PD20-03 GENDER-AFFIRMING CARE AND MENTAL HEALTH AMONG TRANSGENDER AND GENDER DIVERSE YOUTH

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD20-03 GENDER-AFFIRMING CARE AND MENTAL HEALTH AMONG TRANSGENDER AND GENDER DIVERSE YOUTH Helen Sun, Kirtishri Mishra, Jaime Abraham Perez, Regina M Casselberry, Kimberly Tay, Nicholas Sellke, Swagata Banik, and Shubham Gupta Helen SunHelen Sun More articles by this author , Kirtishri MishraKirtishri Mishra More articles by this author , Jaime Abraham PerezJaime Abraham Perez More articles by this author , Regina M CasselberryRegina M Casselberry More articles by this author , Kimberly TayKimberly Tay More articles by this author , Nicholas SellkeNicholas Sellke More articles by this author , Swagata BanikSwagata Banik More articles by this author , and Shubham GuptaShubham Gupta More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003286.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While a growing number of children and adolescents identify as transgender or gender diverse (TGD), little is known about TGD youth and current gender-affirming therapy (GAT). We aim to define the current demographic profile and treatments for TGD youth in the United States (US). We also aim to determine the burden of comorbid mental health disorders (MHD) and whether GAT affects suicidality. METHODS: TriNetX, a de-identified health research network with 70 health care organizations in the US from 2014 to the present, was accessed on August 4, 2022. All patients ≤17 years of age with a diagnosis of gender dysphoria (GD) were identified using ICD-10 codes. Patients were further categorized into cohorts with or without MHD. Clinical data including demographics, comorbidities, medications, surgeries, and documented suicide attempts (SA) were collected. Statistical analysis was done with independent t-tests or chi-square tests. RESULTS: A total of 18,938 youth with a diagnosis of GD were identified. A majority of patients were assigned female at birth (69.5%). Only 10.9% had received puberty suppression therapy (PST) and 13.8% received gender-affirming hormone therapy (HT) at time of analysis. Chest surgery or gonadectomy was documented in 510 (2.7%) patients; 38.2% had their first gender-affirming surgery (GAS) prior to adulthood. Most patients had a concurrent MHD diagnosis (70.7%), and the MHD group was older at diagnosis compared to the no MHD group (14.2 vs. 13.5 years, p<0.001). While there was no significant difference in time from GD diagnosis to start of PST between groups (214.1 vs. 244.3 days, p=0.079), patients in the MHD group took longer to start HT (359.9 vs 230.5 days, p<0.001) and to undergo first GAS (590.8 vs. 257.8 days, p<0.001). The MHD group was more likely to have SA before (3.9% vs. 0.6%, p<0.001) and after GD diagnosis (11.7% vs. 0.4%, p<0.001). SA events decreased after HT initiation compared to before HT initiation (6.4% vs. 8.1%, p<0.001), including for patients with SA prior to HT (37.3% vs. 62.7%, p<0.001). CONCLUSIONS: TGD youth suffer from a high incidence of MHD, which is associated with longer time to HT and GAS after diagnosis of GD. Overall surgical intervention is low for all TGD youth. Future study is needed to facilitate access to GAT among TGD youth to address the disproportionate mental health burden. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e584 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Helen Sun More articles by this author Kirtishri Mishra More articles by this author Jaime Abraham Perez More articles by this author Regina M Casselberry More articles by this author Kimberly Tay More articles by this author Nicholas Sellke More articles by this author Swagata Banik More articles by this author Shubham Gupta More articles by this author Expand All Advertisement PDF downloadLoading ...