Abstract
Menstruation can be a source of significant distress for adolescents with gender dysphoria. While pubertal blockers are not recommended for adolescents who present with gender dysphoria after menarche, menstrual suppression represents an important aspect of their medical care. Levonorgestrel intrauterine devices (LNG IUDs) are associated with less uterine bleeding than any other reversible method of menstrual suppression and are well tolerated by adolescents. However, many adolescents with gender dysphoria have not had vaginal sex and are distressed by their female genitalia, potentially exacerbating pain and anxiety during the intravaginal LNG IUD insertion. We present our experience with 6 cases of LNG IUD use in such adolescents.
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