Overview
Gender dysphoria involves significant distress related to a mismatch between a person's sex assigned at birth and their experienced gender identity, affecting individuals across adolescence and adulthood 1.Diagnosis
Presence of persistent discomfort with one's assigned gender
Strong identification with another gender
Desire for changing primary and/or secondary sex characteristics 1
No specific recommended diagnostic tests; clinical assessment is key 1Management
Psychotherapeutic support, including gender-affirming psychotherapy 1
Hormonal therapy:
- For adolescents: GnRH analogues followed by gender-affirming hormones (e.g., testosterone for transgender males, estrogen for transgender females) 1
- For adults: Initiation of gender-affirming hormones based on individual assessment 1
Surgical interventions considered for those who desire and are appropriate candidates 1Special Populations
Pediatrics: Early intervention with multidisciplinary support crucial; hormonal therapy typically initiated under strict medical supervision post-pubertal suppression 1
Comorbidities: Addressing mental health conditions like depression and anxiety concurrently is essential 1Key Recommendations
Incorporate education on sexual and gender minorities into postgraduate medical training to improve competency and reduce health disparities (Evidence: Expert opinion) 1
Provide culturally competent care through comprehensive training, recognizing that positive attitudes alone are insufficient without adequate knowledge (Evidence: Expert opinion) 1
Offer multidisciplinary support including psychological counseling and gender-affirming medical interventions tailored to individual needs (Evidence: Expert opinion) 1References
1 Burcheri A, Coutin A, Bigham BL, Kruse MI, Lien K, Lim R et al.. Exploring a case for education about sexual and gender minorities in postgraduate emergency medicine training: forming recommendations for change. Postgraduate medicine 2023. link