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Trends in Referrals to a Pediatric Transgender Clinic
We characterized referral trends over time at a transgender clinic within an integrated health system in Northern California. We identified the transition-related requests of pediatric transgender and gender-nonconforming patients and evaluated differences in referrals by age group. Medical records...
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| Published in: | Pediatrics (Evanston) 2019-11, Vol.144 (5), p.1 |
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| Main Authors: | , , , , , |
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| container_issue | 5 |
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| container_title | Pediatrics (Evanston) |
| container_volume | 144 |
| creator | Handler, Ted Hojilla, J Carlo Varghese, Reshma Wellenstein, Whitney Satre, Derek D Zaritsky, Eve |
| description | We characterized referral trends over time at a transgender clinic within an integrated health system in Northern California. We identified the transition-related requests of pediatric transgender and gender-nonconforming patients and evaluated differences in referrals by age group.
Medical records were analyzed for all patients |
| doi_str_mv | 10.1542/peds.2019-1368 |
| format | article |
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Medical records were analyzed for all patients <18 years of age in the Kaiser Permanente Northern California health system who were referred to a specialty transgender clinic between February 2015 and June 2018. Trends in treatment demand, demographic data, service requests, and surgical history were abstracted from medical charts and analyzed by using descriptive statistics.
We identified 417 unique transgender and gender-nonconforming pediatric patients. The median age at time of referral was 15 years (range 3-17). Most (62%) identified on the masculine spectrum. Of the 203 patients with available ethnicity data, 68% were non-Hispanic. During the study period, the clinic received a total of 506 referrals with a significant increase over time (
< .001). Most referrals were for requests to start cross-sex hormones and/or blockers (34%), gender-affirming surgery (32%), and mental health (27%). Transition-related requests varied by age group: younger patients sought more mental health services, and older patients sought hormonal and surgical services. Eighty-nine patients underwent gender-affirming surgeries, mostly before age 18 and most frequently mastectomies (77%).
The increase in referrals supports the need for expanded and accessible health care services for this population. The transition-related care of patients in this large sample varied by age group, underscoring the need for an individualized approach to gender-affirming care.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2019-1368</identifier><identifier>PMID: 31619510</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Adolescent ; Age ; Age groups ; California ; Child ; Child, Preschool ; Datasets as Topic ; Demographics ; Female ; Gender ; Gender Dysphoria ; Gender nonconforming ; Humans ; Male ; Medical records ; Menopause ; Mental health ; Minority & ethnic groups ; Patient Acceptance of Health Care - statistics & numerical data ; Patients ; Pediatrics ; Referral and Consultation - trends ; Sex hormones ; Sex Reassignment Procedures - statistics & numerical data ; Surgery ; Transgender persons ; Transgender Persons - psychology ; Transgender Persons - statistics & numerical data ; Transsexualism - psychology ; Transsexualism - therapy ; Trends</subject><ispartof>Pediatrics (Evanston), 2019-11, Vol.144 (5), p.1</ispartof><rights>Copyright © 2019 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Nov 2019</rights><rights>Copyright © 2019 by the American Academy of Pediatrics 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-ebf8b6029b3e2d956e534a671ff8c4dcb3423d0edc419bcca30ea1e427d0d0af3</citedby><cites>FETCH-LOGICAL-c418t-ebf8b6029b3e2d956e534a671ff8c4dcb3423d0edc419bcca30ea1e427d0d0af3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31619510$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Handler, Ted</creatorcontrib><creatorcontrib>Hojilla, J Carlo</creatorcontrib><creatorcontrib>Varghese, Reshma</creatorcontrib><creatorcontrib>Wellenstein, Whitney</creatorcontrib><creatorcontrib>Satre, Derek D</creatorcontrib><creatorcontrib>Zaritsky, Eve</creatorcontrib><title>Trends in Referrals to a Pediatric Transgender Clinic</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>We characterized referral trends over time at a transgender clinic within an integrated health system in Northern California. We identified the transition-related requests of pediatric transgender and gender-nonconforming patients and evaluated differences in referrals by age group.
Medical records were analyzed for all patients <18 years of age in the Kaiser Permanente Northern California health system who were referred to a specialty transgender clinic between February 2015 and June 2018. Trends in treatment demand, demographic data, service requests, and surgical history were abstracted from medical charts and analyzed by using descriptive statistics.
We identified 417 unique transgender and gender-nonconforming pediatric patients. The median age at time of referral was 15 years (range 3-17). Most (62%) identified on the masculine spectrum. Of the 203 patients with available ethnicity data, 68% were non-Hispanic. During the study period, the clinic received a total of 506 referrals with a significant increase over time (
< .001). Most referrals were for requests to start cross-sex hormones and/or blockers (34%), gender-affirming surgery (32%), and mental health (27%). Transition-related requests varied by age group: younger patients sought more mental health services, and older patients sought hormonal and surgical services. Eighty-nine patients underwent gender-affirming surgeries, mostly before age 18 and most frequently mastectomies (77%).
