title: Early pubertal timing is common among adolescent girl-to-boy sex reassignment applicants.
abstract: OBJECTIVE
  The aim of our study was to explore whether gender dysphoria in adolescent girls is associated with early pubertal timing.
  
  
  METHODS
  We compared menarcheal timing among 52 adolescent girl-to-boy sex reassignment (SR) applicants with that of 644 adolescent girls who participated in an adolescent population mental health survey.
  
  
  RESULTS
  Of the population girls, 21% presented with early (≤11 years), 61% with normative (12-13 years) and 19% with late (≥14 years) menarcheal timing; among the SR applicants, 42% presented with early, 46% with normative and 12% with late menarcheal timing (p = 0.003). The odds ratio for SR applicant girls to have early menarcheal timing was 2.7 (95% confidence interval (CI) 1.3, 5.7), controlling for age and family structure.
  
  
  CONCLUSIONS
  Like emotional and behavioural disorders, gender dysphoria in adolescence is associated in girls with early pubertal timing. The finding is discussed in the light of literature related to pubertal maturation and mental health.
authors.affiliation: a Department of Adolescent Psychiatry , Tampere University Hospital , Tampere , Finland.
authors.forename: Maria
authors.initials: M
authors.lastname: Sumia
authors.affiliation: b Faculty of Medicine , University of Helsinki , Helsinki , Finland.|c Division of Psychoses and Forensic Psychiatry , Helsinki University Hospital , Helsinki , Finland.
authors.forename: Nina
authors.initials: N
authors.lastname: Lindberg
authors.affiliation: a Department of Adolescent Psychiatry , Tampere University Hospital , Tampere , Finland.
authors.forename: Marja
authors.initials: M
authors.lastname: Työläjärvi
authors.affiliation: a Department of Adolescent Psychiatry , Tampere University Hospital , Tampere , Finland.|d School of Medicine , University of Tampere , Tampere , Finland.
authors.forename: Riittakerttu
authors.initials: R
authors.lastname: Kaltiala-Heino
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology* / Q000523:psychology*; D017668:Age of Onset; D000818:Animals; D002648:Child; D015331:Cohort Studies; D005260:Female; D005387:Finland; D000068116:Gender Dysphoria / Q000503:physiopathology* / Q000523:psychology*; D005783:Gender Identity; D006801:Humans; D008297:Male; D008499:Medical Records; D008572:Menarche / Q000502:physiology* / Q000523:psychology; D011627:Puberty / Q000502:physiology / Q000523:psychology*; D012189:Retrospective Studies; D057829:Gender-Affirming Procedures; D011795:Surveys and Questionnaires
keywords: Adolescence; gender dysphoria; pubertal timing