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This risk is highest in gay males who are gender-variant as children. Preventive factors include family connectedness, adult caring, and school safety.

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Factors that promote high-risk behavior among gay and lesbian youth include maladaptive coping with peer, social, and family ostracism; emotional and physical abuse; and neglect. Physicians should monitor for these risks or provide anticipatory guidance when appropriate. Positive coping skills can lower the risk. An important clinical goal in the care of homosexual, bisexual, and transgender youth is protecting their opportunity to achieve full developmental potential. The goal is to support healthy development and honest self-discovery, without making premature conclusions about the patient's sexuality or gender identity.

Therapeutic interventions can influence acceptance by the patient and family members. Family rejection and bullying are appropriate focuses of therapy, rather than the patient's current or future sexual orientation.

Endnotes: Questions and Answers: Sexual Orientation in Schools - procahlacuhist.ml

There is no evidence that therapy to influence sexual orientation is effective, and it may be harmful. Most children display some behaviors that adults would consider a departure from typical gender roles. It is important to distinguish children who display only a variation in gender role behavior from those who also display gender discordance. A clinical interview using the Diagnostic and Statistical Manual of Mental Disorders is the preferred method for making a diagnosis.

Disorders of sexual development are important in the differential diagnosis, and can be addressed with endocrinologic treatment. Proposed goals of treatment for children with gender discordance include reducing the desire to be the other sex, reducing social ostracism, and reducing psychiatric comorbidity. There are no randomized controlled trials of any treatment. Recent treatment strategies based on uncontrolled case series focus on parent guidance and peer group interaction. Because of the lack of evidence and potential risks, more research is needed before treatment can be recommended.

Similarly, there are no data from controlled studies regarding sending children with gender discordance to school in their desired gender.


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Decisions must be made based on clinical judgment. Sometimes, gender discordance presents in adolescence or adulthood. One goal of treatment for adolescents is to help them make developmentally appropriate decisions regarding sex reassignment, reducing risks of reassignment, and managing associated comorbidities.

However, reassignment is ideally delayed until adulthood. Transgender youth may be at risk of hormone misuse. Physicians should be prepared to act as liaison with schools, community entities, and other health care professionals. If you continue browsing the site, you agree to the use of cookies on this website.

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