ABSTRACT
The number of transgender children and teens has increased dramatically since the turn of the twenty-first century. Teens with co-morbid conditions can be confusing to a clinician, raising the fear that somehow the transgender identity is related to their other mental distress. However, co-morbid conditions, while not causing young people to be transgender, can occasionally be a reason to slow down transition. In addition to peer bullying, transgender youth suffer abuse from their parents at higher rates than cisgender young people, and many are thrown out of their homes. Research has shown that parental acceptance, besides preventing homelessness, has a protective effect on young transgender people. Most of the increase in the numbers of transgender youth seeking treatment is accounted for by an increase in trans teens, and particularly trans boys. Testosterone therapy for trans men can suppress ovulation and alter ovarian histology; estrogen therapy in transgender women can produce testicular atrophy and impair sperm production.
