoria on transmasculine youth or the optimal timing of MCS. In this study, we aimed to explore youth experiences of chest dysphoria and the impact of MCS.</p>

<p><strong>METHODS: </strong>Transmasculine youth aged 13 to 21 were recruited from a pediatric hospital-based gender clinic. Participants completed a semistructured qualitative interview exploring the experience of chest dysphoria and thoughts about or experiences with MCS. Interview transcripts were coded by 3 investigators employing modified grounded theory, with the median interrater reliability at κ = 0.92.</p>

<p><strong>RESULTS: </strong>Subjects ( = 30) were a mean age of 17.5 years, and 47% had undergone MCS. Youth reported that chest dysphoria triggered strong negative emotions and suicidal ideation, caused a myriad of functional limitations, and was inadequately relieved by testosterone therapy alone. All post-MCS youth reported near or total resolution of chest dysphoria, lack of regret, and improved quality of life and functioning.</p>

<p><strong>CONCLUSIONS: </strong>We observed consensus that chest dysphoria is a major source of distress and can be functionally disabling to transmasculine youth. MCS performed during adolescence, including before age 18, can alleviate suffering and improve functioning. Additional research is needed to develop patient-reported outcome measures to assess the impact of chest dysphoria and MCS.</p>

DOI

10.1542/peds.2020-013300

Alternate Title

Pediatrics

PMID

33536330
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