Clinical profiles and care of transgender children and adolescents who receive specialized consultations: do individuals who are assigned female at birth differ?

Abstract Context Clinical data on transgender children and adolescents are scarce, and sample sizes often do not allow for comparisons according to sex assigned at birth. Besides, most gender identity clinics have pointed to a recent switch in favor of an increase in the number of adolescents assign...

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Main Authors: Chystelle Lagrange, Nina Verger, Julie Brunelle, Fanny Poirier, Hugues Pellerin, Nicolas Mendes, Gregor Mamou, Nifoular Forno, Laetitia Martinerie, David Cohen, Agnès Condat
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Child and Adolescent Psychiatry and Mental Health
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Online Access:https://doi.org/10.1186/s13034-024-00809-w
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author Chystelle Lagrange
Nina Verger
Julie Brunelle
Fanny Poirier
Hugues Pellerin
Nicolas Mendes
Gregor Mamou
Nifoular Forno
Laetitia Martinerie
David Cohen
Agnès Condat
author_facet Chystelle Lagrange
Nina Verger
Julie Brunelle
Fanny Poirier
Hugues Pellerin
Nicolas Mendes
Gregor Mamou
Nifoular Forno
Laetitia Martinerie
David Cohen
Agnès Condat
author_sort Chystelle Lagrange
collection DOAJ
description Abstract Context Clinical data on transgender children and adolescents are scarce, and sample sizes often do not allow for comparisons according to sex assigned at birth. Besides, most gender identity clinics have pointed to a recent switch in favor of an increase in the number of adolescents assigned females at birth (AFAB) over assigned males at birth (AMAB). Method We collected data on sociodemographic characteristics, and psychiatric and social vulnerabilities according to sex assigned at birth for all youths who were treated at the French largest gender identity clinic. In addition, management modalities for gender transition were discussed in multidisciplinary concertation meetings. Results We collected data from 239 youths [162(68%) AFAB, 74(32%) AMAB, and 3(1%) intersex; mean age = 14.5(± 3.16) years]. The distribution of age at referral was better explained by two clusters (C1: N = 61, mean age = 11.3 years, with more AMAB; C2: N = 175, mean age = 15.9 years with more AFAB). 215(91%) youths had gender incongruence, with 32% reporting it before puberty. School drop-out, suicidality, depression, and anxiety were common and occurred significantly more often in the AFAB group. 178(74%) youths experienced social transition within the family, and 144(61%) at school [mean age = 15.13(± 2.06) years]. The social transition was more frequent in the AFAB group. Twenty-six (11%) youths received puberty blockers [mean age = 13.87(± 2.31) years], and 105(44%) received gender-affirming hormones [mean age = 16.87(± 1.4) years]. AMABs were more likely to take puberty blockers, and there was no difference in the proportion of AMAB and AFAB taking gender-affirming hormones. Surgical requests (mainly torsoplasty) were very rare. Conclusion Age at referral should be considered when exploring gender incongruence. During adolescence, we found that gender incongruence has substantial social and psychological effects, particularly on AFAB youths, possibly explaining their higher referral rates to specialized centers, as in other specialized clinics around the world.
