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Affirming “Gender Identity” in Minors

Cohn, J. (2023). Politics Aside, Healthcare Considerations Motivate More Caution before Medical Intervention for Trans-Identifying Youth. Journal of Controversial Ideas, 3(1), 1. https://doi.org/10.35995/jci03010010


Levine, S. B., & Abbruzzese, E. (2023). Current Concerns About Gender-Affirming Therapy in Adolescents. Current Sexual Health Reports. https://doi.org/10.1007/s11930-023-00358-x

Abbasi, K. (2023). Caring for young people with gender dysphoria. BMJ, p553. https://doi.org/10.1136/bmj.p553


Block, J. (2023). Gender dysphoria in young people is rising—and so is professional disagreement. BMJ, p382. https://doi.org/10.1136/bmj.p382

Evans, M. (2023). Assessment and treatment of a gender-dysphoric person with a traumatic history. Journal of Child Psychotherapy, 1–16. https://doi.org/10.1080/0075417X.2023.2172741


Elkadi, J., Chudleigh, C., Maguire, A. M., Ambler, G. R., Scher, S., & Kozlowska, K. (2023). Developmental Pathway Choices of Young People Presenting to a Gender Service with Gender Distress: A Prospective Follow-Up Study. Children, 10(2), 314. https://doi.org/10.3390/children10020314


Abbruzzese, E., Levine, S. B., & Mason, J. W. (2023). The Myth of “Reliable Research” in Pediatric Gender Medicine: A critical evaluation of the Dutch Studies—and research that has followed. Journal of Sex & Marital Therapy, 1–27. https://doi.org/10.1080/0092623X.2022.2150346


Giovanardi, G., Fortunato, A., Mirabella, M., Speranza, A. M., & Lingiardi, V. (2020). Gender Diverse Children and Adolescents in Italy: A Qualitative Study on Specialized Centers’ Model of Care and Network. International Journal of Environmental Research and Public Health, 17(24), 9536. https://doi.org/10.3390/ijerph17249536


Cohn, J. (2022). Some Limitations of “Challenges in the Care of Transgender and Gender-Diverse Youth: An Endocrinologist’s View.” Journal of Sex & Marital Therapy, 1–17. https://doi.org/10.1080/0092623X.2022.2160396


Clayton, A. (2022). Gender-Affirming Treatment of Gender Dysphoria in Youth: A Perfect Storm Environment for the Placebo Effect—The Implications for Research and Clinical Practice. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-022-02472-8


Kohls, G., & Roessner, V. (2022). Editorial Perspective: Medical body modification in youth with gender dysphoria or body dysmorphic disorder – is current practice coherent and evidence‐based? Journal of Child Psychology and Psychiatry, jcpp.13717. https://doi.org/10.1111/jcpp.13717

Kulesa, R. (2022). Toward a Standard of Medical Care: Why Medical Professionals Can Refuse to Prescribe Puberty Blockers. The New Bioethics, 1–17. https://doi.org/10.1080/20502877.2022.2137906


Levine, S. B., Abbruzzese, E., & Mason, J. W. (2022). What Are We Doing to These Children? Response to Drescher, Clayton, and Balon Commentaries on Levine et al., 2022. Journal of Sex & Marital Therapy, 1–11. https://doi.org/10.1080/0092623X.2022.2136117

Block, J. (2022). US transgender health guidelines leave age of treatment initiation open to clinical judgment. BMJ, o2303. https://doi.org/10.1136/bmj.o2303


Biggs, M. (2022). The Dutch Protocol for Juvenile Transsexuals: Origins and Evidence. Journal of Sex & Marital Therapy, 1–21. https://doi.org/10.1080/0092623X.2022.2121238


McIntosh, B., & Koseda, E. (2022). The interim report of the Cass review into the NHS gender identity development service: a discussion. British Journal of Healthcare Management, 28(8), 1–4. https://doi.org/10.12968/bjhc.2022.0089


