19 - Care of Transgender/Gender Nonconforming Youth

Abstract

Although advances in our understanding of transgender/gender nonconforming youth have been achieved, gaps in knowledge remain. Compelling studies have emerged supporting the concept that gender identity is not simply a psychosocial construct, but likely reflects a complex interplay of biologic, environmental, and cultural factors. Replacement of the term gender identity disorder with gender dysphoria in the Diagnostic and Statistical Manual of Mental Disorders-V underscores that a transgender identity, in and of itself, is no longer considered pathologic. Thus clinical concern should focus on the gender dysphoria that may be present, along with concomitant mental health challenges. The first long-term study, based on current models of care, indicates that mental health comorbidities in gender dysphoric youth diminish or resolve when such individuals are provided with gender-affirming treatment, optimally delivered in a multidisciplinary setting. Further prospective, long-term outcome studies are needed to optimize care for transgender/gender nonconforming youth.