title: Research priorities for gender nonconforming/transgender youth: gender identity development and biopsychosocial outcomes.
abstract: OBJECTIVE
  The review summarizes relevant research focused on prevalence and natural history of gender nonconforming/transgender youth, and outcomes of currently recommended clinical practice guidelines. This review identifies gaps in knowledge, and provides recommendations foci for future research.
  
  
  RESULTS
  Increasing numbers of gender nonconforming youth are presenting for care. Clinically useful information for predicting individual psychosexual development pathways is lacking. Transgender youth are at high risk for poor medical and psychosocial outcomes. Longitudinal data examining the impact of early social transition and medical interventions are sparse. Existing tools to understand gender identity and quantify gender dysphoria need to be reconfigured to study a more diverse cohort of transgender individuals. Increasingly, biomedical data are beginning to change the trajectory of scientific investigation.
  
  
  CONCLUSIONS
  Extensive research is needed to improve understanding of gender dysphoria, and transgender experience, particularly among youth. Recommendations include identification of predictors of persistence of gender dysphoria from childhood into adolescence, and a thorough investigation into the impact of interventions for transgender youth. Finally, examining the social environments of transgender youth is critical for the development of appropriate interventions necessary to improve the lives of transgender people.
authors.affiliation: aCenter for Transyouth Health and Development, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA bDepartment of Medical Psychology, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands cNew York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York dDepartment of Pediatrics, Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago/Northwestern University, Chicago, Illinois eDepartment of Psychiatry, University of Texas Medical Branch, Galveston, Texas fDepartment of Pediatrics, Division of Endocrinology, Child and Adolescent Gender Center, Benioff Children's Hospital, University of California, San Francisco, California, USA.
authors.forename: Johanna
authors.initials: J
authors.lastname: Olson-Kennedy
authors.forename: Peggy T
authors.initials: PT
authors.lastname: Cohen-Kettenis
authors.forename: Baudewijntje P C
authors.initials: BP
authors.lastname: Kreukels
authors.forename: Heino F L
authors.initials: HF
authors.lastname: Meyer-Bahlburg
authors.forename: Robert
authors.initials: R
authors.lastname: Garofalo
authors.forename: Walter
authors.initials: W
authors.lastname: Meyer
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Rosenthal
mesh_terms: D035843:Biomedical Research; D003695:Delivery of Health Care; D005260:Female; D005783:Gender Identity; D006292:Health Priorities; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008913:Minority Groups / Q000523:psychology*; D054525:Minority Health; D020380:Needs Assessment; D057829:Gender-Affirming Procedures; D063106:Transgender Persons / Q000523:psychology*; D014189:Transsexualism / Q000523:psychology* / Q000628:therapy
references.citation: J Behav Brain Sci. 2012 Aug;2(3):357-362
references.pmid: 23724358
references.citation: J Sex Med. 2013 Aug;10(8):1969-77
references.pmid: 23433223
references.citation: Cereb Cortex. 2015 Oct;25(10):3527-34
references.pmid: 25217469
references.citation: J Psychiatr Res. 2011 Feb;45(2):199-204
references.pmid: 20562024
references.citation: J Homosex. 2012;59(3):301-20
references.pmid: 22455322
references.citation: J Pers Assess. 1993 Dec;61(3):443-56
references.pmid: 8295110
