Gender dysphoria in children and adolescents: an inventory of the literature

A systematic scoping review

This report was commissioned by the Swedish government and is a scoping review of the literature on gender dysphoria in children and adolescents. The report can be a basis for further evaluation of risk of bias and evidence.

Reading time approx. 64 minutes Published: Publication type:

SBU Policy support

identifies and presents available scientific evidence to support policy and decision making, including the development of national guidelines, at other government agencies. In consultation with professional experts, SBU staff generates supporting documentation to address the various questions that have been posed.


  • We have not found any scientific studies which explains the increase in incidence in children and adolescents who seek the heath care because of gender dysphoria.
  • We have not found any studies on changes in prevalence of gender dysphoria over calendar time, nor any studies on factors that can affect the societal acceptance of seeking for gender dysphoria.
  • There are few studies on gender affirming surgery in general in children and adolescents and only single studies on gender affirming genital surgery.
  • Studies on long-term effects of gender affirming treatment in children and adolescents are few, especially for the groups that have appeared during the recent decennium.
  • The scientific activity in the field seems high. A large part of the identified studies are published during 2018 and 2019.
  • Almost all identified studies are observational, some with controls and some with evaluation before and after gender affirming treatment. No relevant randomised controlled trials in children and adolescents were found.
  • We have not found any composed national information from Sweden on:
    – the proportion of those who seek health care for gender dysphoria that get a formal diagnosis
    – the proportion starting endocrine treatment to delay puberty
    – the proportion starting gender affirming hormonal treatment
    – the proportion subjected to different gender affirming surgery

Full report in Swedish

The full report in Swedish "Könsdysfori hos barn och unga"

