The treatment of gender dysphoria in children and adolescents is a highly controversial topic within the medical community. Gender dysphoria is a condition where an individual experiences significant distress due to a mismatch between their gender identity and their biological sex.
There are two primary approaches to treating gender dysphoria in children and adolescents. One approach is an ‘affirmation model’, which involves supporting the child’s gender identity and offering rapid gender transition with the use of puberty blockers and cross-sex hormones. The other approach is a more cautious model that emphasises psychological counselling and exploration of gender identity before making any decisions about medical intervention.
Proponents of the affirmation model argue that allowing children and adolescents to transition early can improve their mental health and reduce the risk of suicide. They argue that gender dysphoria is a serious condition that requires prompt treatment to alleviate distress and prevent long-term harm.
Proponents of the more cautious approach argue that affirmation and rapid transitioning may miss addressing underlying conditions and can lead to irreversible physical changes and may not be appropriate for all children and adolescents. Some studies suggest that the use of puberty blockers and cross-sex hormones can have long-term effects on bone density, fertility, sexual function and cognitive and emotional development, and have limited, if any, benefits on long-term psychosocial function and suicidality. Additionally, these practitioners argue that children and adolescents may not have the maturity or cognitive ability to fully understand the long-term consequences of their decisions.
The advocates of a more cautious approach argue that psychological counselling and exploration of gender identity can help children and adolescents better understand their feelings and make more informed decisions about medical intervention. They argue that this approach allows for a more individualised and nuanced approach to treatment that takes into account the unique needs and circumstances of each patient.
The NAPP Guide (link below) offers a respectful, compassionate, cautious, evidence-based and practical approach to caring for children and adolescents with gender dysphoria. While the best approach to treating gender dysphoria in children and adolescents remains a subject of debate and controversy within the medical community, the NAPP Guide provides a clear pathway for a thorough evaluation of each patient’s individual circumstances, taking into account their age, maturity, and other medical and psychological factors, as well as and family circumstances, in order to deliver treatment that is both safe and effective.
Dr Philip Morris AM