• 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.

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