MacKinnon, K. R., Kia, H., Salway, T., Ashley, F., Lacombe-Duncan, A., Abramovich, A., Enxuga, G., & Ross, L. E. (2022). Health Care Experiences of Patients Discontinuing or Reversing Prior Gender-Affirming Treatments. JAMA Network Open, 5(7), e2224717. https://doi.org/10.1001/jamanetworkopen.2022.24717


Clayton, A., D’Angelo, R., & Clarke, P. (2022). Parental consent and the treatment of transgender youth: the impact of Re Imogen. Medical Journal of Australia, mja2.51643. https://doi.org/10.5694/mja2.51643


Latham, A. (2022). Puberty Blockers for Children: Can They Consent? The New Bioethics, 1–24. https://doi.org/10.1080/20502877.2022.2088048


Wiepjes, C. M., Klink, D. T., Hellinga, I., van Trotsenburg, A. S. P., den Heijer, M., & Hannema, S. E. (2022). Transgender Girls Grow Tall: Adult Height Is Unaffected by GnRH Analogue and Estradiol Treatment. The Journal of Clinical Endocrinology & Metabolism, dgac349. https://doi.org/10.1210/clinem/dgac349


Clayton, A. (2022). Commentary on Levine: A Tale of Two Informed Consent Processes. Journal of Sex & Marital Therapy, 1–8. https://doi.org/10.1080/0092623X.2022.2070565


Roberts, C. M., Klein, D. A., Adirim, T. A., Schvey, N. A., & Hisle-Gorman, E. (2022). Continuation of Gender-affirming Hormones Among Transgender Adolescents and Adults. The Journal of Clinical Endocrinology & Metabolism, dgac251. https://doi.org/10.1210/clinem/dgac251


Balon, R. (2022). Commentary on Levine et al: Festina Lente (Rush Slowly). Journal of Sex & Marital Therapy, 1–4. https://doi.org/10.1080/0092623X.2022.2055686


Levine, S. B., Abbruzzese, E., & Mason, J. M. (2022). Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults. Journal of Sex & Marital Therapy, 1–22. https://doi.org/10.1080/0092623X.2022.2046221


Cass, H. (2022). Review of gender identity services for children and young people. BMJ, o629. https://doi.org/10.1136/bmj.o629


Bradley, S. J. (2022). Understanding Vulnerability in Girls and Young Women with High-Functioning Autism Spectrum Disorder. Women, 2(1), 64–67. https://doi.org/10.3390/women2010007


Canvin, L., Hawthorne, O., & Panting, H. (2022). Supporting young people to manage gender-related distress using third-wave cognitive behavioural theory, ideas and practice. Clinical Child Psychology and Psychiatry, 135910452110687. https://doi.org/10.1177/13591045211068729


Biggs, M. (2022). Suicide by Clinic-Referred Transgender Adolescents in the United Kingdom. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-022-02287-7


Boyd, I., Hackett, T., & Bewley, S. (2022). Care of Transgender Patients: A General Practice Quality Improvement Approach. Healthcare (Basel, Switzerland), 10(1), 121. https://doi.org/10.3390/healthcare10010121


Helyar, S., Jackson, L., & Ion, R. (2022). Gender dysphoria in young people: The Interim Cass Review and its implications for nursing. Journal of Clinical Nursing, 31(23–24). https://doi.org/10.1111/jocn.16553


Evans, M. (2022). ‘If only I were a boy …’: Psychotherapeutic Explorations of Transgender in Children and Adolescents. British Journal of Psychotherapy, 38(2), 269–285. https://doi.org/10.1111/bjp.12733


Sinai, J. (2022). Rapid onset gender dysphoria as a distinct clinical phenomenon. The Journal of Pediatrics, S0022347622001858. https://doi.org/10.1016/j.jpeds.2022.03.005


Littman, L. (2022). Saying that Bauer et al studied rapid onset gender dysphoria is inaccurate and misleading. The Journal of Pediatrics, S0022347622001834. https://doi.org/10.1016/j.jpeds.2022.03.003


