Committee Opinion No. 685: Care for Transgender Adolescents.
Committee Opinion No. 685: Care for Transgender Adolescents.
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DOI：
10.1097/aog.0000000000001861
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发表时间：
2017-01-01
影响因子：
7.2
通讯作者：
中科院分区：
文献类型：
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性别不合格的年轻人是一个服务不足的人群，妇产科医生在他们的实践中越来越多地看到他们。目前，妇产科医生在跨性别患者的培训、知识和舒适度方面存在很大差距。本文件的目的是回顾当前适用于妇产科医生的建议。对于妇产科医生来说，了解跨性别人群的社会和心理健康风险非常重要。共识指南支持在青少年确诊跨性别身份并达到坦纳 II 期发展后开始药物治疗。医疗管理包括抑制青春期（通常以促性腺激素释放激素激动剂的形式），然后进行跨性别激素治疗，以在 16 岁时诱导青春期。有多种手术选择，包括双侧乳房切除术、子宫切除术加双侧输卵管卵巢切除术或输卵管切除术，以及可能的新阴茎创建术。跨性别患者是高危人群，预防医学对他们的健康至关重要。这包括适当筛查性传播感染、筛查自杀念头和心理健康问题以及适当的疫苗接种。与所有患者一样，跨性别青少年应该有持续的初级保健来源。
Gender nonconforming youth are an underserved population who obstetrician-gynecologists are seeing increasingly in their practices. Currently, there are large gaps in training, knowledge, and comfort with transgender patients among obstetrician-gynecologists. The purpose of this document is to review current recommendations that apply to an obstetrician-gynecologist. It is important for obstetrician-gynecologists to be aware of the social and mental health risks for the transgender population. Consensus guidelines support initiating medical therapy after an adolescent has an established diagnosis of transgender identity and has reached Tanner stage II development. Medical management involves the suppression of puberty (typically in the form of gonadotropin-releasing hormone agonists) followed by cross-sex hormone therapy to induce puberty at age 16 years. A variety of surgical options are available, including bilateral mastectomy, hysterectomy with bilateral salpingo-oophorectomy or salpingectomy, and possible neophallus creation. Transgender patients are an at-risk population, and preventive medicine is imperative to their health. This includes proper screening for sexually transmitted infections, screening for suicidal thoughts and mental health issues, and appropriate vaccination. Like all patients, transgender adolescents should have a source for ongoing primary care.