Psychological Evaluation and Medical Treatment of Transgender Youth in an Interdisciplinary “Gender Management Service” (GeMS) in a Major Pediatric Center

Harvard Medical School, Boston, Massachusetts, USA.
Journal of Homosexuality (Impact Factor: 0.78). 03/2012; 59(3):321-36. DOI: 10.1080/00918369.2012.653302
Source: PubMed


In 2007, an interdisciplinary clinic for children and adolescents with disorders of sex development (DSD) or gender identity disorder (GID) opened in a major pediatric center. Psychometric evaluation and endocrine treatment via pubertal suppressive therapy and administration of cross-sex steroid hormones was offered to carefully selected patients according to effective protocols used in Holland. Hembree et al.'s (2009) Guidelines for Endocrine Treatment of Transsexual Persons published by the Endocrine Society endorsed these methods. A description of the clinic's protocol and general patient demographics are provided, along with treatment philosophy and goals.

20 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We diagram and discuss theories of gender identity development espoused by the clinical groups represented in this special issue. We contend that theories of origin relate importantly to clinical practice, and argue that the existing clinical theories are under-developed. Therefore, we develop a dynamic systems framework for gender identity development. Specifically, we suggest that critical aspects of presymbolic gender embodiment occur during infancy as part of the synchronous interplay of caregiver-infant dyads. By 18 months, a transition to symbolic representation and the beginning of an internalization of a sense of gender can be detected and consolidation is quite evident by 3 years of age. We conclude by suggesting empirical studies that could expand and test this framework. With the belief that better, more explicit developmental theory can improve clinical practice, we urge that clinicians take a dynamic developmental view of gender identity formation into account.
    Journal of Homosexuality 03/2012; 59(3):398-421. DOI:10.1080/00918369.2012.653310 · 0.78 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The author, a lawyer who advocates for transgender children and youth, explores how clinical approaches to transgender children and youth are keeping pace with social and legal changes affecting these young people and with recent evidence suggesting that children are harmed by family and societal rejection as well as by attempts to change their gender identity or gender expression. The author urges providers and legal advocates to work with policymakers and the families of transgender children and youth to create a future in which these young people can reach their full potential and be embraced as fully equal, respected, and participating members of society.
    Journal of Homosexuality 03/2012; 59(3):422-33. DOI:10.1080/00918369.2012.653311 · 0.78 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Disorders of sex development (DSD), like gender dysphoria, are conditions with major effects on child sexuality and identity, as well as sexual orientation. Each may in some cases lead to change of gender from that assigned neonatally. These similarities-and the conditions' differences-provide a context for reviewing the articles in this issue about clinical approaches to children with gender dysphoria, in relation to assessment, intervention, and ethics.
    Journal of Homosexuality 03/2012; 59(3):434-49. DOI:10.1080/00918369.2012.653312 · 0.78 Impact Factor
Show more