Clinical Models in Transition: Evolving Paradigms in Youth Gender Care.

Abstract

This paper reviews the historical development of psychotherapeutic, psychosocial, and medical approaches to supporting children and adolescents experiencing gender-related distress (GRD). While debates regarding the most appropriate way to support youth with GRD have intensified internationally over the past decade, divergence in clinical opinion and practice is not new. Since the mid-1970s, different models of care have emerged across the Western world, ranging from assessment-focused and psychotherapy-focused models to those privileging medically oriented interventions. In light of recent developments -including the completion of systematic reviews of evidence on Gender-Affirming Medical Treatment (GAMT) in several North European countries, the recommendations of the Cass Review in the United Kingdom prioritizing psychotherapeutic and psychological interventions, and relevant policy changes in the United States- it is timely to critically examine the evolution of clinical models of care for youth experiencing GRD.