ESPE Abstracts

The care provided to minors with gender diversity (GD) in the different communities of Spain is very different. A multidisciplinary management should be carried out from the health care point of view.

Objective: To know the attitude of pediatricians in the field of Pediatric Endocrinology in order to make proposals for improvement in response to the needs expressed.

Material and Methods: An anonymous survey was designed in googleforms, distributed through the Spanish Society of Pediatric Endocrinology, with closed multiple-choice questions aim ed at finding out sociodemographic data and attitudes and experience in the accompaniment of children with GD.

Results: 81 pediatric endocrinologists responded (75% women), 42% of whom had been practicing for more than 20 years. 24% work in referral units. The majority (95%) had contact with children with GD in their practice. 78% consider that there is an increase in cases with onset in adolescence and rapid progression. Contact was complicated for 43% of them. 48% knew where to refer these minors. 67% said that this contact facilitated a better understanding of these minors and their families. 91% showed willingness to support the family, 48% from an active observation. Regarding when to carry out the social transition, 6 % would get involved when the minor demands it if he/she is older than 16 years, 26 % when the minor demands it regardless of age, 58 % would previously assess his/her maturity vs. 43 % who consider it appropriate at any age if he/she has the support of the family and the environment. Regarding possible resources for referral, 80% would refer to referral units, 41% to psychologists, 30% to specific associations. The majority consider these four professionals to be basic: psychologist, pediatrician, school counselor and social worker. 52% would not prescribe blockers and 70% would not prescribe cross-hormonal treatment at the request of the minor or his/her legal guardians. 52% considered it necessary to contact the educational center. The majority (94%) consider that more training is needed for smoother communication and better counseling for these children and their families.

Conclusions: There is a demand for more training to enable pediatric endocrinologist to provide quality support. It is necessary to improve coordination and communication in order to be able to designate at any given moment which is the ideal health care resource. The best interests of the child must always be the guiding principle in shared decision-making.