Published: Report no: 307 Registration no: SBU 2019/427 ISBN: 978-91-88437-49-5

Search strategies

PubMed via NLM 6 September 2019

Title: Gender dysphoria & children/adolescence

* = Truncation
The search result, usually found at the end of the documentation, forms the list of abstracts.; [AU] = Author; [MAJR] = MeSH Major Topic; [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [OT] = Other term; [SB] = Filter for retrieving systematic reviews; [TW] = Text Word; Systematic; [TI] = Title; [TIAB] = Title or abstract
Search terms Items found
Population: persons with gender dysphoria
1. "Gender Dysphoria"[Mesh] 338
2. "Transsexualism"[Mesh] 3545
3. "Sex Reassignment Procedures"[Mesh] 671
4. "Transgender Persons"[Mesh] 2444
5. "Health Services for Transgender Persons"[Mesh] 116
6. (agender[ti] OR "assigned female"[ti] OR "assigned females"[ti] OR "assigned male"[ti] OR "assigned males"[ti] OR bigender[ti] OR bi-gender[ti] OR "confirmation surgery"[ti] OR female-born[ti] OR "gender change"[ti] OR gender confirm*[ti] OR "gender dysphoria"[ti] OR "gender fluid"[ti] OR "gender identity disorder"[ti] OR "gender reassignment"[ti] OR "gender transition"[ti] OR "gender transitioning"[ti] OR gender-affirming[ti] OR gender affirmative[ti] OR gender incongru*[ti] OR gender non-binary[ti] OR gender nonbinary[ti] OR gender non-conform*[ti] OR transfeminine[ti] OR transgender*[ti] OR trans-gender[ti]OR trans-man[ti] OR transmasculine[ti] OR transpeople[ti] OR trans-people[ti] OR transpopulation[ti] OR trans-population[ti] OR transsex*[ti] OR trans-sex*[ti] OR trans-wom*[ti] OR transwom*[ti]) 5265
7. (agender[tiab] OR "assigned female"[tiab] OR "assigned females"[tiab] OR "assigned male"[tiab] OR "assigned males"[tiab] OR bigender[tiab] OR bi-gender[tiab] OR "confirmation surgery"[tiab] OR female-born[tiab] OR "gender change"[tiab] OR gender confirm*[tiab] OR "gender dysphoria"[tiab] OR "gender fluid"[tiab] OR "gender identity disorder"[tiab] OR "gender reassignment"[tiab] OR "gender transition"[tiab] OR "gender transitioning"[tiab] OR gender-affirming[tiab] OR gender affirmative[tiab] OR gender incongru*[tiab] OR gender non-binary[tiab] OR gender nonbinary[tiab] OR gender non-conform*[tiab] OR transfeminine[tiab] OR transgender*[tiab] OR trans-gender[tiab]OR trans-man[tiab] OR transmasculine[tiab] OR transpeople[tiab] OR trans-people[tiab] OR transpopulation[tiab] OR trans-population[tiab] OR transsex*[tiab] OR trans-sex*[tiab] OR trans-wom*[tiab] OR transwom*[tiab]) NOT medline[SB] 1932
8. 1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7 8168
Population: children and adolescents
9. ("Child"[Mesh] OR "child"[tw] OR "children"[tw] OR "Infant"[Mesh] OR "infant"[tw] OR "infants"[tw] OR "infancy"[tw] OR "newborn"[tw] OR "newborns"[tw] OR "new-born"[tw] OR "new-borns"[tw] OR "neonate"[tw] OR "neonates"[tw] OR "neonatal"[tw] OR "neo-nate"[tw] OR "neo-nates"[tw] OR "neo-natal"[tw] OR "neonatology"[tw] OR "NICU"[ti] OR "premature"[tw] OR "prematures"[tw] OR "pre-mature"[tw] OR "pre-matures"[tw] OR "preterm"[tw] OR "pre-term"[tw] OR "postnatal"[tw] OR "post-natal"[tw] OR "baby"[tw] OR "babies"[tw] OR "suckling"[tw] OR "sucklings"[tw] OR "toddler"[tw] OR "toddlers"[tw] OR "childhood"[tw] OR "schoolchild"[tw] OR "schoolchildren"[tw] OR "childcare"[tw] OR "child-care"[tw] OR "young"[ti] OR "youngster"[tw] OR "youngsters"[tw] OR "preschool"[tw] OR "pre-school"[tw] OR "kid"[tw] OR "kids"[tw] OR "boy"[tw] OR "boys"[tw] OR "girl"[tw] OR "girls"[tw] OR "Adolescent"[Mesh] OR "adolescent"[tw] OR "adolescents"[tw] OR "adolescence"[tw] OR "pre-adolescent"[tw] OR "pre-adolescents"[tw] OR "pre-adolescence"[tw] OR "schoolage"[tw] OR "schoolboy"[tw] OR "schoolboys"[tw] OR "schoolgirl"[tw] OR "schoolgirls"[tw] OR "pre-puber"[tw] OR "pre-pubers"[tw] OR "pre-puberty"[tw] OR "prepuber"[tw] OR "prepubers"[tw] OR "prepuberty"[tw] OR "puber"[tw] OR "pubers"[tw] OR "puberty"[tw] OR "puberal"[tw] OR "teenager"[tw] OR "teenagers"[tw] OR "teens"[tw] OR "youth"[tw] OR "youths"[tw] OR "underaged"[tw] OR "under-aged"[tw] OR "Pediatrics"[Mesh] OR "Pediatric"[tw] OR "Pediatrics"[tw] OR "Paediatric"[tw] OR "Paediatrics"[tw] OR "PICU"[ti] OR ("child"[all fields] NOT child[au]) OR children*[all fields] OR schoolchild*[all fields] OR "infant"[all fields] OR "infants"[all fields] OR "infancy"[all fields] OR adolesc*[all fields] OR pediat*[all fields] OR paediat*[all fields] OR neonat*[all fields] OR toddler*[all fields] OR "teen"[all fields] OR "teens"[all fields] OR teenager*[all fields] OR preteen*[all fields] OR newborn*[all fields] OR postneonat*[all fields] OR postnatal*[all fields] OR "puberty"[all fields] OR preschool*[all fields] OR suckling*[all fields] OR "juvenile"[all fields] OR "new born"[all fields] OR "new borns"[all fields] OR new-born*[all fields] OR neo-nat*[all fields] OR neonat*[all fields] OR perinat*[all fields] OR underag*[all fields] OR "under age"[all fields] OR "under aged"[all fields] OR youth*[all fields] OR kinder*[all fields] OR pubescen*[all fields] OR prepubescen*[all fields] OR "prepuberty"[all fields] OR "school age"[all fields] OR "schoolage"[all fields] OR "school ages"[all fields] OR schoolage*[all fields] OR "one year old"[ti] OR "two year old"[ti] OR "three year old"[ti] OR "four year old"[ti] OR "five year old"[ti] OR "six year old"[ti] OR "seven year old"[ti] OR "eight year old"[ti] OR "nine year old"[ti] OR "ten year old"[ti] OR "eleven year old"[ti] OR "twelve year old"[ti] OR "thirteen year old"[ti] OR "fourteen year old"[ti] OR "fifteen year old"[ti] OR "sixteen year old"[ti] OR "seventeen year old"[ti] OR "eighteen year old"[ti] OR "1 year old"[ti] OR "2 year old"[ti] OR "3 year old"[ti] OR "4 year old"[ti] OR "5 year old"[ti] OR "6 year old"[ti] OR "7 year old"[ti] OR "8 year old"[ti] OR "9 year old"[ti] OR "10 year old"[ti] OR "11 year old"[ti] OR "12 year old"[ti] OR "13 year old"[ti] OR "14 year old"[ti] OR "15 year old"[ti] OR "16 year old"[ti] OR "17 year old"[ti] OR "18 year old"[ti] OR "two years old"[ti] OR "three years old"[ti] OR "four years old"[ti] OR "five years old"[ti] OR "six years old"[ti] OR "seven years old"[ti] OR "eight years old"[ti] OR "nine years old"[ti] OR "ten years old"[ti] OR "eleven years old"[ti] OR "twelve years old"[ti] OR "thirteen years old"[ti] OR "fourteen years old"[ti] OR "fifteen years old"[ti] OR "sixteen years old"[ti] OR "seventeen years old"[ti] OR "eighteen years old"[ti] OR "2 years old"[ti] OR "3 years old"[ti] OR "4 years old"[ti] OR "5 years old"[ti] OR "6 years old"[ti] OR "7 years old"[ti] OR "8 years old"[ti] OR "9 years old"[ti] OR "10 years old"[ti] OR "11 years old"[ti] OR "12 years old"[ti] OR "13 years old"[ti] OR "14 years old"[ti] OR "15 years old"[ti] OR "16 years old"[ti] OR "17 years old"[ti] OR "18 years old"[ti]) 4781542
Combined sets
10. 8 AND 9 2729
Combined sets, limited to study types: systematic reviews and meta-analysis (filter: PubMed1, with modifications, broad)
11. (systematic review [ti] OR meta-analysis [pt] OR systematic review[pt] OR meta-analysis [ti] OR systematic literature review [ti] OR this systematic review [tw] OR pooling project [tw] OR (systematic review [tiab] AND review [pt]) OR meta synthesis [ti] OR meta-analy*[ti] OR integrative review [tw] OR integrative research review [tw] OR rapid review [tw] OR umbrella review [tw] OR consensus development conference [pt] OR practice guideline [pt] OR drug class reviews [ti] OR cochrane database syst rev [ta] OR acp journal club [ta] OR health technol assess [ta] OR evid rep technol assess summ [ta] OR jbi database system rev implement rep [ta]) OR (clinical guideline [tw] AND management [tw]) OR ((evidence based[ti] OR evidence-based medicine [mh] OR best practice* [ti] OR evidence synthesis [tiab]) AND (review [pt] OR diseases category[mh] OR behavior and behavior mechanisms [mh] OR therapeutics [mh] OR evaluation studies[pt] OR validation studies[pt] OR guideline [pt] OR pmcbook)) OR ((systematic [tw] OR systematically [tw] OR critical [tiab] OR (study selection [tw]) OR (predetermined [tw] OR inclusion [tw] AND criteri* [tw]) OR exclusion criteri* [tw] OR main outcome measures [tw] OR standard of care [tw] OR standards of care [tw]) AND (survey [tiab] OR surveys [tiab] OR overview* [tw] OR review [tiab] OR reviews [tiab] OR search* [tw] OR handsearch [tw] OR analysis [ti] OR critique [tiab] OR appraisal [tw] OR(reduction [tw]AND (risk [mh] OR risk [tw]) AND (death OR recurrence))) AND (literature [tiab] OR articles [tiab] OR publications [tiab] OR publication [tiab] OR bibliography [tiab] OR bibliographies [tiab] OR published [tiab] OR pooled data [tw] OR unpublished [tw] OR citation [tw] OR citations [tw] OR database [tiab] OR internet [tiab] OR textbooks [tiab] OR references [tw] OR scales [tw] OR papers [tw] OR datasets [tw] OR trials [tiab] OR meta-analy* [tw] OR (clinical [tiab] AND studies [tiab]) OR treatment outcome [mh] OR treatment outcome [tw] OR pmcbook)) NOT(letter [pt] OR newspaper article [pt]) 420344
12. 10 AND 11 97
13. 12 ANDFilters activated: Publication date from 2013/08/01. 81
14. 10 NOT 13 2648
15. 14 NOT (letter [pt] OR newspaper article [pt] OR "Editorial" [Publication Type] OR "Comment" [Publication Type]) AND (english[la] OR swedish[la] OR danish[la] OR norwegian[la]) 2327

