In this month’s Pediatrics, the Trans Youth CAN! Research Team report the results of a prospective observational study of pubertal and postpubertal adolescents with gender dysphoria <16 years of age who presented for gender-affirming hormone treatment (10.1542/peds.2020-047266). This study provides valuable descriptive data and serves as basis for future research.
One of its key strengths is that it includes all major clinics providing hormonal suppression or hormones in Canada during the study period. Of the 174 adolescents who participated, 75.8% identified as male, 15.9% as female, and 8.3% as nonbinary which is consistent with recent trends. The results reinforce the mental health burden borne by this population: 19.3% screened positive for depression and 16.8% reported a suicide attempt in the past year. Data regarding presentation and treatment are interesting relative to the debates regarding “rapid onset gender dysphoria” and accusations of overtreatment: 85.7% reported being aware of gender issues for 2 or more years and 62.4% were prescribed medications at the initial visit. The results regarding the time since participants were first aware of gender issues combined with the finding that 69% of participants were 14-15 years old suggests the need for improved screening and earlier referral as 14-15-year-olds are likely to have completed puberty and therefore less likely to benefit from pubertal suppression.
Reports from the group regarding the cohort over time will hopefully make significant additional contributions to the literature.