Guidelines for pubertal suspension and gender reassignment for transgender adolescents

Child Adolesc Psychiatr Clin N Am. 2011 Oct;20(4):725-32. doi: 10.1016/j.chc.2011.08.004.


Pubertal suppression at Tanner stage 2 should be considered in adolescents with persistent gender identity disorder (GID). Issues related to achievement of adult height, timing of initiating sex steroid treatment, future fertility options, preventing uterine bleeding, and required modifications of genital surgery remain concerns. Concerns have been raised about altering neuropsychological development during cessation of puberty and reinitiation of puberty by the sex steroid opposite those determined by genetic sex. Collaborative assessment and treatment of dysphoric adolescents with persistent GID resolves these concerns and deepens our understanding of gender development.

MeSH terms

  • Adolescent
  • Gender Identity*
  • Gonadal Steroid Hormones / administration & dosage*
  • Gonadal Steroid Hormones / adverse effects
  • Gonadotropin-Releasing Hormone / adverse effects
  • Gonadotropin-Releasing Hormone / analogs & derivatives
  • Gonadotropin-Releasing Hormone / therapeutic use*
  • Guidelines as Topic*
  • Humans
  • Puberty / drug effects
  • Puberty / physiology
  • Sex Reassignment Procedures / standards*
  • Sex Reassignment Surgery / standards
  • Transsexualism / diagnosis
  • Transsexualism / drug therapy*


  • Gonadal Steroid Hormones
  • Gonadotropin-Releasing Hormone