Excluded studies

Gender dysphoria in children and adolescents

Studies considered not relevant

Study Reason for exclusion
Abel BS. Hormone treatment of children and adolescents with gender dysphoria: an ethical analysis. The Hastings Center report. 2014;44 Suppl 4:S23-7. Ethics
Adams N, Hitomi M, Moody C. Varied Reports of Adult Transgender Suicidality: Synthesizing and Describing the Peer-Reviewed and Gray Literature. Transgender health. 2017;2(1):60-75. Mix of literature
Aitken M, Steensma TD, Blanchard R, VanderLaan DP, Wood H, Fuentes A, et al. Evidence for an altered sex ratio in clinic-referred adolescents with gender dysphoria. The journal of sexual medicine. 2015;12(3):756-63. Age
Alessandrin A. The notion of regret in the clinical approach to gender reassignment. Evolution Psychiatrique. 2019;84(2):277-84. Review
Allen LR, Watson LB, Egan AM, Moser CN. Well-being and suicidality among transgender youth after gender-affirming hormones. Clinical Practice in Pediatric Psychology. 2019;7(3):302-11. Short term follow-up
Angus L, Leemaqz S, Ooi O, Cundill P, Silberstein N, Locke P, et al. Cyproterone acetate or spironolactone in lowering testosterone concentrations for transgender individuals receiving oestradiol therapy. Endocr Connect. 2019;8(7):935-40. Cyproterone acetate not used in Sweden
Aranda G, Fernandez-Rebollo E, Pradas-Juni M, Hanzu FA, Kalko SG, Halperin I, et al. Effects of sex steroids on the pattern of methylation and expression of the promoter region of estrogen and androgen receptors in people with gender dysphoria under cross-sex hormone treatment. The Journal of steroid biochemistry and molecular biology. 2017;172:20-8. Non-clinical
Aranda G, Mora M, Hanzu FA, Vera J, Ortega E, Halperin I. Effects of sex steroids on cardiovascular risk profile in transgender men under gender affirming hormone therapy. Endocrinol Diabetes Nutricion. 2019;66(6):385-92. Short term follow-up
Arcelus J, Bouman WP, Van Den Noortgate W, Claes L, Witcomb G, Fernandez-Aranda F. Systematic review and meta-analysis of prevalence studies in transsexualism. European Psychiatry. 2015;30(6):807-15. Data from before rise in numbers seeking care
Armuand G, Dhejne C, Olofsson JI, Rodriguez-Wallberg KA. Transgender men's experiences of fertility preservation: A qualitative study. Hum Reprod. 2017;32(2):383-90. Fertility
Arnold JD, Sarkodie EP, Coleman ME, Goldstein DA. Incidence of Venous Thromboembolism in Transgender Women Receiving Oral Estradiol. The journal of sexual medicine. 2016;13(11):1773-7. Oral oestrogens not relevant in Sweden
Ascha M, Massie JP, Morrison SD, Crane CN, Chen ML. Outcomes of Single Stage Phalloplasty by Pedicled Anterolateral Thigh Flap versus Radial Forearm Free Flap in Gender Confirming Surgery. The Journal of urology. 2018;199(1):206-14. Age
Asscheman H, T'Sjoen G, Lemaire A, Mas M, Meriggiola MC, Mueller A, et al. Venous thrombo-embolism as a complication of cross-sex hormone treatment of male-to-female transsexual subjects: a review. Andrologia. 2014;46(7):791-5. Old data
Auer MK, Fuss J, Nieder TO, Briken P, Biedermann SV, Stalla GK, et al. Desire to Have Children Among Transgender People in Germany: A Cross-Sectional Multi-Center Study. The journal of sexual medicine. 2018;15(5):757-67. Fertility
Aydin D, Buk LJ, Partoft S, Bonde C, Thomsen MV, Tos T. Transgender Surgery in Denmark from 1994 to 2015: 20-Year Follow-Up Study. The journal of sexual medicine. 2016;13(4):720-5. Trends in surgery in Denmark
Bailey L, Ellis SJ, McNeil J. Suicide risk in the UK trans population and the role of gender transition in decreasing suicidal ideation and suicide attempt. Mental Health Review Journal. 2014;19(4):209-20. Fertility
Barnard EP, Dhar CP, Rothenberg SS, Menke MN, Witchel SF, Montano GT, et al. Fertility Preservation Outcomes in Adolescent and Young Adult Feminizing Transgender Patients. Pediatrics. 2019;144(3). Fertility
Bartholomaeus C, Riggs DW. Transgender and non-binary Australians' experiences with healthcare professionals in relation to fertility preservation. Culture, health & sexuality. 2019:1-17. Fertility
Becerra Fernández A. Gender identity disorders: Guidelines for their diagnosis and treatment. Endocrinol Nutr. 2003;50(1):19-33. Guide lines
Becerra-Fernández A, Rodríguez-Molina JM, Asenjo-Araque N, Lucio-Pérez MJ, Cuchí-Alfaro M, García-Camba E, et al. Prevalence, Incidence, and Sex Ratio of Transsexualism in the Autonomous Region of Madrid (Spain) According to Healthcare Demand. Archives of Sexual Behavior. 2017;46(5):1307-12. Regional
Bechard M, VanderLaan DP, Wood H, Wasserman L, Zucker KJ. Psychosocial and Psychological Vulnerability in Adolescents with Gender Dysphoria: A "Proof of Principle" Study. Journal of sex & marital therapy. 2017;43(7):678-88. Short-term follow-up
Bennett CM, Dillman Taylor D. Acting as yourself: Implementing acceptance and commitment therapy for transgender adolescents through a developmental lens. Journal of Child and Adolescent Counseling. 2019. Implementation
Bertrand B, Perchenet AS, Colson TR, Drai D, Casanova D. [Female-to-male transgender chest reconstruction: A retrospective study of patient satisfaction]. Annales de chirurgie plastique et esthetique. 2017;62(4):303-7. Language
Bizic MR, Jeftovic M, Pusica S, Stojanovic B, Duisin D, Vujovic S, et al. Gender Dysphoria: Bioethical Aspects of Medical Treatment. BioMed Research International. 2018;2018. Ethics
Blanchard R, Steiner BW, Clemmensen LH, Dickey R. Prediction of regrets in postoperative transsexuals. Canadian journal of psychiatry Revue canadienne de psychiatrie. 1989;34(1):43-5. Old data, sexuality
Bockting WO. Vulnerability and resilience among gender-nonconforming children and adolescents: Mental health professionals have a key role to play. Journal of the American Academy of Child & Adolescent Psychiatry. 2016;55(6):441-3. Editorial
Boos MD, Yeung H, Inwards-Breland D. Dermatologic care of sexual and gender minority/LGBTQIA youth, part I: An update for the dermatologist on providing inclusive care. Pediatric dermatology. 2019. Guide-lines
Bouman MB, van Zeijl MC, Buncamper ME, Meijerink WJ, van Bodegraven AA, Mullender MG. Intestinal vaginoplasty revisited: a review of surgical techniques, complications, and sexual function. The journal of sexual medicine. 2014;11(7):1835-47. Non-systematic review
Bouman WP, Richards C, Addinall RM, Arango de Montis I, Arcelus J, Duisin D, et al. Yes and yes again: Are standards of care which require two referrals for genital reconstructive surgery ethical? Sexual and Relationship Therapy. 2014;29(4):377-89. Ethics, position paper
Braun H, Nash R, Tangpricha V, Brockman J, Ward K, Goodman M. Cancer in transgender people: Evidence and methodological considerations. Epidemiologic Reviews. 2017;39(1):93-107. Review, methods
Brik T, Vrouenraets L, Schagen SEE, Meissner A, de Vries MC, Hannema SE. Use of Fertility Preservation Among a Cohort of Transgirls in the Netherlands. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. 2019;64(5):589-93. Fertility
Brown GR, Jones KT. Incidence of breast cancer in a cohort of 5,135 transgender veterans. Breast cancer research and treatment. 2015;149(1):191-8. Included in systematic reviews ref 73 och 74 in the report
Bryson C, Honig SC. Genitourinary Complications of Gender-Affirming Surgery. Current Urology Reports. 2019;20(6). Review
Burke SM, Manzouri AH, Dhejne C, Bergstrom K, Arver S, Feusner JD, et al. Testosterone Effects on the Brain in Transgender Men. Cerebral cortex (New York, NY : 1991). 2018;28(5):1582-96. Included in ref 72 in the report
Burke SM, Manzouri AH, Savic I. Structural connections in the brain in relation to gender identity and sexual orientation. Scientific reports. 2017;7(1):17954 Not specifically gender dysphoria
