Johanna Olson, MD, Medical Director of the Center for Transyouth Health and Development at Children’s Hospital Los Angeles, works closely with gender nonconforming children and adolescents to find ways to help them thrive. Gender-nonconforming youth are emerging at increasingly younger ages, and those experiencing gender dysphoria are seeking medical care at the onset of puberty, or sometimes even before. Youth with gender dysphoria are at high risk for depression, anxiety, isolation, self-harm, and suicidality at the onset of a puberty that feels wrong. Existing strategies for treating transgender youth depend on the developmental stage at which these youth present for care. For those transgender youth that present for care in the early stages of pubertal development, treatment is aimed at suppressing their endogenous puberty in order to avoid the development of undesired secondary sexual characteristics that intensify the distress associated with gender incongruence. For those youth in later stages of puberty, the goal of treatment is to use cross-sex hormones in order to induce the development of desired secondary sexual characteristics that bring the body into closer alignment with the youth's internal sense of gender.
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