Johanna Olson, MD, and her colleagues at Children’s Hospital Los Angeles, provide care for the largest number of transgendered youth in the U.S. and have enrolled 101 patients in a prospective observational study to determine the safety and efficacy of treatment that helps patients bring their bodies into closer alignment with their chosen gender.
Baseline characteristics of these individuals were published on July 21 in the Journal of Adolescent Health and include a significant finding: transgendered individuals have sex hormone levels consistent with the gender they were born with.
“We’ve now put to rest the residual belief that transgender experience is a result of a hormone imbalance,” says Olson. “It’s not.”
That leaves self-identification. The classification of “boy” or “girl” at birth is based on genitalia. Transgender individuals have a gender identity different from their sex. Transgendered people state that gender is different from birth sex so a boy may feel like a girl even if they are a boy by birth. Distress and anxiety that may result from this dissonance is called gender dysphoria. People with gender dysphoria are seeking medical advice at a younger age and in greater numbers than ever before so the authors believe it was important to settle the issue of whether or not a hormonal imbalance was at work.
The 101 individuals enrolled in this study include nearly equivalent numbers of individuals born male who identify as feminine (51.5%) and individuals born female who identify as masculine (48.5%).
Participants, who were 12 to 24 years old, identified a discrepancy with their gender of assignment on average at about 8 years of age but disclosed it to their families much later; 17.1 years. Living with this “secret” for such a long period of time may have a negative impact on mental health, the authors believe. Thirty-five percent of participants experienced depression within clinical ranges. Over 50 percent of the youth reported having considered suicide and 30% had made at least one attempt.
Additional contributors include Sheree M. Schrager, PhD, MS; Marvin E. Belzer, MD; Lisa K. Simons, MD; and Leslie F. Clark, PhD, MPH. This work was supported in part by The Saban Research Institute Clinical Research Academic Career Development Award and the NIH National Center for Advancing Translational Sciences (KL2TR000131).
