A systematic overview of the effects of hormonal therapy for gender dysphoria in young men

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The study found that there is a lack of knowledge about hormone therapy and mental health in young people. With regard to skeletal effects, GnRHa treatment slows bone maturation and bone mineralization. However, when a young person receives estrogen or testosterone to change the body in the direction of gender identity, the skeletal system appears to partially recover.

“Our work is important not only because cases of gender dysphoria in young people have increased over a short period of time, but also because the characteristics of the patient cohort have changed. We don’t know what the normal progression is for these children. Studies must first show the extent to which gender dysphoria resolves spontaneously In adolescents who did not display gender-contradictory behavior in childhood.If predictors of persistent gender dysphoria can be found, the second step would be to conduct clinical trials to evaluate the positive and negative effects of hormone therapy.It is important that such studies should follow patients for many years says the final author of the study, Professor Mikael Landen at the Karolinska Institutet and the University of Gothenburg. “In light of the nearly non-existent long-term data, we conclude that GnRHa treatment for children with gender dysphoria should be considered an experimental treatment rather than a routine treatment. This means that treatment should only be offered in the context of a clinical trial with informed consent.”

“Previous studies in the region had obvious shortcomings and long-term studies were usually small with high dropout rates.” says Ludwigson. For this reason, we have also developed a checklist to raise the quality of research in the treatment of gender dysphoria: the GENDHOR Checklist. We hope it will simplify and improve research in this area.”

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The GENDHOR checklist is in the manuscript

financing

SBU, State Committee for Medical and Social Evaluation

Conflict of interest

Dr Ludvigsson coordinated a study commissioned by the Swedish IBD Quality Registry (SWIBREG). This study received funding from Janssen Corporation. The JFL has received funding from Merck Sharp & Dohme to study Chinese records. The JFL is currently discussing a celiac disease collaboration with Takeda. Dr. Landen received a fee for giving lectures on pharmaceuticals at Lundbeck.

communication
Mikael Landen, Professor, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet and University of Gothenburg
Email: [email protected] or [email protected]

Publishing

Systematic review of hormonal therapy for children with gender dysphoria and recommendations for research.
Ludvigsson JF, Adolfsson J, Höistad M, Rydelius PA, Kriström B, Landén M
Acta Pediatric 2023 18th Apr.