Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis.

IF 4.3 3区医学 Q1 PEDIATRICS

Archives of Disease in Childhood Pub Date : 2025-01-30 DOI:10.1136/archdischild-2024-327909

Anna Miroshnychenko, Yetiani Roldan, Sara Ibrahim, Chan Kulatunga-Moruzi, Steven Montante, Rachel Couban, Gordon Guyatt, Romina Brignardello-Petersen

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引用次数: 0

Abstract

Aim: Gender dysphoria (GD) refers to the psychological distress associated with the incongruence between one's sex and one's gender identity. To manage GD, individuals may delay the development of primary and secondary sex characteristics with the use of puberty blockers. In this systematic review, we assess and summarise the certainty of the evidence about the effects of puberty blockers in individuals experiencing GD.

Methods: We searched Medline, Embase, PsychINFO, Social Sciences Abstracts, LGBTQ+ Source and Sociological Abstracts from inception to September 2023. We included observational studies comparing puberty blockers with no puberty blockers in individuals aged <26 years experiencing GD, as well as before-after and case series studies. Outcomes of interest included psychological and physical outcomes. Pairs of reviewers independently screened articles, abstracted data and assessed risk of bias. We performed a meta-analysis and assessed the certainty of a non-zero effect using the grading of recommendations assessment, development and evaluation (GRADE) approach.

Results: We included 10 studies. Comparative observational studies (n=3), comparing puberty blockers versus no puberty blockers, provided very low certainty of evidence on the outcomes of global function and depression. Before-after studies (n=7) provided very low certainty of evidence addressing gender dysphoria, global function, depression, and bone mineral density.

Conclusions: There remains considerable uncertainty regarding the effects of puberty blockers in individuals experiencing GD. Methodologically rigorous prospective studies are needed to understand the effects of this intervention.

Trial registration number: PROSPERO CRD42023452171.

查看原文本刊更多论文

青春期阻滞剂对经历性别不安的青少年：一项系统回顾和荟萃分析。

目的：性别焦虑（Gender dysphoria， GD）是指因性别与性别认同不一致而产生的心理困扰。为了控制性别焦虑，个体可以通过使用青春期阻滞剂来延缓第一和第二性征的发展。在这篇系统综述中，我们评估和总结了青春期阻滞剂对经历GD的个体的影响的证据的确定性。方法：检索Medline、Embase、PsychINFO、Social Sciences Abstracts、LGBTQ+ Source和Sociological Abstracts，检索时间为建站至2023年9月。我们纳入了比较青春期阻滞剂和无青春期阻滞剂在老年个体中的观察性研究结果：我们纳入了10项研究。比较观察性研究（n=3），比较青春期阻滞剂和无青春期阻滞剂，提供了非常低确定性的证据，证明整体功能和抑郁的结果。前后对照研究（n=7）提供了关于性别焦虑、整体功能、抑郁和骨密度的证据的非常低的确定性。结论：青春期阻滞剂对经历GD的个体的影响仍然存在相当大的不确定性。需要在方法学上严格的前瞻性研究来了解这种干预的效果。试验注册号：PROSPERO CRD42023452171。

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来源期刊

Archives of Disease in Childhood 医学-小儿科

CiteScore

5.80

自引率

3.80%

发文量

291

审稿时长

3-6 weeks

期刊介绍： Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.