ESPE Abstracts

Background: In recent years, the number of consultations of transgender children and adolescents has gradually increased. In our region, this group receives care from a specialized multidisciplinary team, formed in 2015. It is basically composed of a psychosexologist, two adult endocrinologist, a pediatric endocrinologist, among other specialists.

Objective: To describe the characteristics of the children and adolescents referred to the pediatric endocrinology unit, within the care program for transgender people.

Material and Methods: retrospective study of all people under 16 years of age, assisted in the pediatric endocrinology unit within the protocol for care of transgender people, in the last 9 years (January 1, 2015 to December 31, 2023), in a region of northern Spain.

Results: During this period, 50 children and adolescents received assessment in our pediatric endocrinology unit. The annual average was 6.2±3.8 people per year (range 3-12), with significant increase in the last 3 years. 70% (35) assigned female at birth (AFAB). Average age at first consultation 13.1±2.7 year (range 5.3-16.2): 13.5±2.2 (range 6.5-15.8) in AFAB and 12.4±3.5 years (range 5.3-16.2) in assigned male at birth (AMAB). Puberty stage: 18% (9) prepubertal, 20% (10) Tanner II-III, 62% (31) Tanner IV-V. 76% had already made social transition. Comorbility in 30% (15): 16% (8) mental health concerns, 12% (6) obesity. Current age: 16.3±3 years (8.9-22). Diagnosis: 6% (3) non-binary person, 10% (5) gender dysphoria, 24% (12) trans female person, 60% (30) trans male person. 68% (34) recibed puberty-blocking medication (GnRH analogues): 9 trans female: mean age 14.0±2.1 years (10.1-16.4), 3 Tanner II, 2 Tanner III; and 25 trans male: mean age 14.2±1.5 years (8.9-16), 2 Tanner II, 2 Tanner III. 34% (17) gender-affirming hormone therapy: 4 trans female: mean age 15.9 ±1.6 years (14.2-17.2); and 13 trans male: mean age 16.2±0.6 years (15.5-17.4). 80% (40) have made social transition and 40% (20) legal transition. 26% (13) without follow-up by our team: 2 cisgender identification, 3 due to transfer of region, 3 detransition and 5 for unknown reasons.

Conclusions: The number of consultations has clearly increased in the last 3 years. In our group of people under 16 years of age there is a clear predominance of AFAB, but the AMAB consult earlier. We must be cautious when starting treatments, especially non-reversible ones, since there is a high proportion of associated mental health concerns and a not inconsiderable percentage of follow-up abandonment.