Medical Management of the Adolescent Individual with Gender Dysphoria

Medical transition for gender expansive adolescents seeks to alleviate distress of undesired physical changes of puberty, prevent irreversible physical changes, and induce desired physical characteristics. Puberty and adrenarche occur in adolescents as a physiologic process of activation of the gonads and adrenal glands. Gonadotropin-releasing hormone agonists are a reversible medication used to “block” pubertal development and are initiated at Tanner Stage 2 or later. Subsequently treatment with gender-affirming hormones induces physical changes of the affirmed gender, and it is often helpful to continue pubertal suppression while giving gender affirming hormones. The medical care of gender non-conforming and transgender youth is a field in evolution as we learn more about the physical, mental, and psychosocial needs of this population. Further study of the long-term effects of these treatments is needed.