Clayton, A. (2022). The Gender Affirmative Treatment Model for Youth with Gender Dysphoria: A Medical Advance or Dangerous Medicine? Archives of Sexual Behavior, 51(2), 691–698. https://doi.org/10.1007/s10508-021-02232-0


Jorgensen, S. C. J., Hunter, P. K., Regenstreif, L., Sinai, J., & Malone, W. J. (2022). Puberty blockers for gender dysphoric youth: A lack of sound science. Journal of the American College of Clinical Pharmacy, 1005–1007(9), 3. https://doi.org/10.1002/jac5.1691


Clayton, A., Malone, W. J., Clarke, P., Mason, J., & D’Angelo, R. (2021). Commentary: The Signal and the Noise—questioning the benefits of puberty blockers for youth with gender dysphoria—a commentary on Rew et al. (2021). Child and Adolescent Mental Health, camh.12533. https://doi.org/10.1111/camh.12533


Hunter, P. K. (2021). Political Issues Surrounding Gender-Affirming Care for Transgender Youth. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2021.5348


Helyar, S., Jackson, L., Patrick, L., Hill, A., & Ion, R. (2021). Gender Dysphoria in children and young people: The implications for clinical staff of the Bell V’s Tavistock Judicial Review and Appeal Ruling. Journal of Clinical Nursing, jocn.16164. https://doi.org/10.1111/jocn.16164


Moschella, M. (2021). Trapped in the Wrong Body? Transgender Identity Claims, Body-Self Dualism, and the False Promise of Gender Reassignment Therapy. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 46(6), 782–804. https://doi.org/10.1093/jmp/jhab030


Schwartz, D. (2021). Clinical and Ethical Considerations in the Treatment of Gender Dysphoric Children and Adolescents: When Doing Less Is Helping More. Journal of Infant, Child, and Adolescent Psychotherapy, 1–11. https://doi.org/10.1080/15289168.2021.1997344


Expósito-Campos, P., & D’Angelo, R. (2021). Letter to the Editor: Regret after Gender-affirmation Surgery: A Systematic Review and Meta-

analysis of Prevalence. Plastic and Reconstructive Surgery - Global Open, 9(11), e3951. https://doi.org/10.1097/GOX.0000000000003951


Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-021-02163-w


Levine, S. B. (2021). Reflections on the Clinician’s Role with Individuals Who Self-identify as Transgender. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-021-02142-1


Lemma, A., & Savulescu, J. (2021). To be, or not to be? The role of the unconscious in transgender transitioning: identity, autonomy and well-being. Journal of Medical Ethics, medethics-2021-107397. https://doi.org/10.1136/medethics-2021-107397


Laidlaw, M. K., Van Mol, A., Van Meter, Q., & Hansen, J. E. (2021). Letter to the Editor from Laidlaw et al: “Erythrocytosis in a Large Cohort of Transgender Men Using Testosterone: A Long-Term Follow-Up Study on Prevalence, Determinants, and Exposure Years.” The Journal of Clinical Endocrinology & Metabolism, dgab514. https://doi.org/10.1210/clinem/dgab514


Vandenbussche, E. (2021). Detransition-Related Needs and Support: A Cross-Sectional Online Survey. Journal of Homosexuality, 20. https://doi.org/10.1080/00918369.2021.1919479


Biggs, M. (2021). Revisiting the effect of GnRH analogue treatment on bone mineral density in young adolescents with gender dysphoria. Journal of Pediatric Endocrinology and Metabolism, 0(0), 000010151520210180. https://doi.org/10.1515/jpem-2021-0180


Kozlowska, K., McClure, G., Chudleigh, C., Maguire, A. M., Gessler, D., Scher, S., & Ambler, G. R. (2021). Australian children and adolescents with gender dysphoria: Clinical presentations and challenges experienced by a multidisciplinary team and gender service. Human Systems, 26344041211010776. https://doi.org/10.1177/26344041211010777


