Dr. Sun discusses gender-affirming care among transgender and gender diverse youth

In this video, Helen Sun, MD, highlights findings from her study, “Gender-affirming care and mental health among transgender and gender diverse youth,” which was presented at the 2023 American Urological Association Annual Meeting in Chicago, Illinois. Sun is a urology resident at University Hospitals in Cleveland, Ohio.

Video Transcript:

We used a large secondary database called TriNetX in order to look at all patients that were diagnosed with gender dysphoria under the age of 18. We found approximately 19,000 of these patients just within that database alone. Of these, the average age of diagnosis was 14 years old. Approximately 70% of them identified as or were assigned female at birth, and the majority of these were Caucasian. About 1/3 of these children in the database were reported to have any type of gender-affirming medical therapy, which we defined for the purposes of our study, as any puberty suppression therapy, gender affirming hormonal therapy, or gender affirming surgery. The most commonly documented therapy was hormonal therapy. There were rare instances of fertility preservation that were documented as well. I think something that we expected and that we did find was that there was a high prevalence of concurrent mental health disorder diagnoses, about 70%, with most of these being anxiety disorders, mood disorders, or ADHD.

Something that we did find that was more promising was that regardless of whether a patient did or did not have a mental health disorder diagnosis, that did not affect their rate of receiving gender-affirming medical therapy. That was reassuring. We did find that there was approximately a 10% rate of suicide attempts throughout this database. We looked at the aggregate of patients within the database, so we weren't able to identify any temporal effects of any of the gender-affirming medical therapy. Segwaying into future directions, that would be something that we would want to look at and see, are there temporal effects? How long does it take for any gender-affirming medical therapy benefits or harms to take effect?

This transcription has been edited for clarity.