Butler G, De Graaf N, Wren B, Carmichael P. Assessment and support of children and adolescents with gender dysphoria. Archives of disease in childhood. 2018;103(7):631-6. Review
Campo-Engelstein L, Chen D, Baratz AB, Johnson EK, Finlayson C. The Ethics of Fertility Preservation for Pediatric Patients with Differences (Disorders) of Sex Development. Journal of the Endocrine Society. 2017;1(6):638-45. Fertility
Cartaya J, Lopez X. Gender dysphoria in youth: a review of recent literature. Current opinion in endocrinology, diabetes, and obesity. 2018;25(1):44-8. Review
Casado JC, Rodriguez-Parra MJ, Adrian JA. Voice feminization in male-to-female transgendered clients after Wendler's glottoplasty with vs. without voice therapy support. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2017;274(4):2049-58. Age
Castellano E, Crespi C, Dell'Aquila C, Rosato R, Catalano C, Mineccia V, et al. Quality of life and hormones after sex reassignment surgery. J Endocrinol Invest. 2015;38(12):1373-81. Short-term follow-up
Chen D, Kyweluk MA, Sajwani A, Gordon EJ, Johnson EK, Finlayson CA, et al. Factors Affecting Fertility Decision-Making Among Transgender Adolescents and Young Adults. LGBT Health. 2019;6(3):107-15. Fertility
Chen D, Matson M, Macapagal K, Johnson EK, Rosoklija I, Finlayson C, et al. Attitudes Toward Fertility and Reproductive Health Among Transgender and Gender-Nonconforming Adolescents. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. 2018;63(1):62-8. Fertility
Chen D, Simons L, Johnson EK, Lockart BA, Finlayson C. Fertility Preservation for Transgender Adolescents. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. 2017;61(1):120-3. Fertility
Cheng PJ, Pastuszak AW, Myers JB, Goodwin IA, Hotaling JM. Fertility concerns of the transgender patient. Translational andrology and urology. 2019;8(3):209-18. Fertility
Chiniara LN, Viner C, Palmert M, Bonifacio H. Perspectives on fertility preservation and parenthood among transgender youth and their parents. Archives of disease in childhood. 2019;104(8):739-44. Fertility
Churcher Clarke A, Spiliadis A. 'Taking the lid off the box': The value of extended clinical assessment for adolescents presenting with gender identity difficulties. Clinical child psychology and psychiatry. 2019;24(2):338-52. Case description
Claes KEY, Pattyn P, D'Arpa S, Robbens C, Monstrey SJ. Male-to-Female Gender Confirmation Surgery: Intestinal Vaginoplasty. Clinics in plastic surgery. 2018;45(3):351-60. Methods description
Colizzi M, Costa R, Scaramuzzi F, Palumbo C, Tyropani M, Pace V, et al. Concomitant psychiatric problems and hormonal treatment induced metabolic syndrome in gender dysphoria individuals: a 2-year follow-up study. Journal of psychosomatic research. 2015;78(4):399-406. Age
Colizzi M, Costa R, Todarello O. Transsexual patients’ psychiatric comorbidity and positive effect of cross-sex hormonal treatment on mental health: Results from a longitudinal study. Psychoneuroendocrinology. 2014;39:65-73. Short-term follow-up
Cristofari S, Bertrand B, Leuzzi S, Rem K, Rausky J, Revol M, et al. Postoperative complications of male to female sex reassignment surgery: A 10-year French retrospective study. Annales de chirurgie plastique et esthetique. 2019;64(1):24-32. Surgical complications
Cuccolo NG, Kang CO, Boskey ER, Ibrahim AMS, Blankensteijn LL, Taghinia A, et al. Masculinizing Chest Reconstruction in Transgender and Nonbinary Individuals: An Analysis of Epidemiology, Surgical Technique, and Postoperative Outcomes. Aesthetic plastic surgery. 2019. Method, complications
D’Angelo R. Psychiatry’s ethical involvement in gender-affirming care. Australasian Psychiatry. 2018;26(5):460-3. Ethics
Davidge-Pitts C, Clarke BL. Transgender bone health. Maturitas. 2019;127:35-42. Review
de Vries ALC, Roehle R, Marshall L, Frisen L, van de Grift TC, Kreukels BPC, et al. Mental Health of a Large Group of Adults with Disorders of Sex Development in Six European Countries. Psychosomatic medicine. 2019;81(7):629-40. Different sex development disorders
de Vries ALC, Steensma TD, Doreleijers TAH, Cohen‐Kettenis PT. Puberty suppression in adolescents with gender identity disorder: A prospective follow‐up study. Journal of Sexual Medicine. 2011;8(8):2276-83. See ref 52 in the report
Deebel NA, Morin JP, Autorino R, Vince R, Grob B, Hampton LJ. Prostate Cancer in Transgender Women: Incidence, Etiopathogenesis, and Management Challenges. Urology. 2017;110:166-71. Non-systematic review
Deuster D, Matulat P, Knief A, Zitzmann M, Rosslau K, Szukaj M, et al. Voice deepening under testosterone treatment in female-to-male gender dysphoric individuals. Eur Arch Oto-Rhino-Laryngol. 2016;273(4):959-65. Age
Djordjevic ML, Bizic MR, Duisin D, Bouman MB, Buncamper M. Reversal surgery in regretful male-to-female transsexuals after sex reassignment surgery. Journal of Sexual Medicine. 2016;13(6):1000-7. Surgical method
Djordjevic ML, Bizic MR. Comparison of two different methods for urethral lengthening in female to male (metoidioplasty) surgery. The journal of sexual medicine. 2013;10(5):1431-8. Surgical method
Dy GW, Nolan IT, Hotaling J, Myers JB. Patient reported outcome measures and quality of life assessment in genital gender confirming surgery. Translational andrology and urology. 2019;8(3):228-40. Review
Eldh J, Berg A, Gustafsson M. Long-term follow up after sex reassignment surgery. Scandinavian journal of plastic and reconstructive surgery and hand surgery. 1997;31(1):39-45. Age, surgical outcome
Fakin RM, Zimmermann S, Kaye K, Lunger L, Weinforth G, Giovanoli P. Long-Term Outcomes in Breast Augmentation in Trans-Women: A 20-Year Experience. Aesthetic surgery journal. 2019;39(4):381-90. Surgical outcome
Falcone M, Garaffa G, Gillo A, Dente D, Christopher AN, Ralph DJ. Outcomes of inflatable penile prosthesis insertion in 247 patients completing female to male gender reassignment surgery. BJU international. 2018;121(1):139-44. Surgical outcome
Ferlatte O, Salway T, Rice SM, Oliffe JL, Knight R, Ogrodniczuk JS. Inequities in depression within a population of sexual and gender minorities. Journal of mental health (Abingdon, England). 2019:1-8. Not specifically gender dysphoria
Fernandez JD, Tannock LR. Metabolic effects of hormone therapy in transgender patients. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2016;22(4):383-8. Review
Fighera TM, da Silva E, Lindenau JD, Spritzer PM. Impact of cross-sex hormone therapy on bone mineral density and body composition in transwomen. Clinical endocrinology. 2018;88(6):856-62. Included in ref 86 in the report
Fisher AD, Castellini G, Bandini E, Casale H, Fanni E, Benni L, et al. Cross-Sex Hormonal Treatment and Body Uneasiness in Individuals with Gender Dysphoria. Journal of Sexual Medicine. 2014;11(3):709-19. Satisfaction
Frederick MJ, Berhanu AE, Bartlett R. Chest Surgery in Female to Male Transgender Individuals. Annals of plastic surgery. 2017;78(3):249-53. Age, cannot differ younger pts.
Frisen L, Soder O, Rydelius PA. [Dramatic increase of gender dysphoria in youth]. Lakartidningen. 2017;114. Review
Gaither TW, Awad MA, Osterberg EC, Murphy GP, Romero A, Bowers ML, et al. Postoperative Complications following Primary Penile Inversion Vaginoplasty among 330 Male-to-Female Transgender Patients. The Journal of urology. 2018;199(3):760-5. Surgical method
Gava G, Cerpolini S, Martelli V, Battista G, Seracchioli R, Meriggiola MC. Cyproterone acetate vs leuprolide acetate in combination with transdermal oestradiol in transwomen: a comparison of safety and effectiveness. Clinical endocrinology. 2016;85(2):239-46. Cyproterone acetate nor used in Sweden
Gijs L, Brewaeys A. Surgical Treatment of Gender Dysphoria in Adults and Adolescents: Recent Developments, Effectiveness, and Challenges. Annual Review of Sex Research. 2007;18(1):178-224. Review