Malone, W. J., Hruz, P. W., Mason, J. W., & Beck, S. (2021). Letter to the Editor from William J. Malone et al: “Proper Care of Transgender and Gender-diverse Persons in the Setting of Proposed Discrimination: A Policy Perspective.” The Journal of Clinical Endocrinology & Metabolism, dgab205. https://doi.org/10.1210/clinem/dgab205


Bewley, S., McCartney, M., Meads, C., & Rogers, A. (2021). Sex, gender, and medical data. BMJ, n735. https://doi.org/10.1136/bmj.n735


Giordano, S., Garland, F., & Holm, S. (2021). Gender dysphoria in adolescents: can adolescents or parents give valid consent to puberty blockers? Journal of Medical Ethics, medethics-2020-106999. https://doi.org/10.1136/medethics-2020-106999


Dyer, C. (2021). Puberty blockers do not alleviate negative thoughts in children with gender dysphoria, finds study. BMJ, n356. https://doi.org/10.1136/bmj.n356


Biggs, M. (2021, February 3). More questions than answers about the outcomes of puberty suppression. https://journals.plos.org/plosone/article/comment?id=10.1371%2Fannotation%2F71faadb8-de18-4c65-9482-93ded40984b6&s=08


Walch, A., Davidge-Pitts, C., Safer, J. D., Lopez, X., Tangpricha, V., & Iwamoto, S. J. (2021). Proper Care of Transgender and Gender Diverse Persons in the Setting of Proposed Discrimination: A Policy Perspective*. The Journal of Clinical Endocrinology & Metabolism, 106(2), 305–308. https://doi.org/10.1210/clinem/dgaa816


Expósito-Campos, P. (2021). A Typology of Gender Detransition and Its Implications for Healthcare Providers. Journal of Sex & Marital Therapy. https://www.tandfonline.com/doi/abs/10.1080/0092623X.2020.1869126


Malone, W., D’Angelo, R., Beck, S., Mason, J., & Evans, M. (2021). Puberty blockers for gender dysphoria: the science is far from settled. The Lancet Child & Adolescent Health, 5(9), e33–e34. https://doi.org/10.1016/S2352-4642(21)00235-2


O’Malley, S., Garner, M., Withers, R., Caspian, J., & Jenkins, P. (2021). The communication of evidence to inform trans youth health care. The Lancet Child & Adolescent Health, S2352464221001978. https://doi.org/10.1016/S2352-4642(21)00197-8


Armitage, R. (2021). The communication of evidence to inform trans youth health care. The Lancet Child & Adolescent Health, S2352464221001929. https://doi.org/10.1016/S2352-4642(21)00192-9


Dahlen, S., Connolly, D., Arif, I., Junejo, M. H., Bewley, S., & Meads, C. (2021). International clinical practice guidelines for gender minority/trans people: systematic review and quality assessment. BMJ Open, 11(4), e048943. https://doi.org/10.1136/bmjopen-2021-048943


Singh, D., Bradley, S. J., & Zucker, K. J. (2021). A Follow-Up Study of Boys With Gender Identity Disorder. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.632784


Kozlowska, K., Chudleigh, C., McClure, G., Maguire, A. M., & Ambler, G. R. (2021). Attachment Patterns in Children and Adolescents With Gender Dysphoria. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.582688


D’Angelo, R., Syrulnik, E., Ayad, S., Marchiano, L., Kenny, D. T., & Clarke, P. (2020). One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-020-01844-2


D’Angelo, R. (2020). The man I am trying to be is not me. The International Journal of Psychoanalysis, 101(5), 951–970. https://doi.org/10.1080/00207578.2020.1810049


Bell, D. (2020). First do no harm. The International Journal of Psychoanalysis, 101(5), 1031–1038. https://doi.org/10.1080/00207578.2020.1810885


Anckarsäter, H., & Gillberg, C. (2020). Methodological Shortcomings Undercut Statement in Support of Gender-Affirming Surgery. American Journal of Psychiatry, 177(8), 764–765. https://doi.org/10.1176/appi.ajp.2020.19111117


