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While an increasing number of teens identify as transgender, an badysis aims to help primary care physicians to take charge of this vulnerable group and its specific needs. The journal, published in CMAJ (Journal of the Canadian Medical Association), examines emerging evidence for the management of gender dysphoria, including social and medical approaches for youth in transition.
"[T]The brand of care will remain a thoughtful, badertive and well-reasoned individual approach that seeks to maximize support for this vulnerable population, as young people and their caregivers make complex and difficult decisions, "writes Dr. Joseph Bonifacio, Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, with co-authors.
Gender dysphoria is "the distress felt by an individual when his gender identity and gender attributed to birth are discordant". Although the exact figures are unknown, studies in other countries indicate that 1.2% to 4.1% of adolescents identify with a bad different from that at birth, a rate greater than that of the adult population.
A recent Canadian study found that less than half of transgender youth are comfortable discussing their health care needs with their family doctor.
"Ideally, the approach of gender dysphoria in young people articulates around collaborative decision-making between youth, family or guardians, and caregivers," writes the Dr. Bonifacio, with coauthors. "The voice of young people is always paramount."
The review follows the Endocrine Society's recommendation that drugs meant to suppress puberty, allowing young people to explore their evolving gender identity, should not be used until puberty.
"Some young people find that their dysphoria diminishes at the onset of puberty, hence the importance of letting the first changes in puberty occur," writes Dr. Bonifacio. "On the other hand, some young people may find that their gender dysphoria increases with puberty, thus corroborating their need for additional care."
As this is a relatively new area, there are gaps in the research base, such as the number of non-binary youth who identify men and women from outside and data on adolescents who ask for information. a surgical intervention. The authors also note that ethnocultural diversity is underrepresented in the populations studied and in their clinics in the greater city of Toronto and needs to be better understood.
"[A]Having access to optimal individualized care can be difficult for some populations, so it is important to help GPs strengthen their capacity to support young people with gender dysphoria and to liaise with other professions to support families, "write the authors.
The journal also includes quick reference boxes containing definitions, criteria for diagnosing gender dysphoria and resources for children, carers and clinicians.
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"Management of gender dysphoria in adolescents in primary care" is published on January 21, 2019
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