Gooren L, Morgentaler A. Prostate cancer incidence in orchidectomised male-to-female transsexual persons treated with oestrogens. Andrologia. 2014;46(10):1156-60. Included in ref 74 in the report
Gooren LJ, van Trotsenburg MA, Giltay EJ, van Diest PJ. Breast cancer development in transsexual subjects receiving cross-sex hormone treatment. The journal of sexual medicine. 2013;10(12):3129-34. Included in ref 73 and 74 in the report
Gurney K. Sex and the surgeon's knife: The family court's dilemma... informed consent and the specter of iatrogenic harm to children with intersex characteristics. Am J Law Med. 2007;33(4):625-61. Ethics
Hamidi O, Davidge-Pitts CJ. Transfeminine Hormone Therapy. Endocrinol Metab Clin North Am. 2019;48(2):341-55. Review
Hancock AB. An ICF Perspective on Voice-related Quality of Life of American Transgender Women. Journal of Voice. 2017;31(1):115.e1-.e8. Method, age
Harris RM, Tishelman AC, Quinn GP, Nahata L. Decision Making and the Long-Term Impact of Puberty Blockade in Transgender Children. American Journal of Bioethics. 2019;19(2):67-9. Ethics
Hartley RL, Stone JP, Temple-Oberle C. Breast cancer in transgender patients: A systematic review. Part 1: Male to female. European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2018;44(10):1455-62. Same as ref 73 and 74 in the report
Hess J, Neto RR, Panic L, Rübben H, Senf W. Satisfaction with male-to-female gender reassignment surgery: Results of a retrospective analysis. Deutsches Ärzteblatt International. 2014;111(47):795-801. Surgery, satisfaction
Hirsch S, Pickering J, Adler R. Meeting the Needs of Trans and Gender Diverse Youth: The Varied, Ubiquitous Role of the Speech-Language Pathologist in Voice and Communication Therapy/Training. Perspectives of the ASHA Special Interest Groups. 2019;4(1):111-7. Review
Horbach SE, Bouman MB, Smit JM, Ozer M, Buncamper ME, Mullender MG. Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques. The journal of sexual medicine. 2015;12(6):1499-512. Surgical method
Houk CP, Lee PA. The diagnosis and care of transsexual children and adolescents: a pediatric endocrinologists' perspective. Journal of pediatric endocrinology & metabolism: JPEM. 2006;19(2):103-9. Review
Irwin JA, Coleman JD, Fisher CM, Marasco VM. Correlates of Suicide Ideation Among LGBT Nebraskans. Journal of Homosexuality. 2014;61(8):1172-91. Nor gender dysphoria specifically
Jacobsson J, Andréasson M, Kölby L, Elander A, Selvaggi G. Patients’ Priorities Regarding Female-to-Male Gender Affirmation Surgery of the Genitalia—A Pilot Study of 47 Patients in Sweden. Journal of Sexual Medicine. 2017;14(6):857-64. Surgery, attitudes
Jain J, Kwan D, Forcier M. Medroxyprogesterone Acetate in Gender-Affirming Therapy for Transwomen: Results from a Retrospective Study. The Journal of clinical endocrinology and metabolism. 2019. Medroxyprogesterone acetate nor used in Sweden
Jeftovic M, Stojanovic B, Bizic M, Stanojevic D, Kisic J, Bencic M, et al. Hysterectomy with Bilateral Salpingo-Oophorectomy in Female-to-Male Gender Affirmation Surgery: Comparison of Two Methods. BioMed research international. 2018;2018:3472471. Surgery, method, age
Kääriäinen M, Salonen K, Helminen M, Karhunen-Enckell U. Chest-wall contouring surgery in female-to-male transgender patients: A one-center retrospective analysis of applied surgical techniques and results. Scand J Surg. 2017;106(1):74-9. Surgery, method, age
Kang A, Aizen JM, Cohen AJ, Bales GT, Pariser JJ. Techniques and considerations of prosthetic surgery after phalloplasty in the transgender male. Translational andrology and urology. 2019;8(3):273-82. Surgery, method, age
Karpel L, Gardel B, Revol M, Brémont-Weil C, Ayoubi JM, Cordier B. Psychological and sexual well being of 207 transsexuals after sex reassignment in France. Annales Medico-Psychologiques. 2015;173(6):511-9. Language
Kjölhede A, Cornelius F, Huss F, Kratz G. Metoidioplasty and groin flap phalloplasty as two surgical methods for the creation of a neophallus in female-to-male gender-confirming surgery: A retrospective study comprising 123 operated patients. JPRAS Open. 2019;22:1-8. Surgery, method
Klein C, Gorzalka BB. Sexual functioning in transsexuals following hormone therapy and genital surgery: A review. Journal of Sexual Medicine. 2009;6(11):2922-39. Review
Knox ADC, Ho AL, Leung L, Hynes S, Tashakkor AY, Park YS, et al. A Review of 101 Consecutive Subcutaneous Mastectomies and Male Chest Contouring Using the Concentric Circular and Free Nipple Graft Techniques in Female-to-Male Transgender Patients. Plastic and reconstructive surgery. 2017;139(6):1260e-72e. Surgery, method
Kosche C, Mansh M, Luskus M, Nguyen A, Martinez-Diaz G, Inwards-Breland D, et al. Dermatologic care of sexual and gender minority/LGBTQIA youth, Part 2: Recognition and management of the unique dermatologic needs of SGM adolescents. Pediatric dermatology. 2019. Not gender dysphoria specifically
Lamm B, Gernhardt A, Rübeling H. How Societal Changes Have Influenced German Children's Gender Representations as Expressed in Human Figure Drawings in 1977 and 2015. Sex Roles. 2019;81(1/2):118-25. Scientific method
Landén M, Bodlund O, Ekselius L, Hambert G, Lundström B. Done is done - and gone is gone; sex change presently the best remedy for transsexuals. Lakartidningen. 2001;98(30-31):3322-6. Review
Levy JA, Edwards DC, Cutruzzula-Dreher P, McGreen BH, Akanda S, Tarry S, et al. Male-to-Female Gender Reassignment Surgery: An Institutional Analysis of Outcomes, Short-term Complications, and Risk Factors for 240 Patients Undergoing Penile-Inversion Vaginoplasty. Urology. 2019;131:228-33. Surgery. method, age
Lundgren KC, Koudstaal MJ. Midfacial Bony Remodeling. Facial plastic surgery clinics of North America. 2019;27(2):221-6. Surgery, method
Mahfouda S, Moore JK, Siafarikas A, Hewitt T, Ganti U, Lin A, et al. Gender-affirming hormones and surgery in transgender children and adolescents. The lancet Diabetes & endocrinology. 2019;7(6):484-98. Review
Marchand JB, Pelladeau E, Pommier F. Transsexualism/transgenderism: Psychotherapy and sex/gender reassignment therapy. Annales Medico-Psychologiques. 2017;175(3):210-6. Language
Mattawanon N, Spencer JB, Schirmer DA, 3rd, Tangpricha V. Fertility preservation options in transgender people: A review. Reviews in endocrine & metabolic disorders. 2018;19(3):231-42. Ethics
McDonald K. Social support and mental health in LGBTQ adolescents: A review of the literature. Issues in Mental Health Nursing. 2018;39(1):16-29. Review
McEvenue G, Xu FZ, Cai R, McLean H. Female-to-Male Gender Affirming Top Surgery: A Single Surgeon's 15-Year Retrospective Review and Treatment Algorithm. Aesthetic surgery journal. 2017;38(1):49-57. Surgery, method
McQueen P. Authenticity, intersubjectivity and the ethics of changing sex. Journal of Gender Studies. 2016;25(5):557-70. Ethics
McQueen P. The Role of Regret in Medical Decision-making. Ethical Theory Moral Pract. 2017;20(5):1051-65. Ethics
Meerwijk EL, Sevelius JM. Transgender Population Size in the United States: a Meta-Regression of Population-Based Probability Samples. American Journal of Public Health. 2017;107(2):e1-e8. Review
Meister J, Kuhn H, Shehata-Dieler W, Hagen R, Kleinsasser N. Perceptual analysis of the male-to-female transgender voice after glottoplasty-the telephone test. Laryngoscope. 2017;127(4):875-81. Surgery
Meriggiola MC, Gava G. Endocrine care of transpeople part II. A review of cross-sex hormonal treatments, outcomes and adverse effects in transwomen. Clinical endocrinology. 2015;83(5):607-15. Review
Miller TJ, Wilson SC, Massie JP, Morrison SD, Satterwhite T. Breast augmentation in male-to-female transgender patients: Technical considerations and outcomes. JPRAS Open. 2019;21:63-74. Surgery, method