Ring, A., & Malone, W. J. (2020). Confounding Effects on Mental Health Observations After Sex Reassignment Surgery. American Journal of Psychiatry, 177(8), 768–769. https://doi.org/10.1176/appi.ajp.2020.19111169


Van Mol, A., Laidlaw, M. K., Grossman, M., & McHugh, P. R. (2020). Gender-Affirmation Surgery Conclusion Lacks Evidence. American Journal of Psychiatry, 177(8), 765–766. https://doi.org/10.1176/appi.ajp.2020.19111130


Evans, M. (2020). Freedom to think: the need for thorough assessment and treatment of gender dysphoric children. BJPsych Bulletin, 1–5. https://doi.org/10.1192/bjb.2020.72


Griffin, L., Clyde, K., Byng, R., & Bewley, S. (2020). Sex, gender and gender identity: a re-evaluation of the evidence. BJPsych Bulletin, 1–9. https://doi.org/10.1192/bjb.2020.73


Pilgrim, D., & Entwistle, K. (2020). GnRHa (‘Puberty Blockers’) and Cross Sex Hormones for Children and Adolescents: Informed Consent, Personhood and Freedom of Expression. The New Bioethics, 26(3), 224–237. https://doi.org/10.1080/20502877.2020.1796257


Entwistle, K. (2020). Debate: Reality check – Detransitioner’s testimonies require us to rethink gender dysphoria. Child and Adolescent Mental Health, camh.12380. https://doi.org/10.1111/camh.12380


Kaltiala, R., Heino, E., Työläjärvi, M., & Suomalainen, L. (2020). Adolescent development and psychosocial functioning after starting cross-sex hormones for gender dysphoria. Nordic Journal of Psychiatry, 74(3), 213–219. https://doi.org/10.1080/08039488.2019.1691260


D’Angelo, R. (2020). Who is Phoenix? Journal of Medical Ethics, 46(11), 753–754. https://doi.org/10.1136/medethics-2020-106822


D’Angelo, R. (2020). The complexity of childhood gender dysphoria. Australasian Psychiatry, 28(5), 530–532. https://doi.org/10.1177/1039856220917076


de Vries, A. L. C. (2020). Challenges in Timing Puberty Suppression for Gender-Nonconforming Adolescents. Pediatrics, 146(4), e2020010611. https://doi.org/10.1542/peds.2020-010611


Biggs, M. (2020). Puberty Blockers and Suicidality in Adolescents Suffering from Gender Dysphoria. Archives of Sexual Behavior, 49(7), 2227–2229. https://doi.org/10.1007/s10508-020-01743-6


Biggs, M. (2020). Gender Dysphoria and Psychological Functioning in Adolescents Treated with GnRHa: Comparing Dutch and English Prospective Studies. Archives of Sexual Behavior, 49(7), 2231–2236. https://doi.org/10.1007/s10508-020-01764-1


Hruz, P. W. (2020). Deficiencies in Scientific Evidence for Medical Management of Gender Dysphoria. The Linacre Quarterly, 87(1), 34–42. https://doi.org/10.1177/0024363919873762


Zucker, K. J. (2020). Debate: Different strokes for different folks. Child and Adolescent Mental Health, 25(1), 36–37. https://doi.org/10.1111/camh.12330


Hutchinson, A., Midgen, M., & Spiliadis, A. (2020). In Support of Research Into Rapid-Onset Gender Dysphoria. Archives of Sexual Behavior, 49(1), 79–80. https://doi.org/10.1007/s10508-019-01517-9


Withers, Robert. (2020). Transgender medicalization and the attempt to evade psychological distress. Journal of Analytical Psychology, 65(5), 865–889. https://onlinelibrary.wiley.com/doi/10.1111/1468-5922.12641


Byng, R., & Bewley, S. (2019). Gender dysphoria: scientific oversight falling between responsible institutions should worry us all. BMJ, l6439. https://doi.org/10.1136/bmj.l6439


