Psychological Support, Puberty Suppression, and Psychosocial Functioning in Adolescents with Gender Dysphoria

Abstract

Introduction

Puberty suppression by gonadotropin‐releasing hormone analogs (GnRHa) is prescribed to relieve the distress associated with pubertal development in adolescents with gender dysphoria (GD) and thereby to provide space for further exploration. However, there are limited longitudinal studies on puberty suppression outcome in GD. Also, studies on the effects of psychological support on its own on GD adolescents' well‐being have not been reported.

Aim

This study aimed to assess GD adolescents' global functioning after psychological support and puberty suppression.

Methods

Two hundred one GD adolescents were included in this study. In a longitudinal design we evaluated adolescents' global functioning every 6 months from the first visit.

Main Outcome Measures

All adolescents completed the Utrecht Gender Dysphoria Scale (UGDS), a self‐report measure of GD‐related discomfort. We used the Children's Global Assessment Scale (CGAS) to assess the psychosocial functioning of adolescents.

Results

At baseline, GD adolescents showed poor functioning with a CGAS mean score of 57.7 ± 12.3. GD adolescents' global functioning improved significantly after 6 months of psychological support (CGAS mean score: 60.7 ± 12.5; P < 0.001). Moreover, GD adolescents receiving also puberty suppression had significantly better psychosocial functioning after 12 months of GnRHa (67.4 ± 13.9) compared with when they had received only psychological support (60.9 ± 12.2, P = 0.001).

Conclusion

Psychological support and puberty suppression were both associated with an improved global psychosocial functioning in GD adolescents. Both these interventions may be considered effective in the clinical management of psychosocial functioning difficulties in GD adolescents.

Gender Dysphoria, Adolescents, Psychosocial Functioning, Puberty Suppression

© International Society for Sexual Medicine 2015