title: Gynecologic care for transgender youth.
abstract: OBJECTIVE
  To provide an overview of the care of the adolescent transgender patient with regard to the guidelines and recommendations that currently exist, and to review the role of the clinician caring for transgender youth.
  
  
  RESULTS
  The World Professional Association for Transgender Health and the Endocrine Society continue to provide comprehensive guidelines for the care of adolescent transgender patients. The decision to perform surgery on a patient who is a minor remains a complex one, and a case-by-case approach should be taken with important ethical principles in mind. Cross-sex steroid use places transgender adolescents at risk for metabolic disorders, and careful surveillance is necessary. In addition, transgender teens are at high risk for depression, anxiety and suicidality and have been shown to engage in more high-risk behaviors compared with their nontransgender heterosexual counterparts.
  
  
  CONCLUSIONS
  Clinicians who care for adolescents can play an important role in the counseling, screening, health maintenance and support of their patients through the transition process.
authors.affiliation: Department of Obstetrics & Gynecology, Division of Female Pelvic Medicine & Reconstructive Surgery, Cleveland Clinic Foundation, Women's Health Institute, Cleveland, Ohio, USA.
authors.forename: Cécile A
authors.initials: CA
authors.lastname: Unger
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D016497:Adolescent Health Services / Q000592:standards*; D003657:Decision Making / Q000941:ethics; D003863:Depression / Q000175:diagnosis*; D005783:Gender Identity; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D062985:Health Services for Transgender Persons / Q000941:ethics / Q000592:standards*; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D010287:Parent-Child Relations; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D057830:Gender-Affirming Surgery / Q000941:ethics / Q000592:standards; D012944:Social Support; D059039:Standard of Care; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology; D059020:Suicidal Ideation; D063106:Transgender Persons / Q000523:psychology*; D008297:Male; D005260:Female
chemical_list: D012739:Gonadal Steroid Hormones; D007987:Gonadotropin-Releasing Hormone