A slate of significant data is helping advance the care of transgender youth from reliance on expert-based guidance to evidence-based guidelines. Stephen M. Rosenthal, MD, will rely heavily on some of the most recent research in his Saturday Meet-the-Expert session “Managing Transgender Youth” which will begin at 2:15 pm in Room 16B and repeat at 4:45 pm in Room 18AB.
A paper published earlier this year put the prevalence of transgender adolescents, ages 13-17, at .7 percent, or about 150,000 across the United States based on current estimates of the U.S. population.
“This is not a rare thing,” said Dr. Rosenthal, who is Professor of Pediatrics in the Division of Pediatric Endocrinology and Medical Director of the Child and Adolescent Gender Center at the University of California San Francisco Benioff Children’s Hospital. “This is something endocrinologists need to know about in their practice because they are likely to see kids like this and need to know how to take care of them properly.”
This work is important, he noted, because there is very compelling mental health data available that show that transgender youth and young adults at the time of seeking service are markedly at increased risk for depression, anxiety, suicide ideation and suicide attempts.
“It’s important to know these people have risks and that justifies why it is important to pay attention. It’s not just the prevalence but also consequences of not doing anything about it,” he said.
Dr. Rosenthal will talk about the current clinical practice guidelines and those currently under revision; studies that show supporting patients with affirming transgender care have much better outcomes, as well as new compelling evidence from the genetic, endocrine and brain studies realms that gender identity is influenced by biology.
“The current guidelines are based on expert opinion and very little on published long-term data,” he said. “So, I’ll talk about the guidelines, but also what are the few but significant published studies that support the guidelines, what are the gaps in knowledge, what are the important research priorities and how our group, among other groups, is working in research right now supported by the NIH to learn more so we can truly optimize the way we care for transgender individuals.”
During the last part of his presentation, he will draw on that data in a discussion of patient management in several cases, including both male to female and female to male transgender care of adolescents. In addition to delivering affirming care in their management of transgender youth, Dr. Rosenthal hopes that endocrinologists will realize the importance of lending their expertise to research and advocacy.
“It’s very important for our professional societies to play a role not just in being educated in how to provide care for these patients, but also in the advocacy realm and to do research because the most effective advocacy is that which is supported by objective data,” he said. “It’s an important time to make people aware of how to provide care, but it’s also an important time to be responsible and speak up on behalf of the patients we care for.”