Rise in Referrals for Pediatric Transgender Care Underscores Growing Demand

By Reuters Staff

October 19, 2019

NEW YORK (Reuters Health) - Referrals for pediatric transgender and gender-nonconforming (TGNC) care nearly tripled from 2015 to 2018, researchers from a California transgender clinic report.

"Our findings highlight the growing demand for TGNC care and support the need for expanded and accessible health care services for this medically underserved population," Dr. Ted Handler of Kaiser Permanente Northern California in Oakland and colleagues write in Pediatrics, online October 16.

Most research on transgender individuals has focused on adults, Dr. Handler and his team note. The first-ever U.S. study of the demographics of pediatric TGNC patients was published in 2012.

The new study included 417 pediatric TGNC patients referred to the clinic between 2015 and 2018. Patients' median age at first referral was 15, and 73% were female at birth. Sixty-two percent of the patients identified as masculine, 24% as feminine and 13% as gender non-binary.

The number of referrals per year increased from 56 in 2015 to 154 in the first half of 2018, the authors found.

About one-third of referrals were for puberty suppression/cross-sex hormone treatment; 32% for gender-affirming surgery; 27% for mental health and 16% for other services. Among surgery referrals, 85% were for mastectomy and 10% were for vaginoplasty.

Two-thirds of the 50 patients aged 8 or younger had been referred for mental health services, while 15% sought help with legal name changes or other general resources.

Among the patients aged 9-13, 46% were referred for mental health services and 39% for puberty suppression or cross-sex hormone treatment. Adolescents aged 14 to 17 were most commonly referred for gender-affirming surgery (42%).

During the study period 89 patients underwent 104 gender-affirming surgeries, and 64% had at least one surgery before turning 18.

Other research has suggested that the number of referrals for pediatric TGNC care has risen in recent years, the authors note. "It is likely that as acceptance continues to progress and barriers to care are mitigated, the number of pediatric TGNC patients seeking transition-related care will grow."

They add, "Affirmative approaches to care that support a child's gender identity are essential because many mental health outcomes are likely tied to experiences of rejection and abuse. When children and adolescents are supported in their identity, mental health outcomes significantly improve."

SOURCE: https://bit.ly/2OVUjUM

Pediatrics 2019.