Gender diversity in adolescents with polycystic ovary syndrome.
Gender diversity in adolescents with polycystic ovary syndrome.
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DOI：
10.1515/jpem-2022-0249
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发表时间：
2022-11-25
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影响因子：
--
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我们的研究目的是描述多囊卵巢综合征（PCOS）青少年中性别多样（GD）的患病率。我们对符合多学科青少年PCOS项目（MAPP）中NIH PCOS标准的患者进行了回顾性病历审查。我们比较了PCOS患者与不符合PCOS标准的MAPP患者以及来自青少年专科诊所（ASC）的非PCOS患者。分析的变量包括性别认同、雄激素水平、多毛症评分和情绪障碍。我们使用卡方检验、Fisher精确检验、t检验和Wilcoxon秩和检验来比较各组。将自我报告为男性、液体/两者或非二元性别的性别身份汇总至GD类别。在MAPP中，7.6%（n=12）的PCOS青年自认为是GD，而非PCOS青年为1.8%（n=3）（p=0.01，卡方）。当与ASC的非PCOS GD青少年（4.4%; n=3）相比时，与PCOS青少年的差异不再显著（p=0.56）。在MAPP患者中，性别多样性与较高的多毛症评分相关（p<0.01），但与较高的雄激素水平无关。在PCOS中，GD青年的抑郁/焦虑高于顺性别青年（分别为100% vs. 37.6%，p<0.01和77.8% vs. 35.8%，p=0.03）。在符合PCOS标准的人群中，性别多样性更为常见。PCOS GD青年更多毛，并报告更多的抑郁/焦虑。在综合性青少年PCOS项目中对性别认同差异进行常规筛查可能会使这些患者受益，因为可能需要替代治疗方法来支持跨男性身份。
The objective of our study was to describe the prevalence of gender diverse (GD) youth among adolescents with polycystic ovary syndrome (PCOS). We conducted a retrospective chart review on patients who met NIH criteria for PCOS in our Multidisciplinary Adolescent PCOS Program (MAPP). We compared those with PCOS to MAPP patients who did not meet PCOS criteria as well as to non-PCOS patients from the Adolescent Specialty Clinic (ASC). Variables analyzed included gender identity, androgen levels, hirsutism scores, and mood disorders. We used chi-square, Fisher’s exact, t-tests, and Wilcoxon rank sum tests to compare groups. Gender identities self-reported as male, fluid/both or nonbinary were pooled into the GD category. Within the MAPP, 7.6% (n=12) of PCOS youth self-identified as GD compared to 1.8% (n=3) of non PCOS youth (p=0.01, chi-square). When compared to non-PCOS GD adolescents from ASC (4.4%; n=3), the difference to PCOS youth was no longer significant (p=0.56). Among MAPP patients, gender diversity was associated with higher hirsutism scores (p<0.01), but not higher androgen levels. In PCOS, depression/anxiety was higher in GD vs cisgender youth (100% vs. 37.6%, p<0.01 and 77.8% vs. 35.8%, p=0.03 respectively). Gender diversity was observed more commonly in those meeting PCOS criteria. PCOS GD youth were more hirsute and reported more depression/anxiety. Routine screening for differences in gender identity in comprehensive adolescent PCOS programs could benefit these patients, as alternate treatment approaches may be desired to support a transmasculine identity.
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