Milrod C, Karasic DH. Age Is Just a Number: WPATH-Affiliated Surgeons' Experiences and Attitudes Toward Vaginoplasty in Transgender Females Under 18 Years of Age in the United States. The journal of sexual medicine. 2017;14(4):624-34. Ethics
Milrod C. How young is too young: Ethical concerns in genital surgery of the transgender MTF adolescent. Journal of Sexual Medicine. 2014;11(2):338-46. Ethics
Moravek MB. Fertility preservation options for transgender and gender-nonconforming individuals. Current opinion in obstetrics & gynecology. 2019;31(3):170-6. Fertility
Morrison SD, Satterwhite T. Lower Jaw Recontouring in Facial Gender-Affirming Surgery. Facial Plastic Surgery Clinics of North America. 2019;27(2):233-42. Surgery, method
Nahata L, Tishelman AC, Caltabellotta NM, Quinn GP. Low Fertility Preservation Utilization Among Transgender Youth. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. 2017;61(1):40-4. Fertility
Neblett MF, 2nd, Hipp HS. Fertility Considerations in Transgender Persons. Endocrinology and metabolism clinics of North America. 2019;48(2):391-402. Fertility
Neuville P, Morel-Journel N, Maucourt-Boulch D, Ruffion A, Paparel P, Terrier JE. Surgical Outcomes of Erectile Implants After Phalloplasty: Retrospective Analysis of 95 Procedures. Journal of Sexual Medicine. 2016;13(11):1758-64. Surgery, method
Nikolic D, Granic M, Ivanovic N, Zdravkovic D, Nikolic A, Stanimirovic V, et al. Breast cancer and its impact in male transsexuals. Breast cancer research and treatment. 2018;171(3):565-9. Review
Nolan IT, Morrison SD, Arowojolu O, Crowe CS, Massie JP, Adler RK, et al. The Role of Voice Therapy and Phonosurgery in Transgender Vocal Feminization. The Journal of craniofacial surgery. 2019;30(5):1368-75. Age
Nota NM, Dekker MJHJ, Klaver M, Wiepjes CM, van Trotsenburg MA, Heijboer AC, et al. Prolactin levels during short- and long-term cross-sex hormone treatment: an observational study in transgender persons. Andrologia. 2017;49(6). Metabolism
Notini L, McDougall R, Pang KC. Should Parental Refusal of Puberty-Blocking Treatment be Overridden? The Role of the Harm Principle. American Journal of Bioethics. 2019;19(2):69-72. Ethics
Nygren U, Nordenskjöld A, Arver S, Södersten M. Effects on Voice Fundamental Frequency and Satisfaction with Voice in Trans Men during Testosterone Treatment—A Longitudinal Study. Journal of Voice. 2016;30(6):766.e23-.e34. Treatment outcome, age
Olson KR. Prepubescent transgender children: What we do and do not know. Journal of the American Academy of Child & Adolescent Psychiatry. 2016;55(3):155-6. Review
Olsson SE, Möller A. Regret after sex reassignment surgery in a male-to-female transsexual: A long-term follow-up. Archives of Sexual Behavior. 2006;35(4):501-6. Case description
Özkan O, Ozkan O, Cinpolat A, Dogan NU, Bektas G, Dolay K, et al. Vaginal reconstruction with the modified rectosigmoid colon: surgical technique, long-term results and sexual outcomes. Journal of plastic surgery and hand surgery. 2018;52(4):210-6. Surgery, method
Papadopulos NA, Lelle JD, Zavlin D, Herschbach P, Henrich G, Kovacs L, et al. Quality of Life and Patient Satisfaction Following Male-to-Female Sex Reassignment Surgery. The journal of sexual medicine. 2017;14(5):721-30. Surgery, method
Papadopulos NA, Zavlin D, Lelle JD, Herschbach P, Henrich G, Kovacs L, et al. Combined vaginoplasty technique for male-to-female sex reassignment surgery: Operative approach and outcomes. Journal of plastic, reconstructive & aesthetic surgery : JPRAS. 2017;70(10):1483-92. Surgery, method
Pariser JJ, Kim N. Transgender vaginoplasty: Techniques and outcomes. Translational andrology and urology. 2019;8(3):241-7. Surgery, method
Peitzmeier S, Gardner I, Weinand J, Corbet A, Acevedo K. Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Cult Health Sexual. 2017;19(1):64-75. Age
Perry DG, Pauletti RE, Cooper PJ. Gender identity in childhood: A review of the literature. International Journal of Behavioral Development. 2019;43(4):289-304 Review
Postuvan V, Podlogar T, Zadravec Sedivy N, De Leo D. Suicidal behaviour among sexual-minority youth: a review of the role of acceptance and support. The Lancet Child & adolescent health. 2019;3(3):190-8. Review
Poudrier G, Nolan IT, Cook TE, Saia W, Motosko CC, Stranix JT, et al. Assessing Quality of Life and Patient-Reported Satisfaction with Masculinizing Top Surgery: A Mixed-Methods Descriptive Survey Study. Plastic and reconstructive surgery. 2019;143(1):272-9. Age
Priest M. Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm. The American journal of bioethics: AJOB. 2019;19(2):45-59. Ethics
Priest MM. Response to Commentaries on "Transgender Children and the Right to Transition". American Journal of Bioethics. 2019;19(6):W10-W5. Ethics
Proulx CN, Coulter RWS, Egan JE, Matthews DD, Mair C. Associations of lesbian, gay, bisexual, transgender, and questioning–inclusive sex education with mental health outcomes and school-based victimization in US high school students. Journal of Adolescent Health. 2019;64(5):608-14. Not only gender dysphoria.
Puckett JA, Matsuno E, Dyar C, Mustanski B, Newcomb ME. Mental health and resilience in transgender individuals: What type of support makes a difference? Journal of Family Psychology. 2019. Age, 16-73 yrs, adolescents cannot be distinguished
Puszczyk M, Czajeczny D. Gender dysphoria and gender variance in children – Diagnostic and therapeutic controversies. Archives of Psychiatry and Psychotherapy. 2017;19(3):34-42. Review
Radix A, Davis AM. Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons. JAMA: Journal of the American Medical Association. 2017;318(15):1491-2. Synopsis
Raigosa M, Avvedimento S, Yoon TS, Cruz‐Gimeno J, Rodriguez G, Fontdevila J. Male‐to‐female genital reassignment surgery: A retrospective review of surgical technique and complications in 60 patients. Journal of Sexual Medicine. 2015;12(8):1837-45. Surgery, method
Reisner SL, Hughto JMW. Comparing the health of non-binary and binary transgender adults in a statewide non-probability sample. PLoS One. 2019;14(8):e0221583. Age, short-term follow-up
Remington AC, Morrison SD, Massie JP, Crowe CS, Shakir A, Wilson SC, et al. Outcomes after Phalloplasty: Do Transgender Patients and Multiple Urethral Procedures Carry a Higher Rate of Complication? Plastic and reconstructive surgery. 2018;141(2):220e-9e. Surgery, method
Rider GN, McMorris BJ, Gower AL, Coleman E, Eisenberg ME. Gambling Behaviors and Problem Gambling: A Population-Based Comparison of Transgender/Gender Diverse and Cisgender Adolescents. Journal of gambling studies. 2019;35(1):79-92 Gambling
Rosenthal SM. Approach to the patient: transgender youth: endocrine considerations. The Journal of clinical endocrinology and metabolism. 2014;99(12):4379-89 Cases, review
Rothman MS, Iwamoto SJ. Bone Health in the Transgender Population. Clinical reviews in bone and mineral metabolism. 2019;17(2):77-85. Review
Rowlands S, Amy JJ. Preserving the reproductive potential of transgender and intersex people. The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception. 2018;23(1):58-63. Fertility
Sanchez Lorenzo I, Mora Mesa JJ, Oviedo de Lucas O. Psychomedical care in gender identity dysphoria during adolescence. Revista de psiquiatria y salud mental. 2017;10(2):96-103. Language
Schwarz K, Fontanari AMV, Schneider MA, Borba Soll BM, da Silva DC, Spritzer PM, et al. Laryngeal surgical treatment in transgender women: A systematic review and meta-analysis. Laryngoscope. 2017;127(11):2596-603. Systematic review, age adolescents cannot be distinguished.
Seal LJ. A review of the physical and metabolic effects of cross-sex hormonal therapy in the treatment of gender dysphoria. Annals of clinical biochemistry. 2016;53(Pt 1):10-20. Review
