Introduction: During last years there is an increasing number of referrals because of gender incongruence worldwide. In Argentina, in 2012, a gender identity law was sanctioned, stablishing the right of gender reassignment during childhood, adolescence, youth and adulthood, without the need of previous medical and/or mental health evaluation. This was followed by a great number of referrals. There is scarce literature regarding longterm outcome in transgender persons who started treatment at early Tanner stages (23)
Objective: To describe clinical, biochemical and epidemiological features of the first pediatric transgender cohort in a pediatric hospital of Argentina.
Methods: Epidemiological characteristics, such as number of referrals/year, age, desired gender, age at first manifestations; anthropometric data (height, weight, target height, BMI); biochemistry (gonadal and adrenal function, metabolic and bone profile); age at menarchy in transgender boys and the presence of comorbidities was evaluated.
Results: 21 patients were evaluated (6 transgender girls and 15 transgender boys), with a ratio M:F 2,5 to 1. The number of referrals/year was: 2014:1/2015:2/2016:7 and 2017:11. Median age at referral was 14.23±2.16, without differences between sex (range 9.25-16.91). First manifestations were detected during infancy in 10 patients and during puberty in 9 patients (in 2 patients it was not possible to determine age at first manifestation because of mental retardation). There were no differences regarding height, target height or final height in SDS, nor differences regarding biochemical study of gonadal and/or adrenal function. Median age of GnRH analog treatment initiation was 13,7 years and only one patient started gender reinforcement treatment with testosterone at 17.8 years of age. Regarding comorbidities 4 patients have obesity (2 with hyperinsulinism), 1 has type 1 diabetes, 2 have personality disorder and mental retardation, 1 central precocious puberty, 1 celiac disease, 1 minor thalassemia, 1 tricho-rhino-phalangeal syndrome with chronic renal failure, 1 acute myeloblastic leukemia and 1 patient presented urticarial after first triptorelin dose.
Conclusion: During 3 years, 21 transgender children and adolescence were evaluated, and no significant alterations were seen regarding height, weight, gonadal and adrenal function and metabolic profile. Transgender in pediatric endocrinology is seen every year with more frequency, so it is necessary to keep studying this growing population, specially those who start puberty suppression treatment at early Tanner stage (2-3). More studies are needed with focus in the impact of treatment in quality of life.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology