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      A self-guided curriculum on endocrinology standard of care for gender diverse youth, including ethical considerations

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          Abstract

          Objective:

          While the field of pediatric endocrinology, and the American Board of Pediatrics, continues expanding training to include gender-affirming care, many pediatric endocrinology fellowship programs do not have formal curriculum for this patient population. Members of the Pediatric Endocrine Society (PES) that have a special interest in transgender health designed a curriculum based on Endocrine Society practice guidelines to expand the knowledge of gender affirming care for medical trainees’ and faculty.

          Methods:

          PES members designed a 5-part self-guided educational module series with embedded knowledge questions. Uniquely, medical ethical reflections were included within each module. Participants completed baseline demographic and baseline and follow-up knowledge surveys.

          Results:

          Most participants were pediatric endocrinology fellows and 44 % percent ( n = 21) completed all study components, including the follow up knowledge survey. Knowledge question data analysis demonstrated knowledge gained in medical management of pubertal youth and surgical interventions.

          Conclusion:

          This is the first medical education curriculum in gender-affirming care created by pediatric endocrinologists grounded in the Endocrine Society practice guidelines. This study demonstrates medical knowledge gained in caring for gender diverse youth and is the first to incorporate ethical considerations for this patient population. While initially designed for pediatric endocrinology trainees and faculty, this curriculum may be of great utility for any provider interested in caring for gender diverse youth.

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          Most cited references18

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          Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society* Clinical Practice Guideline

          To update the "Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guideline," published by the Endocrine Society in 2009.
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            Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

            Abstract Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
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              Mental Health of Transgender Children Who Are Supported in Their Identities

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                Author and article information

                Journal
                101776826
                50456
                Endocr Metab Sci
                Endocr Metab Sci
                Endocrine and metabolic science
                2666-3961
                25 June 2023
                30 June 2023
                6 May 2023
                27 July 2023
                : 11
                : 100131
                Affiliations
                [a ]Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States of America
                [b ]Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States of America
                [c ]Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
                [d ]Department of Pediatrics, Harvard Medical School, Boston, MA, United States of America
                [e ]Department of Pediatrics, Memorial Healthcare System, Hollywood, FL, United States of America
                [f ]Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
                [g ]Department of Pediatrics, University of Maryland Medical Center, Baltimore, MD, United States of America
                [h ]Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
                [i ]Department of Pediatrics, George Washington University, Washington, DC, United States of America
                Author notes
                [1]

                Co-first authors.

                [* ]Corresponding author at: Department of Pediatrics, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, Michigan 48109-5010, United States of America. bschweig@ 123456med.umich.edu (E.S. Sandberg).
                Article
                NIHMS1911036
                10.1016/j.endmts.2023.100131
                10373477
                4128fb61-19f7-4b66-9d4a-5ee12693c8cd

                This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Categories
                Article

                gender diverse,transgender,gender dysphoria,gender-affirming care,pediatric endocrinology,education modules

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