Seyed-Forootan K, Karimi H, Seyed-Forootan NS. Autologous Fibroblast-Seeded Amnion for Reconstruction of Neo-vagina in Male-to-Female Reassignment Surgery. Aesthetic plastic surgery. 2018;42(2):491-7. Surgery, experimental
Shatzel JJ, Connelly KJ, DeLoughery TG. Thrombotic issues in transgender medicine: A review. American journal of hematology. 2017;92(2):204-8. Systematic review, overlap with ref 82 (later) in the report
Sherer I. Social transition: Supporting our youngest transgender children. Pediatrics. 2016;137(3):1-2. Commentary
Shulman GP, Holt NR, Hope DA, Eyer J, Mocarski R, Woodruff N. A review of contemporary assessment tools for use with transgender and gender nonconforming adults. Psychology of Sexual Orientation and Gender Diversity. 2017;4(3):304-13. Review
Sigurjonsson H, Rinder J, Möllermark C, Farnebo F, Lundgren TK. Male to female gender reassignment surgery: Surgical outcomes of consecutive patients during 14 years. JPRAS Open. 2015;6:69-73. Surgery, method
Slater MW, Vinaja X, Aly I, Loukas M, Terrell M, Schober J. Neovaginal Construction with Pelvic Peritoneum: Reviewing an Old Approach for a New Application. Clinical anatomy (New York, NY). 2018;31(2):175-80. Surgery, method
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Song TE, Jiang N. Transgender Phonosurgery: A Systematic Review and Meta-analysis. Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery. 2017;156(5):803-8. Surgery, method, age
Spivey LA, Edwards-Leeper L. Future Directions in Affirmative Psychological Interventions with Transgender Children and Adolescents. Journal of clinical child and adolescent psychology: the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53. 2019;48(2):343-56. Review/editorial
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Stevenson MO, Tangpricha V. Osteoporosis and Bone Health in Transgender Persons. Endocrinology and metabolism clinics of North America. 2019;48(2):421-7. Review
Streed CG, Harfouch O, Marvel F, Blumenthal RS, Martin SS, Mukherjee M. Cardiovascular disease among transgender adults receiving hormone therapy: A narrative review. Annals of Internal Medicine. 2017;167(4):256-67. Systematic review, overlap with ref 80 and 81 in the report
Sutcliffe PA, Dixon S, Akehurst RL, Wilkinson A, Shippam A, White S, et al. Evaluation of surgical procedures for sex reassignment: a systematic review. J Plast Reconstr Aesthetic Surg. 2009;62(3):294-306. Surgery, method
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Tebbens M, Nota NM, Liberton NPTJ, Meijer BA, Kreukels BPC, Forouzanfar T, et al. Gender-affirming hormone treatment induces facial feminization in transwomen and masculinization in transmen: Quantification by 3D scanning and patient-reported outcome measures. Journal of Sexual Medicine. 2019;16(5):746-54. Treatment effect
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Tellier P-P, Wren B. Reflections on 'Thinking an Ethics of Gender Exploration: Against Delaying Transition for Transgender and Gender Variant Youth'. Clinical Child Psychology & Psychiatry. 2019;24(2):237-40. Ethics
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Traish AM, Gooren LJ. Safety of physiological testosterone therapy in women: lessons from female-to-male transsexuals (FMT) treated with pharmacological testosterone therapy. The journal of sexual medicine. 2010;7(11):3758-64. Review
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T'Sjoen G, Van Caenegem E, Wierckx K. Transgenderism and reproduction. Current opinion in endocrinology, diabetes, and obesity. 2013;20(6):575-9. Review
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Walls NE, Atteberry-Ash B, Kattari SK, Peitzmeier S, Kattari L, Langenderfer-Magruder L. Gender Identity, Sexual Orientation, Mental Health, and Bullying as Predictors of Partner Violence in a Representative Sample of Youth. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. 2019;64(1):86-92 Short-term, bullying
Van Boerum MS, Salibian AA, Bluebond-Langner R, Agarwal C. Chest and facial surgery for the transgender patient. Translational andrology and urology. 2019;8(3):219-27. Surgery, method
Van Caenegem E, Wierckx K, Taes Y, Dedecker D, Van de Peer F, Toye K, et al. Bone mass, bone geometry, and body composition in female-to-male transsexual persons after long-term cross-sex hormonal therapy. The Journal of clinical endocrinology and metabolism. 2012;97(7):2503-11. Include in ref 86 in the report
Van Caenegem E, Wierckx K, Taes Y, Schreiner T, Vandewalle S, Toye K, et al. Preservation of volumetric bone density and geometry in trans women during cross-sex hormonal therapy: a prospective observational study. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2015;26(1):35-47. Included in ref 85 in the report
Van Damme S, Cosyns M, Deman S, Van den Eede Z, Van Borsel J. The Effectiveness of Pitch-raising Surgery in Male-to-Female Transsexuals: A Systematic Review. Journal of voice: official journal of the Voice Foundation. 2017;31(2):244.e1-.e5. Systematic review, surgery, method age,
van de Grift TC, Pigot GLS, Boudhan S, Elfering L, Kreukels BPC, Gijs L, et al. A Longitudinal Study of Motivations Before and Psychosexual Outcomes After Genital Gender-Confirming Surgery in Transmen. The journal of sexual medicine. 2017;14(12):1621-8. Surgery, motivation
van der Sluis WB, Bouman MB, de Boer NKH, Buncamper ME, van Bodegraven AA, Neefjes-Borst EA, et al. Long-Term Follow-Up of Transgender Women After Secondary Intestinal Vaginoplasty. Journal of Sexual Medicine. 2016;13(4):702-10. Surgery, method
van der Sluis WB, Pavan N, Liguori G, Bucci S, Bizic MR, Kojovic V, et al. Ileal vaginoplasty as vaginal reconstruction in transgender women and patients with disorders of sex development: an international, multicentre, retrospective study on surgical characteristics and outcomes. BJU international. 2018;121(6):952-8. Surgery, method
van der Sluis WB, Smit JM, Pigot GLS, Buncamper ME, Winters HAH, Mullender MG, et al. Double flap phalloplasty in transgender men: Surgical technique and outcome of pedicled anterolateral thigh flap phalloplasty combined with radial forearm free flap urethral reconstruction. Microsurgery. 2017;37(8):917-23. Surgery, method
Vaughan SC. Suicidality in LGBTQ+ Youth. Psychoanal Study Child. 2018;71(1):40-54 Review
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Wiepjes CM, Vlot MC, Klaver M, Nota NM, de Blok CJM, de Jongh RT, et al. Bone Mineral Density Increases in Trans Persons After 1 Year of Hormonal Treatment: A Multicenter Prospective Observational Study. J Bone Miner Res. 2017;32(6):1252-60. Short-term follow-up
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Wilson SC, Morrison SD, Anzai L, Massie JP, Poudrier G, Motosko CC, et al. Masculinizing Top Surgery: A Systematic Review of Techniques and Outcomes. Annals of plastic surgery. 2018;80(6):679-83. Surgery, method
Wirthmann AE, Majenka P, Kaufmann MC, Wellenbrock SV, Kasper L, Hüttinger S, et al. Phalloplasty in Female-to-Male Transsexuals by Gottlieb and Levine's Free Radial Forearm Flap Technique--A Long-Term Single-Center Experience over More than Two Decades. J Reconstr Microsurg. 2018;34(4):235-41. Surgery, method
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Zavlin D, Schaff J, Lellé JD, Jubbal KT, Herschbach P, Henrich G, et al. Male-to-Female Sex Reassignment Surgery using the Combined Vaginoplasty Technique: Satisfaction of Transgender Patients with Aesthetic, Functional, and Sexual Outcomes. Aesthet Plast Surg. 2018;42(1):178-87. Surgery, method
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Zeluf G, Dhejne C, Orre C, Mannheimer LN, Deogan C, Höijer J, et al. Health, disability and quality of life among trans people in Sweden-a web-based survey. BMC Public Health. 2016;16(1):1-15. Not only gender dysphoria.
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Tables of included studies



