ABSTRACT
In recent years, there has been an increase in the number of transgender youth presenting for care. For transgender children and adolescents, their gender identity is incongruent with the gender they were assigned at birth, which often leads to significant dysphoria. Transgender youth face significant health and social burdens, with alarmingly high risks of victimization, risk-taking behaviors, sexually transmitted infections, self-harm, and suicidality. Providers are charged with providing a safe and welcoming environment for patients, giving appropriate referrals, and aiding in social and/or medical transition as needed. There are well-established guidelines available to aid practitioners in caring for this vulnerable population. The clinician providing for adolescents has an essential role in providing care for transgender youth, including preventive health care, management of menses and other acute or chronic gynecologic concerns, as well as fertility preservation counseling. In addition, the adolescent gynecologist may also provide hormonal or surgical management. This chapter reviews the historical and recent literature on transgender care for adolescents, including terminology, diagnosis, and treatment guidelines, with a focus on important considerations for the gynecologist.