The increase in referrals supports the need for expanded and accessible health care services for this population. The transition-related care of patients in this large sample varied by age group, underscoring the need for an individualized approach to gender-affirming care.</description><subject>Adolescent</subject><subject>Age</subject><subject>Age groups</subject><subject>California</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Datasets as Topic</subject><subject>Demographics</subject><subject>Female</subject><subject>Gender</subject><subject>Gender Dysphoria</subject><subject>Gender nonconforming</subject><subject>Humans</subject><subject>Male</subject><subject>Medical records</subject><subject>Menopause</subject><subject>Mental health</subject><subject>Minority & ethnic groups</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Referral and Consultation - trends</subject><subject>Sex hormones</subject><subject>Sex Reassignment Procedures - statistics & numerical data</subject><subject>Surgery</subject><subject>Transgender persons</subject><subject>Transgender Persons - psychology</subject><subject>Transgender Persons - statistics & numerical data</subject><subject>Transsexualism - psychology</subject><subject>Transsexualism - therapy</subject><subject>Trends</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNpdkUtLAzEURoMoWh9blzLgxs3Um9c02QhSfIGgSF2HTHKnRtqZmkwF_70ZqqLChSzuycd3OYQcUxhTKdj5Cn0aM6C6pLxSW2REQatSsIncJiMATksBIPfIfkqvACDkhO2SPU4rqiWFEZGziK1PRWiLJ2wwRrtIRd8VtnhEH2wfgytm0bZpnjGMxXQR2uAOyU6TQTz6eg_I8_XVbHpb3j_c3E0v70snqOpLrBtVV8B0zZF5LSuUXNhqQptGOeFdzQXjHtBnXNfOWQ5oKeb2HjzYhh-Qi03ual0vM4ZtnwuaVQxLGz9MZ4P5u2nDi5l376ZSUio9yQFnXwGxe1tj6s0yJIeLhW2xWyfDOFRCM6pERk__oa_dOrb5vExRqodRmRpvKBe7lCI2P2UomMGIGYyYwYgZjOQPJ79P-MG_FfBPVKeHcw</recordid><startdate>201911</startdate><enddate>201911</enddate><creator>Handler, Ted</creator><creator>Hojilla, J Carlo</creator><creator>Varghese, Reshma</creator><creator>Wellenstein, Whitney</creator><creator>Satre, Derek D</creator><creator>Zaritsky, Eve</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201911</creationdate><title>Trends in Referrals to a Pediatric Transgender Clinic</title><author>Handler, Ted ; Hojilla, J Carlo ; Varghese, Reshma ; Wellenstein, Whitney ; Satre, Derek D ; Zaritsky, Eve</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-ebf8b6029b3e2d956e534a671ff8c4dcb3423d0edc419bcca30ea1e427d0d0af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Age</topic><topic>Age groups</topic><topic>California</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Datasets as Topic</topic><topic>Demographics</topic><topic>Female</topic><topic>Gender</topic><topic>Gender Dysphoria</topic><topic>Gender nonconforming</topic><topic>Humans</topic><topic>Male</topic><topic>Medical records</topic><topic>Menopause</topic><topic>Mental health</topic><topic>Minority & ethnic groups</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Referral and Consultation - trends</topic><topic>Sex hormones</topic><topic>Sex Reassignment Procedures - statistics & numerical data</topic><topic>Surgery</topic><topic>Transgender persons</topic><topic>Transgender Persons - psychology</topic><topic>Transgender Persons - statistics & numerical data</topic><topic>Transsexualism - psychology</topic><topic>Transsexualism - therapy</topic><topic>Trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Handler, Ted</creatorcontrib><creatorcontrib>Hojilla, J Carlo</creatorcontrib><creatorcontrib>Varghese, Reshma</creatorcontrib><creatorcontrib>Wellenstein, Whitney</creatorcontrib><creatorcontrib>Satre, Derek D</creatorcontrib><creatorcontrib>Zaritsky, Eve</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Handler, Ted</au><au>Hojilla, J Carlo</au><au>Varghese, Reshma</au><au>Wellenstein, Whitney</au><au>Satre, Derek D</au><au>Zaritsky, Eve</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends in Referrals to a Pediatric Transgender Clinic</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2019-11</date><risdate>2019</risdate><volume>144</volume><issue>5</issue><spage>1</spage><pages>1-</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><abstract>We characterized referral trends over time at a transgender clinic within an integrated health system in Northern California. We identified the transition-related requests of pediatric transgender and gender-nonconforming patients and evaluated differences in referrals by age group.
Medical records were analyzed for all patients <18 years of age in the Kaiser Permanente Northern California health system who were referred to a specialty transgender clinic between February 2015 and June 2018. Trends in treatment demand, demographic data, service requests, and surgical history were abstracted from medical charts and analyzed by using descriptive statistics.
We identified 417 unique transgender and gender-nonconforming pediatric patients. The median age at time of referral was 15 years (range 3-17). Most (62%) identified on the masculine spectrum. Of the 203 patients with available ethnicity data, 68% were non-Hispanic. During the study period, the clinic received a total of 506 referrals with a significant increase over time (
< .001). Most referrals were for requests to start cross-sex hormones and/or blockers (34%), gender-affirming surgery (32%), and mental health (27%). Transition-related requests varied by age group: younger patients sought more mental health services, and older patients sought hormonal and surgical services. Eighty-nine patients underwent gender-affirming surgeries, mostly before age 18 and most frequently mastectomies (77%).
The increase in referrals supports the need for expanded and accessible health care services for this population. The transition-related care of patients in this large sample varied by age group, underscoring the need for an individualized approach to gender-affirming care.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>31619510</pmid><doi>10.1542/peds.2019-1368</doi><oa>free_for_read</oa></addata></record> |
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| source | EZB Electronic Journals Library |
| subjects | Adolescent Age Age groups California Child Child, Preschool Datasets as Topic Demographics Female Gender Gender Dysphoria Gender nonconforming Humans Male Medical records Menopause Mental health Minority & ethnic groups Patient Acceptance of Health Care - statistics & numerical data Patients Pediatrics Referral and Consultation - trends Sex hormones Sex Reassignment Procedures - statistics & numerical data Surgery Transgender persons Transgender Persons - psychology Transgender Persons - statistics & numerical data Transsexualism - psychology Transsexualism - therapy Trends |
| title | Trends in Referrals to a Pediatric Transgender Clinic |
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