Care of Transgender and Gender Diverse Youth

In many parts of the world, increasing numbers of transgender and gender diverse (TGD) youth are seeking medical services to enable the development of physical characteristics aligned with their gender identities. Such medical services include use of agents to pause endogenous puberty as early as Tanner stage 2 with subsequent use of gender-affirming sex hormones and are based on longitudinal studies, demonstrating that those individuals who were first identified as gender dysphoric in early or middle childhood and continue to meet the mental health criteria for gender incongruence at early puberty are likely to persist in their gender identities as adults. This chapter addresses terms and definitions applicable to TGD youth, studies that shed light on the biologic underpinnings of gender identity, outcomes and potential complications of current treatment models, gaps in knowledge, and priorities for research.