J Clin Res Pediatr Endocrinol. Ahead of Print: JCRPE-96158 | DOI: 10.4274/jcrpe.galenos.2023.2023-1-13

Endocrinological Approach to Adolescents with Gender Dysphoria: Experience of a Pediatric Endocrinology Department in a Tertiary Center in Turkey

Esin Karakilic Ozturan¹, Ayse Pinar Ozturk¹, Firdevs Bas¹, Ayse Burcu Erdogdu², Seven Kaptan³, Asli Derya Kardelen Al¹, Sukran Poyrazoglu¹, Melek Yýldýz¹, Neþe Direk⁴, Sahika Yuksel⁵, Feyza Darendeliler^1
1Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit
²Marmara University Pendik Training and Research Hospital, Department of Child and Adolescent Psychiatry Unit
³Psychiatrists in Private Practice
⁴Istanbul University, Istanbul Faculty of Medicine, Department of Psychiatry
⁵Istanbul University, Istanbul Faculty of Medicine, Department of Psychiatry, Emeritus Professor, Psychiatrist in Private Practice

INTRODUCTION: Objective: A significant rise in the number of trans adolescents seeking medical interventions has been reported in recent years. In this study, we aimed to report the clinical features, treatment, and follow-up of adolescents with gender dysphoria (GD) with our increased experience.
METHODS: Methods: Twenty-six male-to-female (MTF) and twenty-seven female-to-male (FTM) adolescents who were referred to our GD-outpatient clinic between the years 2016 and 2022 were reviewed. The clinical and laboratory findings of thirty transgender adolescents (15FTM /15 MTF) who received medical intervention were evaluated retrospectively.
RESULTS: Results: The vast majority of individuals (60.4%) were admitted between 2020 and 2022, and the remaining (39.6%) were admitted between 2016 and 2019. At the referral time, median age was 16.3 years (IQR,1.53; range, 13.2-19.4) in 26 MTF, and 16.4 years (IQR,1.74; range, 11.7-21.6) in 27 FTM adolescents. The median age of the pubertal blockage with gonadotropin-releasing hormone analog (GnRHa) and androgen receptor blocker was 16.4 years (IQR,1.4; range, 11.7- 17.8) in 22 adolescents (9 MTF,13 FTM), and 17.4 years (IQR,1.4; range, 15.5-19.4) in 6 MTF individuals, respectively. The cross-sex hormone therapy (CSH) was commenced in 21 adolescents (12 MTF, 9 FTM) at the median age of 17.7 years (IQR,0.61; range,16-19.5). Fifteen individuals (8 MTF, 7 FTM) have been transferred to the adult endocrinology department in transition clinics.
DISCUSSION AND CONCLUSION: Conclusion: All treatments were well tolerated and effective including bicalutamide, no side effects were observed. Besides, transition clinics play an important role in the better management of gender reassignment processes.

Keywords: Transgender, gender reassignment, gonadotropin-releasing hormone treatment, bicalutamide, cross-sex hormone, transition, multidisciplinary followup

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