references.citation: J Sex Med. 2012 Mar;9(3):751-7
references.pmid: 22146048
references.citation: Psychoneuroendocrinology. 2015 Jun;56:190-9
references.pmid: 25837854
references.citation: Front Endocrinol (Lausanne). 2014 May 28;5:60
references.pmid: 24904525
references.citation: J Nerv Ment Dis. 1984 Feb;172(2):90-7
references.pmid: 6693867
references.citation: Endocr Pract. 2015 Feb;21(2):199-204
references.pmid: 25667367
references.citation: Pediatr Rev. 2012 Jun;33(6):273-5
references.pmid: 22659258
references.citation: J Sex Res. 2007 Nov;44(4):370-9
references.pmid: 18321016
references.citation: J Clin Endocrinol Metab. 2015 Feb;100(2):E270-5
references.pmid: 25427144
references.citation: Pediatrics. 2014 Oct;134(4):696-704
references.pmid: 25201798
references.citation: Pediatr Endocrinol Rev. 2007 Jun;4(4):343-51
references.pmid: 17643082
references.citation: Neuroimage. 2009 Jul 15;46(4):904-7
references.pmid: 19341803
references.citation: J Abnorm Child Psychol. 2014 May;42(4):635-47
references.pmid: 24114528
references.citation: J Sex Med. 2015 Mar;12(3):756-63
references.pmid: 25612159
references.citation: Cereb Cortex. 2011 Nov;21(11):2525-33
references.pmid: 21467211
references.citation: Psychiatry Res. 2011 Apr 30;186(2-3):414-8
references.pmid: 20801524
references.citation: J Am Acad Child Adolesc Psychiatry. 2007 Oct;46(10):1307-1314
references.pmid: 17885572
references.citation: Clin Child Psychol Psychiatry. 2011 Oct;16(4):499-516
references.pmid: 21216800
references.citation: J LGBT Health Res. 2007;3(2):49-61
references.pmid: 19835041
references.citation: Horm Metab Res. 2015 May;47(5):361-6
references.pmid: 25853895
references.citation: J Clin Endocrinol Metab. 2014 Dec;99(12):4379-89
references.pmid: 25140398
references.citation: Pediatr Ann. 2014 Jun;43(6):238-44
references.pmid: 24972419
references.citation: Arch Sex Behav. 2011 Aug;40(4):843-7
references.pmid: 21503817
references.citation: Can J Psychiatry. 1990 Aug;35(6):477-86
references.pmid: 2207982
references.citation: J Child Psychol Psychiatry. 2011 Nov;52(11):1195-202
references.pmid: 21671938
references.citation: Dev Psychol. 2008 Jan;44(1):34-45
references.pmid: 18194003
references.citation: Cereb Cortex. 2008 Aug;18(8):1900-8
references.pmid: 18056697
references.citation: Pediatr Ann. 2014 Jun;43(6):e132-7
references.pmid: 24972421
references.citation: AIDS Behav. 2009 Oct;13(5):902-13
references.pmid: 19199022
references.citation: J Clin Endocrinol Metab. 2009 Sep;94(9):3132-54
references.pmid: 19509099
references.citation: J Pediatr. 2014 Apr;164(4):906-11
references.pmid: 24315505
references.citation: J Am Acad Child Adolesc Psychiatry. 2008 Dec;47(12):1413-23
references.pmid: 18981931
references.citation: J Sex Med. 2010 May;7(5):1858-67
references.pmid: 19751389
references.citation: Clin Child Psychol Psychiatry. 2006 Jul;11(3):397-405
references.pmid: 17080776
references.citation: J Psychiatr Res. 2011 Jul;45(7):949-54
references.pmid: 21195418
references.citation: J Am Acad Child Adolesc Psychiatry. 2013 Jun;52(6):582-90
references.pmid: 23702447
references.citation: J Adolesc Health. 2015 Mar;56(3):274-9
references.pmid: 25577670
references.citation: J Adolesc Health. 2015 Oct;57(4):374-80
references.pmid: 26208863
references.citation: J Am Acad Child Adolesc Psychiatry. 1997 Feb;36(2):263-71
references.pmid: 9031580
references.citation: Pediatrics. 2012 Mar;129(3):418-25
references.pmid: 22351896
references.citation: J Sex Med. 2011 Aug;8(8):2276-83
references.pmid: 20646177
references.citation: J Autism Dev Disord. 2010 Aug;40(8):930-6
references.pmid: 20094764
references.citation: Brain Res. 2008 Apr 24;1206:76-88
references.pmid: 18359009
references.citation: Monogr Soc Res Child Dev. 1981;46(1):1-82
references.pmid: 7242540