Diane Chen, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine
John F Strang, Children's National Medical Center, Washington, District of Columbia, George Washington University School of Medicine,
Victoria D Kolbuck, Ann & Robert H. Lurie Children's Hospital of Chicago
Stephen M Rosenthal, University of California San Francisco
Kim Wallen, Emory University
Deborah P Waber, Boston Children's Hospital, Harvard Medical School
Laurence Steinberg, Temple University
Cheryl L Sisk, Michigan State University
Judith Ross, Nemours duPont Hospital for Children, Thomas Jefferson UniversityFollow
Tomas Paus, Holland Bloorview Kids Rehabilitation Hospital, Toronto, University of Toronto, Ontario,
Sven C Mueller, Ghent University, University of Deusto, Bilbao
Margaret M McCarthy, University of Maryland School of Medicine,
Paul E Micevych, David Geffen School of Medicine at UCLA
Carol L Martin, Arizona State University
Baudewijntje P C Kreukels, Amsterdam UMC, Location VUmc, Department of Medical Psychology and Center of Expertise on Gender Dysphoria
Lauren Kenworthy, Children's National Medical Center, Washington, District of Columbia, George Washington University School of Medicine,
Megan M Herting, University of Southern California
Agneta Herlitz, Karolinska Institutet, Stockholm, Sweden.
Ira R J Hebold Haraldsen, Oslo University Hospital
Ronald Dahl, University of California, Berkeley
Eveline A Crone, Leiden University
Gordon J Chelune, University of Utah School of Medicine
Sarah M Burke, Leiden University
Sheri A Berenbaum, The Pennsylvania State University, University Park
Adriene M Beltz, University of Michigan, Ann Arbor
Julie Bakker, Liège University
Lise Eliot, Liège University
Eric Vilain, Children's National Medical Center, Washington, District of Columbia, George Washington University, Centre National de la Recherche Scientifique, Paris
Gregory L Wallace, George Washington University
Eric E Nelson, Nationwide Children's Hospital, Columbus, Ohio, The Ohio State University College of Medicine
Robert Garofalo, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine

Document Type

Article

Publication Date

12-2020

Comments

This is the final published article from Transgender Health, 2020 Dec 11;5(4):246-257.

The article can also be accessed at the journal's webpage: https://doi.org/10.1089/trgh.2020.0006

Copyright. The Authors.

Abstract

Purpose: Pubertal suppression is standard of care for early pubertal transgender youth to prevent the development of undesired and distressing secondary sex characteristics incongruent with gender identity. Preliminary evidence suggests pubertal suppression improves mental health functioning. Given the widespread changes in brain and cognition that occur during puberty, a critical question is whether this treatment impacts neurodevelopment.

Methods: A Delphi consensus procedure engaged 24 international experts in neurodevelopment, gender development, puberty/adolescence, neuroendocrinology, and statistics/psychometrics to identify priority research methodologies to address the empirical question: is pubertal suppression treatment associated with real-world neurocognitive sequelae? Recommended study approaches reaching 80% consensus were included in the consensus parameter.

Results: The Delphi procedure identified 160 initial expert recommendations, 44 of which ultimately achieved consensus. Consensus study design elements include the following: a minimum of three measurement time points, pubertal staging at baseline, statistical modeling of sex in analyses, use of analytic approaches that account for heterogeneity, and use of multiple comparison groups to minimize the limitations of any one group. Consensus study comparison groups include untreated transgender youth matched on pubertal stage, cisgender (i.e., gender congruent) youth matched on pubertal stage, and an independent sample from a large-scale youth development database. The consensus domains for assessment includes: mental health, executive function/cognitive control, and social awareness/functioning.

Conclusion: An international interdisciplinary team of experts achieved consensus around primary methods and domains for assessing neurodevelopmental effects (i.e., benefits and/or difficulties) of pubertal suppression treatment in transgender youth.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

33376803

Language

English

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