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  47. Lawrence AA. Factors associated with satisfaction or regret following male-to-female sex reassignment surgery. Arch Sex Behav 2003;32:299-315.
  48. Nelson L, Whallett EJ, McGregor JC. Transgender patient satisfaction following reduction mammaplasty. J Plast Reconstr Aesthet Surg 2009;62:331-4.
  49. Defreyne J, Motmans J, T’sjoen G. Healthcare costs and quality of life outcomes following gender affirming surgery in trans men: a review. Expert Rev Pharmacoecon Outcomes Res 2017;17:543-56.
  50. van de Grift TC, Elaut E, Cerwenka SC, Cohen-Kettenis PT, Kreukels BPC. Surgical satisfaction, Quality of life, and their association after gender-affirming surgery: A follow-up study. J Sex Marital Ther 2018;44:138-48.
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  53. Dhejne C, Van Vlerken R, Heylens G, Arcelus J. Mental health and gender dysphoria: A review of the literature. Int Rev Psychiatry 2016;28:44-57.
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  55. Keo-Meier CL, Herman LI, Reisner SL, Pardo ST, Sharp C, Babcock JC. Testosterone treatment and MMPI-2 improvement in transgender men: a prospective controlled study. J Consult Clin Psychol 2015;83:143-56.
  56. Millet N, Longworth J, Arcelus J. Prevalence of anxiety symptoms and disorders in the transgender population: A systematic review of the literature. Int J Transgenderism 2017;18:27-38.
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  65. Simonsen RK, Giraldi A, Kristensen E, Hald GM. Long-term follow-up of individuals undergoing sex reassignment surgery: Psychiatric morbidity and mortality. Nord J Psychiatry 2016;70:241-7.
  66. Weinforth G, Fakin R, Giovanoli P, Garcia Nuñez D. Quality of life following male-to-female sex reassignment surgery. Dtsch Arztebl Int 2019;116:253-60.
  67. Wernick JA, Busa S, Matouk K, Nicholson J, Janssen A. A systematic review of the psychological benefits of gender-affirming surgery. Urol Clin North Am 2019;46:475-86.
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  69. Özata Yildizhan B, Yüksel Ş, Avayu M, Noyan H, Yildizhan E. Effects of gender reassignment on quality of life and mental health in people with gender dysphoria. Türk Psikiyatri Derg 2018;29:1-10.
  70. Staphorsius AS, Kreukels BP, Cohen-Kettenis PT, Veltman DJ, Burke SM, Schagen SE, et al. Puberty suppression and executive functioning: An fMRI-study in adolescents with gender dysphoria. Psychoneuroendocrinology 2015;56:190-9.
  71. Schneider MA, Andreazza T, Fontanari AM, Costa AB, Silva DC, Aguiar BW, et al. Serum concentrations of brain-derived neurotrophic factor in patients diagnosed with gender dysphoria undergoing sex reassignment surgery. Trends Psychiatry Psychotheer 2017;39:43-7.
  72. Nguyen HB, Loughead J, Lipner E, Hantsoo L, Kornfield SL, Epperson CN. What has sex got to do with it? The role of hormones in the transgender brain. Neuropsychopharmacology 2019;44:22-37.
  73. Joint R, Chen ZE, Cameron S. Breast and reproductive cancers in the transgender population: a systematic review. BJOG. 2018;125:1505-12.
  74. McFarlane T, Zajac JD, Cheung AS. Gender-affirming hormone therapy and the risk of sex hormone-dependent tumours in transgender individuals - A systematic review. Clin Endocrinol 2018;89:700-11.
  75. de Blok CJM, Wiepjes CM, Nota NM, Van Engelen K, Adank MA, Dreijerink KMA, et al. Breast cancer risk in transgender people receiving hormone treatment: Nationwide cohort study in the Netherlands. BMJ 2019;365:l1652. doi: 10.1136/bmj.l1652.
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  79. Getahun D, Nash R, Flanders WD, Baird TC, Becerra-Culqui TA, Cromwell L, et al. Cross-sex hormones and acute cardiovascular events in transgender persons: A Cohort Study. Ann Intern Med 2018;169:205-13.
  80. Dutra E, Lee J, Torbati T, Garcia M, Merz CNB, Shufelt C. Cardiovascular implications of gender-affirming hormone treatment in the transgender population. Maturitas 2019;129:45-9.
  81. Goldstein Z, Khan M, Reisman T, Safer JD. Managing the risk of venous thromboembolism in transgender adults undergoing hormone therapy. J Blood Med 2019;10:209-16.
  82. Khan J, Schmidt RL, Spittal MJ, Goldstein Z, Smock KJ, Greene DN. Venous thrombotic risk in transgender women undergoing estrogen therapy: A systematic review and metaanalysis. Clin Chem 2019;65:57-66.
  83. Joseph T, Ting J, Butler G. The effect of GnRH analogue treatment on bone mineral density in young adolescents with gender dysphoria: findings from a large national cohort. J Pediatr Endocrinol Metab 2019;32:1077-81.
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