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spelling doaj-art-a569841f3cda4e5bae23c4aee60d5e772025-08-20T02:49:56ZengBMCChild and Adolescent Psychiatry and Mental Health1753-20002024-11-0118111110.1186/s13034-024-00809-wClinical profiles and care of transgender children and adolescents who receive specialized consultations: do individuals who are assigned female at birth differ?Chystelle Lagrange0Nina Verger1Julie Brunelle2Fanny Poirier3Hugues Pellerin4Nicolas Mendes5Gregor Mamou6Nifoular Forno7Laetitia Martinerie8David Cohen9Agnès Condat10Service de Psychiatrie de l’Enfant et de l’Adolescent, APHP.SU, Sorbonne Université, Groupe Hospitalier Pitié-SalpêtrièreService de Psychiatrie de l’Enfant et de l’Adolescent, APHP.SU, Sorbonne Université, Groupe Hospitalier Pitié-SalpêtrièreService de Psychiatrie de l’Enfant et de l’Adolescent, APHP.SU, Sorbonne Université, Groupe Hospitalier Pitié-SalpêtrièreService de Psychiatrie de l’Enfant et de l’Adolescent, APHP.SU, Sorbonne Université, Groupe Hospitalier Pitié-SalpêtrièreService de Psychiatrie de l’Enfant et de l’Adolescent, APHP.SU, Sorbonne Université, Groupe Hospitalier Pitié-SalpêtrièreService de Psychiatrie de l’Enfant et de l’Adolescent, APHP.SU, Sorbonne Université, Groupe Hospitalier Pitié-SalpêtrièreService de Psychiatrie de l’Enfant et de l’Adolescent, APHP.SU, Sorbonne Université, Groupe Hospitalier Pitié-SalpêtrièreService de Psychiatrie de l’Enfant et de l’Adolescent, APHP.SU, Sorbonne Université, Groupe Hospitalier Pitié-SalpêtrièreRéseau Trajectoire Trans d’Ile de France, APHPService de Psychiatrie de l’Enfant et de l’Adolescent, APHP.SU, Sorbonne Université, Groupe Hospitalier Pitié-SalpêtrièreService de Psychiatrie de l’Enfant et de l’Adolescent, APHP.SU, Sorbonne Université, Groupe Hospitalier Pitié-SalpêtrièreAbstract Context Clinical data on transgender children and adolescents are scarce, and sample sizes often do not allow for comparisons according to sex assigned at birth. Besides, most gender identity clinics have pointed to a recent switch in favor of an increase in the number of adolescents assigned females at birth (AFAB) over assigned males at birth (AMAB). Method We collected data on sociodemographic characteristics, and psychiatric and social vulnerabilities according to sex assigned at birth for all youths who were treated at the French largest gender identity clinic. In addition, management modalities for gender transition were discussed in multidisciplinary concertation meetings. Results We collected data from 239 youths [162(68%) AFAB, 74(32%) AMAB, and 3(1%) intersex; mean age = 14.5(± 3.16) years]. The distribution of age at referral was better explained by two clusters (C1: N = 61, mean age = 11.3 years, with more AMAB; C2: N = 175, mean age = 15.9 years with more AFAB). 215(91%) youths had gender incongruence, with 32% reporting it before puberty. School drop-out, suicidality, depression, and anxiety were common and occurred significantly more often in the AFAB group. 178(74%) youths experienced social transition within the family, and 144(61%) at school [mean age = 15.13(± 2.06) years]. The social transition was more frequent in the AFAB group. Twenty-six (11%) youths received puberty blockers [mean age = 13.87(± 2.31) years], and 105(44%) received gender-affirming hormones [mean age = 16.87(± 1.4) years]. AMABs were more likely to take puberty blockers, and there was no difference in the proportion of AMAB and AFAB taking gender-affirming hormones. Surgical requests (mainly torsoplasty) were very rare. Conclusion Age at referral should be considered when exploring gender incongruence. During adolescence, we found that gender incongruence has substantial social and psychological effects, particularly on AFAB youths, possibly explaining their higher referral rates to specialized centers, as in other specialized clinics around the world.https://doi.org/10.1186/s13034-024-00809-wGender incongruenceGender dysphoriaComorbidityChildhoodAdolescenceTreatment
spellingShingle Chystelle Lagrange
Nina Verger
Julie Brunelle
Fanny Poirier
Hugues Pellerin
Nicolas Mendes
Gregor Mamou
Nifoular Forno
Laetitia Martinerie
David Cohen
Agnès Condat
Clinical profiles and care of transgender children and adolescents who receive specialized consultations: do individuals who are assigned female at birth differ?
Child and Adolescent Psychiatry and Mental Health
Gender incongruence
Gender dysphoria
Comorbidity
Childhood
Adolescence
Treatment
title Clinical profiles and care of transgender children and adolescents who receive specialized consultations: do individuals who are assigned female at birth differ?
title_full Clinical profiles and care of transgender children and adolescents who receive specialized consultations: do individuals who are assigned female at birth differ?
title_fullStr Clinical profiles and care of transgender children and adolescents who receive specialized consultations: do individuals who are assigned female at birth differ?
title_full_unstemmed Clinical profiles and care of transgender children and adolescents who receive specialized consultations: do individuals who are assigned female at birth differ?
title_short Clinical profiles and care of transgender children and adolescents who receive specialized consultations: do individuals who are assigned female at birth differ?
title_sort clinical profiles and care of transgender children and adolescents who receive specialized consultations do individuals who are assigned female at birth differ
topic Gender incongruence
Gender dysphoria
Comorbidity
Childhood
Adolescence
Treatment
url https://doi.org/10.1186/s13034-024-00809-w
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