What medical treatments can transgender youth receive?

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Gender-affirming therapies include hormones, surgery, and puberty blockers

In many states, transgender medical treatment for children or teens is being attacked. It has been called child abuse and can be criminalized. However, it is approved by major medical organizations and has been around for more than a decade.

A recent review by the British Psych Bulletin found that many clinics are using treatment plans first developed in Amsterdam thirty years ago. According to the review, the number youth who have been referred to gender clinics in the U.S., U.K., Canada, and Finland has increased tenfold since 2005.

Both the World Professional Association for Transgender Health (a professional and educational organization) and the Endocrine Society (which represents hormone specialists), have guidelines for this treatment. Here’s a look at what’s typically involved.

Specialty clinics that provide gender-confirming care are often recommended to children who continue to question the sex they were assigned at birth. Such care typically begins with a psychological evaluation to determine whether the children have “gender dysphoria,” or distress caused when gender identity doesn’t match a person’s assigned sex.

First, medication is given to children who meet the clinical guidelines. This temporarily stops puberty. This medication is for children with gender dysphoria diagnosed after they have been counseled by their families and are able to comprehend the treatment.

The medication isn’t started until youngsters show early signs of puberty — enlargement of breasts or testicles. This usually occurs between the ages of 8 and 13 for girls, and one to two years later for boys.

GnRH agonists block the brain’s release of key hormones that are involved in sexual maturation. They are used to treat precocious, a rare medical condition in which puberty begins abnormally early.

The drug can be administered as an injection once a month or as implants in the arms that last for a year. Their effects are reversible — puberty and sexual development resume as soon as the drugs are stopped.

Some kids continue taking them for years. One side effect is that they may lead to a decrease of bone density. This reverses once the drug is stopped.

Puberty blockers can be used to allow children to experience puberty but still identify as one of the genders or start treatment that will make their bodies more like their gender.

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