• Annelou L C de Vries, Jenifer K McGuire, Thomas D Steensma, Eva C F Wagenaar, Theo A H Doreleijers, and Peggy T Cohen-Kettenis.
• Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, Netherlands; and alc.devries@vumc.nl.
• Pediatrics. 2014 Oct 1; 134 (4): 696-704.

BackgroundIn recent years, puberty suppression by means of gonadotropin-releasing hormone analogs has become accepted in clinical management of adolescents who have gender dysphoria (GD). The current study is the first longer-term longitudinal evaluation of the effectiveness of this approach.MethodsA total of 55 young transgender adults (22 transwomen and 33 transmen) who had received puberty suppression during adolescence were assessed 3 times: before the start of puberty suppression (mean age, 13.6 years), when cross-sex hormones were introduced (mean age, 16.7 years), and at least 1 year after gender reassignment surgery (mean age, 20.7 years). Psychological functioning (GD, body image, global functioning, depression, anxiety, emotional and behavioral problems) and objective (social and educational/professional functioning) and subjective (quality of life, satisfaction with life and happiness) well-being were investigated.ResultsAfter gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being.ConclusionsA clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, followed by cross-sex hormones and gender reassignment surgery, provides gender dysphoric youth who seek gender reassignment from early puberty on, the opportunity to develop into well-functioning young adults.Copyright © 2014 by the American Academy of Pediatrics.

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