title: Characteristics of Referrals for Gender Dysphoria Over a 13-Year Period.
abstract: OBJECTIVE
  Our Pediatric Endocrinology Clinic has seen a sharp increase in referrals for gender dysphoria (GD) during recent years. However, the frequency and characteristics of referrals have not been objectively examined.
  
  
  METHODS
  A retrospective chart review of referrals for GD during the past 13 years was performed. Variables analyzed included numbers of referrals per year, patient characteristics, comorbid conditions, and hormonal therapy. Timing of referral and eligibility for treatment were measured against established recommendations.
  
  
  RESULTS
  Of 38 patients, 74% were referred during the last 3 years. Most patients presented late in puberty before a GD-specific psychological evaluation and few were eligible for hormonal treatment at baseline. Over half had psychiatric and/or developmental comorbidities.
  
  
  CONCLUSIONS
  A dramatic increase in referrals for GD since 2002 was confirmed. Enhanced provider education and outreach regarding care of patients with GD are needed.
authors.affiliation: Department of Pediatrics, Section of Pediatric Endocrinology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: chenmeli@iupui.edu.
authors.forename: Melinda
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, Section of Pediatric Endocrinology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: John
authors.initials: J
authors.lastname: Fuqua
authors.affiliation: Department of Pediatrics, Section of Pediatric Endocrinology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Erica A
authors.initials: EA
authors.lastname: Eugster
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D000068116:Gender Dysphoria / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D020249:Hormone Replacement Therapy / Q000379:methods; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D008297:Male; D012017:Referral and Consultation / Q000639:trends; D012189:Retrospective Studies; D012741:Sexual Maturation
keywords: Gender dysphoria; Referrals; Transgender