The DOI matches its Crossref record; 42 of the 42 references it cites were found in a registry or an index.
Early Medical Treatment of Children and Adolescents With Gender Dysphoria: An Empirical Ethical Study
Open accessAbstract
Purpose The Endocrine Society and the World Professional Association for Transgender Health published guidelines for the treatment of adolescents with gender dysphoria (GD). The guidelines recommend the use of gonadotropin-releasing hormone agonists in adolescence to suppress puberty. However, in actual practice, no consensus exists whether to use these early medical interventions. The aim of this study was to explicate the considerations of proponents and opponents of puberty suppression in GD to move forward the ethical debate. Methods Qualitative study (semi-structured interviews and open-ended questionnaires) to identify considerations of proponents and opponents of early treatment (pediatric endocrinologists, psychologists, psychiatrists, ethicists) of 17 treatment teams worldwide. Results Seven themes give rise to different, and even opposing, views on treatment: (1) the (non-)availability of an explanatory model for GD; (2) the nature of GD (normal variation, social construct or [mental] illness); (3) the role of physiological puberty in developing gender identity; (4) the role of comorbidity; (5) possible physical or psychological effects of (refraining from) early medical interventions; (6) child competence and decision making authority; and (7) the role of social context how GD is perceived. Strikingly, the guidelines are debated both for being too liberal and for being too limiting. Nevertheless, many treatment teams using the guidelines are exploring the possibility of lowering the current age limits. Conclusions As long as debate remains on these seven themes and only limited long-term data are available, there will be no consensus on treatment. Therefore, more systematic interdisciplinary and (worldwide) multicenter research is required.
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“For example, recent studies in rats indicate that while reproductive physiology and behavior are delayed with the usage of leuprolide acetate, these are later restored following cessation of the puberty blockade (7, 8).”
From Puberty Blocker, Leuprolide, Reduces Sex Differences in Rough-and-Tumble Play and Anxiety-like Behavior in Juvenile Rats (2024) · cites this paper as [8]
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“While pubertal development is paused using puberty blockers, studies indicate that pubertal development proceeds in a typical manner on withdrawal of puberty blockers.”
From Puberty Blocker, Leuprolide, Reduces Sex Differences in Rough-and-Tumble Play and Anxiety-like Behavior in Juvenile Rats (2024) · cites this paper as [8]
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Metadata
- Authors
- Vrouenraets, L. J. J. J., Fredriks, A. M., Hannema, S. E., Cohen-Kettenis, P. T., & de Vries, M. C.
- Affiliations
- Leiden University (NL)
- Leiden University Medical Center (NL)
- Corresponding author
- Vrouenraets, Lieke Josephina Jeanne Johanna
- Venue
- Journal of Adolescent Health
- Publisher
- Elsevier BV
- Published
- 2015-10
- Volume
- 57
- Issue
- 4
- Pages
- 367-373
- ISSN
- 1054-139X (ISSN-L)
- OpenAlex
- W1565459500
- Cited by
- 127
- References
- 42
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 6 · 2023: 28 · 2022: 13 · 2021: 13 · 2020: 16 · 2019: 12 · 2018: 12 · 2017: 8 · 2016: 4 · 2015: 2
- FWCI
- 14.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Adolescent Health (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Funders
- European Society for Paediatric Endocrinology
- Universiteit Leiden
- ZonMw (731010002)
- Leids Universitair Medisch Centrum
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Sexual Differentiation and Disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Ethics and Legal Issues in Pediatric Healthcare
- Keywords
- gender dysphoria, puberty suppression, GnRH agonist, early medical intervention, transgender youth, ethical considerations, treatment guidelines, child competence, gender identity development, comorbidities
- MeSH terms
- Child Health, Adolescent Health, Gender Dysphoria, Adolescent, Child, Female, Gender Identity, Humans, Gonadotropin-Releasing Hormone, Male, Puberty, Gonadal Steroid Hormones, Sexual Maturation, Practice Guidelines as Topic, Qualitative Research
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