Friday, 17 February 2012

Pubertal blockade safe for pediatric patients with gender identity disorder

Pubertal blockade safe for pediatric patients with gender identity
disorder <http://www.endocrinetoday.com/view.aspx?rid=92635>

    Pubertal blockade can safely be initiated in pediatric patients
who experience gender identity disorder, according to researchers at
the Canadian Pediatric Endocrine Group 2012 Meeting. With exposure to
hormones such as estrogen or testosterone later in their adolescence,
these patients will experience normal metabolic processes.

    “If kids are persisting at puberty (My emphasis - ZEB) [about the
need to be the other gender], they will almost always persist,” said
Daniel Metzger, MD, FRCPC, a pediatric endocrinologist at BC
Children’s Hospital in Vancouver, British Columbia, Canada, and a
clinical professor, division of endocrinology in the department of
pediatrics, University of British Columbia in Vancouver.

    Metzger spoke about the endocrine management of transgender youth
and said pediatric patients who experience gender identity disorder
require watchful management to reduce the risks for suicidality,
depression, drug use and eating disorders, which are often secondary
to gender identity disorder.

    “These issues are frequently dealt with if patients can get on the
road to transition,” Metzger said, noting that parental support is key
in making the transition smooth.

    Patients will undergo counseling and therapy if they express a
desire to transition from male to female or female to male to ensure
they are serious about their desire, he said.

    “The effect of the puberty-blocking drugs is reversible,” Metzger
said. “If they change their mind, they would come off the
(puberty-blocking) drugs and enter puberty.”

    Although pubertal blockade, such as gonadotropin-releasing hormone
agonists, puts bone and mineral status on hold, youths can resume the
process of building bone once they are exposed to estrogen or
testosterone, Metzger said.

    In response to Metzger’s presentation, Norman Spack, MD, an
associate in endocrinology and co-director of the Gender Management
Service Clinic at Children’s Hospital Boston, said not treating youths
with gender identity disorder is beginning to be thought of as
disregard for the Hippocratic Oath. Spack co-wrote guidelines on
treating gender identity disorder published by the Endocrine Society
in 2009.

    “[These patients] often harm themselves if they are not treated
because they are clearly in the wrong body,” Spack said. “The younger
generation (of endocrinologists) who have grown up with gender-variant
people is seeing this as a disregard for a human right.”

    In addition, pediatric patients are continually being
psychologically tested to affirm their choice because the
administration of sex steroids will not produce effects that can be
reversed, Spack said.

    “It is not reversible when you do a hormonal flip and give boys
estrogen and girls testosterone,” he said. “The Dutch experience has
demonstrated that pubertal blockade does not preclude the ability of
youths to have normal bone density.”

Reference : Metzger D. The endocrine management of transgender youth.
Presented at: the Canadian Pediatric Endocrine Group 2012 Scientific
Meeting; Feb. 9-11, 2012; Winnipeg, MB, Canada. (Link to article will
be included when I can get it)

Finally, endocrinologists have plucked up the courage to state in
public what until now they've only said in private. I (and they
themselves) expect them to be pilloried for it of course, but lives
are at stake.

at 2/17/2012 11:38:00 PM

http://aebrain.blogspot.com/2012/02/pubertal-blockade-safe-for-pediat...