Key Points
The prevalence of gender dysphoria is increasing, and all providers should be prepared to interact with transgender patients.
Gender-affirming care has been shown to improve health outcomes. The specific treatments recommended vary depending on age and developmental stage.
Pubertal suppression may be used for children at Tanner stages 2 to 4 to prevent unwanted pubertal changes and allow more time to evaluate goals.
Hormone therapy is partially irreversible and may be considered for teenagers with stable gender identity.
Surgery is typically deferred until adulthood, although masculinizing chest reconstruction may be pursued in adolescence.
Care through a multidisciplinary program may be optimal, but pediatricians have an important role in providing resources and psychosocial support and navigating family discussions.