Psychological support, puberty suppression, and psychosocial functioning in adolescents with gender dysphoria
Open accessAbstract
Introduction: Puberty suppression by gonadotropin-releasing hormone analogs (GnRHa) is prescribed to relieve the distress associated with pubertal development in adolescents with gender dysphoria (GD) and thereby to provide space for further exploration. However, there are limited longitudinal studies on puberty suppression outcome in GD. Also, studies on the effects of psychological support on its own on GD adolescents' well-being have not been reported. Aim: This study aimed to assess GD adolescents' global functioning after psychological support and puberty suppression. Methods: Two hundred one GD adolescents were included in this study. In a longitudinal design we evaluated adolescents' global functioning every 6 months from the first visit. Main Outcome Measures: All adolescents completed the Utrecht Gender Dysphoria Scale (UGDS), a self-report measure of GD-related discomfort. We used the Children's Global Assessment Scale (CGAS) to assess the psychosocial functioning of adolescents. Results: At baseline, GD adolescents showed poor functioning with a CGAS mean score of 57.7 ± 12.3. GD adolescents' global functioning improved significantly after 6 months of psychological support (CGAS mean score: 60.7 ± 12.5; P < 0.001). Moreover, GD adolescents receiving also puberty suppression had significantly better psychosocial functioning after 12 months of GnRHa (67.4 ± 13.9) compared with when they had received only psychological support (60.9 ± 12.2, P = 0.001). Conclusion: Psychological support and puberty suppression were both associated with an improved global psychosocial functioning in GD adolescents. Both these interventions may be considered effective in the clinical management of psychosocial functioning difficulties in GD adolescents.
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Those receiving gender-affirming health care exhibit lower levels of anxiety, depression, and suicidal ideation.
“Recent studies have shown that those receiving gender-affirming health care exhibit lower levels of anxiety, depression, and suicidal ideation (13, 14)”
From Puberty Blocker, Leuprolide, Reduces Sex Differences in Rough-and-Tumble Play and Anxiety-like Behavior in Juvenile Rats (2024) · cites this paper as [13]
The CGAS at Follow-Up section reports improved psychosocial functioning among adolescents receiving psychological support and, for some, puberty suppression. The Discussion says the study assessed only a measure of psychosocial well-being; it does not establish lower levels of anxiety, depression, or suicidal ideation specifically. (LLM, conf=0.86)
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A Children's Global Assessment Scale (CGAS)
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Oliveira, G. D. F., Nguyen, A. T., Carreras-Simons, L., Niepsuj, T., Gadelhak, S. H., Johnson, A. K., Abdalla, A., Lev, E., Torres Román, S. G., Fuchs, S. N., et al. (2024) · Endocrinology · doi:10.1210/endocr/bqae046 · Cited by 5 · see citing works
- Authors
- Costa, R., Dunsford, M., Skagerberg, E., Holt, V., Carmichael, P., & Colizzi, M.
- Affiliations
- The Tavistock and Portman NHS Foundation Trust (GB)
- King's College London (GB)
- Corresponding author
- Costa, Rosalia
- ORCID
- Colizzi, Marco
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-11-01
- Volume
- 12
- Issue
- 11
- Pages
- 2206-2214
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- OpenAlex
- W2108321369
- Cited by
- 257
- References
- 1
- Citations by year
- 2026: 12 · 2025: 23 · 2024: 26 · 2023: 53 · 2022: 31 · 2021: 29 · 2020: 31 · 2019: 24 · 2018: 18 · 2017: 5 · 2016: 4 · 2015: 1
- FWCI
- 15.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Sexual Medicine (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (University of Udine) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
- Staff Publications Online (The Tavistock and Portman) (submittedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- gender dysphoria, puberty suppression, GnRH analogues, psychological support, psychosocial functioning, adolescents, global functioning, Children's Global Assessment Scale
- MeSH terms
- Gender Dysphoria, Adolescent, Adolescent Behavior, Counseling, Female, Gender Identity, Humans, Gonadotropin-Releasing Hormone, Longitudinal Studies, Male, Neuropsychological Tests, Puberty, Sexual Maturation, Transsexualism, Adolescent Health Services, Prefrontal Cortex, Executive Function, Sex Reassignment Procedures, Gender-Affirming Procedures
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