Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment
BACKGROUND: In recent years, puberty suppression by means of gonadotropin releasing hormone analogs has become accepted in clinical management of adolescents who have gender dysphoria (GD) The current study is the first longer term longitudinal evaluation of the effectiveness of this approach. METHODS: A total of 55 young transgender adults (22 transwomen and 33 transmen) who had received puberty suppression during adolescence were assessed 3 times: before the start of puberty suppression (mean age, 13.6 years) when cross sex hormones were introduced (mean age, 16.7 years) and at least 1 year after gender reassignment surgery (mean age, 20.7 years) Psychological functioning (GD, body image, global functioning, depression, anxiety, emotional and behavioral problems) and objective (social and educational/professional functioning) and subjective (quality of life, satisfaction with life and happiness) well being were investigated. RESULTS: After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well being was similar to or better than same age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well being. CONCLUSIONS: A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, followed by cross sex hormones and gender reassignment surgery, provides gender dysphoric youth who seek gender reassignment from early puberty on, the opportunity to develop into well functioning young adults.
Pediatrics