Systematic Review: Puberty suppression with GnRH analogues in adolescents with gender incongruity
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REVIEW
Systematic Review: Puberty suppression with GnRH analogues in adolescents with gender incongruity G. G. F. Ramos1 · A. C. S. Mengai1 · C. A. T. Daltro1 · P. T. Cutrim1 · E. Zlotnik1 · A. P. A. Beck1 Received: 30 June 2020 / Accepted: 8 October 2020 © Italian Society of Endocrinology (SIE) 2020
Abstract Context Gender incongruence is defined as disharmony between assigned gender and gender identity. Several interventions are liable in this case including genital affirming surgery among other surgical interventions such as harmonization, and also the use of gonadotropin-releasing hormone agonists (GnRHa) for gonadal shielding. This aids in preventing the development of secondary sexual characteristics related to the genetic sex. Objective Systematically review the treatment of gender incongruity with GnRHa analogues. Data sources The data source of this research is from Pubmed-Medline and Embase. Study selection Articles published between 2009 and 2019 which studied transgender adolescents treated with GnRHa were carefully selected. Data extraction Were extracted: design, sample size, study context, targeted subjects of intervention, outcome measures, and results. Results Eleven studies were included. The use of GnRHa seems to be well tolerated by the studied population. When started in pubertal transition, it was associated with a more distinct resemblance to body shape than to the affirmed sex. In addition to preventing the irreversible phenotypic changes that occur in cross-hormonal therapy, the use of GnRHa can equally contribute to the mental health of these adolescents. Limitation There are few consistent studies on the use of GnRHa for gender incongruence. Conclusion As the population of transgender children and adolescents grows, they acquire knowledge and greater access to the various forms and stages of treatment for sex reassignment. The medical community needs to be adequately prepared to better serve this population and offer the safest resources available. Keywords Disorders of sex development · Gonadotropin-releasing hormone · Gender disorders Abbreviations GnRHa Gonadotropin-releasing hormone agonists BMD Bone mineral density BMAD Apparent bone mineral density LH Luteinizing hormone FSH Follicle-stimulating hormone FA Alkaline phosphatase GT range Glutamyl transferase range GI Gender incongruence
* G. G. F. Ramos [email protected] 1
Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Morumbi, São Paulo, SP 05652‑900, Brazil
Context Gender incongruence (GI) is defined as disharmony between gender assigned at birth and gender identity to which the individual identifies. In addition, cisgender denotes a person whose sense of personal identity corresponds to their gender assigned at birth [1]. Pubertal development of the gender assigned at birth can be profoundly distressing for adolescents, therefore, causing intense anguish, requiring multiprofessional monitoring. In addition to genital affirming surgery, hormonal therapy options may help the managemen
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