Levine, S. B. (2019). Informed Consent for Transgendered Patients. Journal of Sex & Marital Therapy, 45(3), 218–229. https://doi.org/10.1080/0092623X.2018.1518885


Laidlaw, M. K., Van Meter, Q. L., Hruz, P. W., Van Mol, A., & Malone, W. J. (2019). Letter to the Editor: “Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline.” The Journal of Clinical Endocrinology & Metabolism, 104(3), 686–687. https://doi.org/10.1210/jc.2018-01925


Heneghan, Carl, & Jefferson, Tom. (2019, February 25). Gender-affirming hormone in children and adolescents. BMJ EBM Spotlight. https://blogs.bmj.com/bmjebmspotlight/2019/02/25/gender-affirming-hormone-in-children-and-adolescents-evidence-review/


Biggs, M. (2019). A Letter to the Editor Regarding the Original Article by Costa et al: Psychological Support, Puberty Suppression, and Psychosocial Functioning in Adolescents with Gender Dysphoria. The Journal of Sexual Medicine, 16(12), 2043. https://doi.org/10.1016/j.jsxm.2019.09.002


Zucker, K. J. (2019). Adolescents with Gender Dysphoria: Reflections on Some Contemporary Clinical and Research Issues. Archives of Sexual Behavior, 48(7), 1983–1992. https://doi.org/10.1007/s10508-019-01518-8


Richards, C., Maxwell, J., & McCune, N. (2019). Use of puberty blockers for gender dysphoria: a momentous step in the dark. Archives of Disease in Childhood, 104(6), 611–612. https://doi.org/10.1136/archdischild-2018-315881


Churcher Clarke, A., & Spiliadis, A. (2019). ‘Taking the lid off the box’: The value of extended clinical assessment for adolescents presenting with gender identity difficulties. Clinical Child Psychology and Psychiatry, 24(2), 338–352. https://doi.org/10.1177/1359104518825288


Bewley, S., Clifford, D., McCartney, M., & Byng, R. (2019). Gender incongruence in children, adolescents, and adults. British Journal of General Practice, 69(681), 170–171. https://doi.org/10.3399/bjgp19X701909


Laidlaw, M., Cretella, M., & Donovan, K. (2019). The Right to Best Care for Children Does Not Include the Right to Medical Transition. The American Journal of Bioethics, 19(2), 75–77. https://doi.org/10.1080/15265161.2018.1557288


Spiliadis, A. (2019). Towards a gender exploratory model: Slowing things down, opening things up and exploring identity development. Metalogos Systemic Therapy Journal, 35, 1–9. https://www.researchgate.net/publication/334559847_Towards_a_Gender_Exploratory_Model_slowing_things_down_opening_things_up_and_exploring_identity_development


Byng, R., Bewley, S., Clifford, D., & McCartney, M. (2018). Redesigning gender identity services: an opportunity to generate evidence. BMJ, k4490. https://doi.org/10.1136/bmj.k4490


Zucker, K. J. (2018). The myth of persistence: Response to “A critical commentary on follow-up studies and ‘desistance’ theories about transgender and gender non-conforming children” by Temple Newhook et al. (2018). International Journal of Transgenderism, 19(2), 231–245. https://doi.org/10.1080/15532739.2018.1468293


Levine, S. B. (2018). Ethical Concerns About Emerging Treatment Paradigms for Gender Dysphoria. Journal of Sex & Marital Therapy, 44(1), 29–44. https://doi.org/10.1080/0092623X.2017.1309482


de Graaf, N. M., Carmichael, P., Steensma, T. D., & Zucker, K. J. (2018). Evidence for a Change in the Sex Ratio of Children Referred for Gender Dysphoria: Data From the Gender Identity Development Service in London (2000–2017). The Journal of Sexual Medicine, 15(10), 1381–1383. https://doi.org/10.1016/j.jsxm.2018.08.002


Marchiano, L. (2017). Outbreak: On Transgender Teens and Psychic Epidemics. Psychological Perspectives, 60(3), 345–366. https://doi.org/10.1080/00332925.2017.1350804


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