Progression of Gender Dysphoria in Children and Adolescents: A Longitudinal Study.
Progression of Gender Dysphoria in Children and Adolescents: A Longitudinal Study.
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DOI：
10.1542/peds.2020-027722
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发表时间：
2021-07
期刊：
影响因子：
8
通讯作者：
Goodman M
中科院分区：
文献类型：
--
作者：
Wagner S;Panagiotakopoulos L;Nash R;Bradlyn A;Getahun D;Lash TL;Roblin D;Silverberg MJ;Tangpricha V;Vupputuri S;Goodman M
儿童和青少年的性别扩张行为发展到性别焦虑和性别肯定激素治疗（GAHT）的进展知之甚少。确定了一个由958名性别多样性（GD）儿童和青少年组成的队列，这些儿童和青少年在索引时没有性别焦虑相关诊断（GDRD）或GAHT。在不同人口统计学组中比较了首次GDRD和首次GAHT处方的发生率。总体而言，在平均3.5年（最长9年）的随访期间，29%的参与者接受了GDRD，25%的参与者接受了GAHT。与出生时指定为男性的青年相比，出生时指定为女性的青年更有可能接受诊断并启动GAHT，风险比（95%置信区间）估计值分别为1.3（1.0-1.7）和2.5（1.8-3.3）。与10 - 14岁和3 - 9岁的患者相比，首次就诊时年龄≥15岁的患者中进展至诊断更常见（分别为37% vs 28% vs 16%）。通过使用最年轻组作为参考，年龄10 - 14岁GDRD的校正风险比（95%置信区间）为2.0（1.3-3.0），年龄≥15岁为2.7（1.8-3.9）。种族和少数民族不太可能接受诊断或被开GAHT。这项研究的特点是GD行为在儿童和青少年的发展。不到三分之一的GD青年最终获得GDRD，大约四分之一的人获得GAHT。出生时为女性、初次GD就诊年龄较大、非西班牙裔白色人种和种族增加了接受诊断和治疗的可能性。
The progression of gender-expansive behavior to gender dysphoria and to gender-affirming hormonal treatment (GAHT) in children and adolescents is poorly understood. A cohort of 958 gender-diverse (GD) children and adolescents who did not have a gender dysphoria–related diagnosis (GDRD) or GAHT at index were identified. Rates of first GDRD and first GAHT prescription were compared across demographic groups. Overall, 29% of participants received a GDRD and 25% were prescribed GAHT during the average follow-up of 3.5 years (maximum 9 years). Compared with youth assigned male sex at birth, those assigned female sex at birth were more likely to receive a diagnosis and initiate GAHT with hazard ratio (95% confidence interval) estimates of 1.3 (1.0–1.7), and 2.5 (1.8–3.3), respectively. A progression to diagnosis was more common among those aged ≥15 years at initial presentation compared with those aged 10 to 14 years and those aged 3 to 9 years (37% vs 28% vs 16%, respectively). By using the youngest group as a reference, the adjusted hazard ratios (95% confidence interval) for a GDRD were 2.0 (1.3–3.0) for age 10 to 14 years and 2.7 (1.8–3.9) for age ≥15 years. Racial and ethnic minorities were less likely to receive a diagnosis or be prescribed GAHT. This study characterized the progression of GD behavior in children and adolescents. Less than one-third of GD youth receive an eventual GDRD, and approximately one-quarter receive GAHT. Female sex at birth, older age of initial GD presentation to medical care, and non-Hispanic white race and ethnicity increased the likelihood of receiving diagnosis and treatment.
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影响因子：
2.6
作者：
de Vries, Annelou L. C.;Cohen-Kettenis, Peggy T.
通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
3
作者：
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通讯作者：
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影响因子：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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