title: Young adult psychological outcome after puberty suppression and gender reassignment.
abstract: BACKGROUND
  In recent years, puberty suppression by means of gonadotropin-releasing hormone analogs has become accepted in clinical management of adolescents who have gender dysphoria (GD). The current study is the first longer-term longitudinal evaluation of the effectiveness of this approach.
  
  
  METHODS
  A total of 55 young transgender adults (22 transwomen and 33 transmen) who had received puberty suppression during adolescence were assessed 3 times: before the start of puberty suppression (mean age, 13.6 years), when cross-sex hormones were introduced (mean age, 16.7 years), and at least 1 year after gender reassignment surgery (mean age, 20.7 years). Psychological functioning (GD, body image, global functioning, depression, anxiety, emotional and behavioral problems) and objective (social and educational/professional functioning) and subjective (quality of life, satisfaction with life and happiness) well-being were investigated.
  
  
  RESULTS
  After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being.
  
  
  CONCLUSIONS
  A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, followed by cross-sex hormones and gender reassignment surgery, provides gender dysphoric youth who seek gender reassignment from early puberty on, the opportunity to develop into well-functioning young adults.
authors.affiliation: Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, Netherlands; and alc.devries@vumc.nl.
authors.forename: Annelou L C
authors.initials: AL
authors.lastname: de Vries
authors.affiliation: Department of Human Development, Washington State University, Pullman, Washington.
authors.forename: Jenifer K
authors.initials: JK
authors.lastname: McGuire
authors.affiliation: Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, Netherlands; and.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Steensma
authors.affiliation: Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, Netherlands; and.
authors.forename: Eva C F
authors.initials: EC
authors.lastname: Wagenaar
authors.affiliation: Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, Netherlands; and.
authors.forename: Theo A H
authors.initials: TA
authors.lastname: Doreleijers
authors.affiliation: Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, Netherlands; and.
authors.forename: Peggy T
authors.initials: PT
authors.lastname: Cohen-Kettenis
mesh_terms: D000293:Adolescent; D001828:Body Image / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006727:Hormone Antagonists / Q000008:administration & dosage; D006801:Humans; D008297:Male; D011627:Puberty / Q000187:drug effects / Q000523:psychology*; D057829:Gender-Affirming Procedures / Q000379:methods / Q000523:psychology* / Q000639:trends; D063106:Transgender Persons / Q000523:psychology*; D014189:Transsexualism / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006727:Hormone Antagonists
keywords: adolescents; gender dysphoria; longitudinal outcomes; psychological functioning; puberty suppression; transgenderism