Treatment
7
Treatment of Adolescents
➤ ES suggests that adolescents who meet diagnostic criteria for GD/GI,
fulfill criteria for treatment, and are requesting treatment should initially
undergo treatment to suppress pubertal development. (2|⊕⊕
)
➤ ES suggests that clinicians begin pubertal hormone suppression after girls
and boys first exhibit physical changes of puberty (Tanner stages G2/B2).
(2|⊕⊕
)
➤ ES recommends that, where indicated, GnRH analogues are used to
suppress pubertal hormones. (1|⊕⊕
)
➤ In adolescents who request sex hormone treatment (given this is a partly
irreversible treatment), ES recommends initiating treatment using a
gradually increasing dose schedule after a multidisciplinary team of
medical and MHPs has confirmed the persistence of GD/GI and sufficient
mental capacity to give informed consent, which most adolescents have by
age 16 years. (1|⊕⊕
).
➤ We recognize that there may be compelling reasons to initiate sex hormone
treatment prior to the age of 16 years in some adolescents with GD/GI,
even though there are minimal published studies of gender-affirming
hormone treatments administered before age 13.5–14 years. As with
the care of adolescents ≥16 years of age, ES recommends that an expert
multidisciplinary team of medical practitioners and MHPs manage this
treatment. (1|⊕
)
➤ ES suggests monitoring clinical pubertal development every 3–6 months
and laboratory parameters every 6–12 months during sex hormone
treatment. (2|⊕⊕
)
