Transgender adolescents and the gender-affirming interventions: Pubertal suppression, hormones, surgery, and other pharmacological interventions

For adolescents with gender dysphoria, puberty is an especially complicated time that may cause anxiety and distress, more so than what is typically experienced by cisgender adolescents. These physical and physiological changes can be addressed through medical interventions that are recognized by the World Professional Association of Transgender Health Standards of Care. Multidisciplinary teams that consist of psychologists, psychiatrists, pediatricians, social workers, advanced nurse specialists, and pediatric endocrinologists can guide families in the decision-making process around gender-affirming medical care. These exogenous interventions progress from most reversible to irreversible as an adolescent matures. This chapter aims to review pubertal stages for youth, to present the medical interventions recommended for adolescents who are experiencing gender dysphoria, and to comprehensively review the guidelines provided by the Endocrine Society and the World Professional Association for Transgender Health.