Psychological and medical care of gender nonconforming youth

Pediatrics. 2014 Dec;134(6):1184-92. doi: 10.1542/peds.2014-0772. Epub 2014 Nov 17.


Gender nonconforming (GN) children and adolescents, collectively referred to as GN youth, may seek care to understand their internal gender identities, socially transition to their affirmed genders, and/or physically transition to their affirmed genders. Because general pediatricians are often the first point of contact with the health care system for GN youth, familiarity with the psychological and medical approaches to providing care for this population is crucial. The objective of this review is to provide an overview of existing clinical practice guidelines for GN youth. Such guidelines emphasize a multidisciplinary approach with collaboration of medical, mental health, and social services/advocacy providers. Appropriate training needs to be provided to promote comprehensive, culturally competent care to GN youth, a population that has traditionally been underserved and at risk for negative psychosocial outcomes.

Keywords: affirmed gender; cross-sex hormones; gender dysphoria; gender identity; gender nonconforming; gender-affirming surgery; pubertal suppression; transgender.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Child
  • Cooperative Behavior
  • Female
  • Gender Identity*
  • Gonadal Steroid Hormones / therapeutic use
  • Health Services for Transgender Persons
  • Humans
  • Interdisciplinary Communication
  • Male
  • Physician's Role*
  • Practice Guidelines as Topic
  • Puberty / drug effects
  • Sex Reassignment Surgery
  • Transgender Persons / psychology*
  • Transsexualism / psychology*
  • Transsexualism / therapy*


  • Gonadal Steroid Hormones