Abstract
Puberty suppression by means of gonadotropin releasing hormone (GnRH) analogs is considered a diagnostic aid in gender dysphoric
adolescents. However, there are also concerns about potential risks, such as poor outcome or post-surgical regret, adverse
effects on metabolic and endocrine status, impaired increment of bone mass, and interference with brain development. This
case report is on a 22-year follow-up of a female-to-male transsexual, treated with GnRH analogs at 13 years of age and considered
eligible for androgen treatment at age 17, and who had gender reassignment surgery at 20 and 22 years of age. At follow-up,
he indicated no regrets about his treatment. He was functioning well psychologically, intellectually, and socially; however,
he experienced some feelings of sadness about choices he had made in a long-lasting intimate relationship. There were no clinical
signs of a negative impact on brain development. He was physically in good health, and metabolic and endocrine parameters
were within reference ranges. Bone mineral density was within the normal range for both sexes. His final height was short
as compared to Dutch males; however, his body proportions were within normal range. This first report on long-term effects
of puberty suppression suggests that negative side effects are limited and that it can be a useful additional tool in the
diagnosis and treatment of gender dysphoric adolescents.
adolescents. However, there are also concerns about potential risks, such as poor outcome or post-surgical regret, adverse
effects on metabolic and endocrine status, impaired increment of bone mass, and interference with brain development. This
case report is on a 22-year follow-up of a female-to-male transsexual, treated with GnRH analogs at 13 years of age and considered
eligible for androgen treatment at age 17, and who had gender reassignment surgery at 20 and 22 years of age. At follow-up,
he indicated no regrets about his treatment. He was functioning well psychologically, intellectually, and socially; however,
he experienced some feelings of sadness about choices he had made in a long-lasting intimate relationship. There were no clinical
signs of a negative impact on brain development. He was physically in good health, and metabolic and endocrine parameters
were within reference ranges. Bone mineral density was within the normal range for both sexes. His final height was short
as compared to Dutch males; however, his body proportions were within normal range. This first report on long-term effects
of puberty suppression suggests that negative side effects are limited and that it can be a useful additional tool in the
diagnosis and treatment of gender dysphoric adolescents.
- Content Type Journal Article
- Pages 1-5
- DOI 10.1007/s10508-011-9758-9
- Authors
- Peggy T. Cohen-Kettenis, Department of Medical Psychology and Medical Social Work, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Sebastiaan E. E. Schagen, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
- Thomas D. Steensma, Department of Medical Psychology and Medical Social Work, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Annelou L. C. de Vries, Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
- Henriette A. Delemarre-van de Waal, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
- Journal Archives of Sexual Behavior
- Online ISSN 1573-2800
- Print ISSN 0004-0002