{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:23:17Z","timestamp":1789608197564,"version":"build-2803163510"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2015,11,1]],"date-time":"2015-11-01T00:00:00Z","timestamp":1446336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Puberty suppression by gonadotropin-releasing hormone analogs (GnRHa) is prescribed to relieve the distress associated with pubertal development in adolescents with gender dysphoria (GD) and thereby to provide space for further exploration. However, there are limited longitudinal studies on puberty suppression outcome in GD. Also, studies on the effects of psychological support on its own on GD adolescents' well-being have not been reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>This study aimed to assess GD adolescents' global functioning after psychological support and puberty suppression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Two hundred one GD adolescents were included in this study. In a longitudinal design we evaluated adolescents' global functioning every 6 months from the first visit.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>All adolescents completed the Utrecht Gender Dysphoria Scale (UGDS), a self-report measure of GD-related discomfort. We used the Children's Global Assessment Scale (CGAS) to assess the psychosocial functioning of adolescents.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At baseline, GD adolescents showed poor functioning with a CGAS mean score of 57.7 \u00b1 12.3. GD adolescents' global functioning improved significantly after 6 months of psychological support (CGAS mean score: 60.7 \u00b1 12.5; P &amp;lt; 0.001). Moreover, GD adolescents receiving also puberty suppression had significantly better psychosocial functioning after 12 months of GnRHa (67.4 \u00b1 13.9) compared with when they had received only psychological support (60.9 \u00b1 12.2, P = 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Psychological support and puberty suppression were both associated with an improved global psychosocial functioning in GD adolescents. Both these interventions may be considered effective in the clinical management of psychosocial functioning difficulties in GD adolescents.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1111\/jsm.13034","type":"journal-article","created":{"date-parts":[[2015,11,10]],"date-time":"2015-11-10T02:32:40Z","timestamp":1447122760000},"page":"2206-2214","source":"Crossref","is-referenced-by-count":214,"title":["Psychological Support, Puberty Suppression, and Psychosocial Functioning in Adolescents with Gender Dysphoria"],"prefix":"10.1093","volume":"12","author":[{"given":"Rosalia","family":"Costa","sequence":"first","affiliation":[{"name":"Gender Identity Development Service \u00a0 , London , UK"},{"name":"Tavistock and Portman NHS Foundation Trust, Tavistock Centre \u00a0 , London , UK"},{"name":"Department of Medical Basic Sciences, Neuroscience and Sense Organs \u00a0 , Bari , Italy"},{"name":"University of Bari \u201cA. Moro \u00a0 , Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Dunsford","sequence":"additional","affiliation":[{"name":"Gender Identity Development Service \u00a0 , London , UK"},{"name":"Tavistock and Portman NHS Foundation Trust, Tavistock Centre \u00a0 , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elin","family":"Skagerberg","sequence":"additional","affiliation":[{"name":"Gender Identity Development Service \u00a0 , London , UK"},{"name":"Tavistock and Portman NHS Foundation Trust, Tavistock Centre \u00a0 , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Holt","sequence":"additional","affiliation":[{"name":"Gender Identity Development Service \u00a0 , London , UK"},{"name":"Tavistock and Portman NHS Foundation Trust, Tavistock Centre \u00a0 , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polly","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Gender Identity Development Service \u00a0 , London , UK"},{"name":"Tavistock and Portman NHS Foundation Trust, Tavistock Centre \u00a0 , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Colizzi","sequence":"additional","affiliation":[{"name":"Department of Medical Basic Sciences, Neuroscience and Sense Organs \u00a0 , Bari , Italy"},{"name":"University of Bari \u201cA. Moro \u00a0 , Bari , Italy"},{"name":"Institute of Psychiatry, Psychology and Neuroscience \u00a0 , London , UK"},{"name":"King's College London \u00a0 , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,11,1]]},"reference":[{"key":"2023012309110804900_bb0010","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","article-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"2013"},{"key":"2023012309110804900_bb0015","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1542\/peds.2013-2958","article-title":"Young adult psychological outcome after puberty suppression and gender reassignment","volume":"134","author":"de Vries","year":"2014","journal-title":"Pediatrics"},{"key":"2023012309110804900_bb0020","doi-asserted-by":"crossref","first-page":"3049","DOI":"10.1111\/jsm.12155","article-title":"Hormonal treatment reduces psychobiological distress in gender identity disorder, independently of attachment style","volume":"10","author":"Colizzi","year":"2013","journal-title":"J Sex Med"},{"key":"2023012309110804900_bb0025","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1080\/15532739.2011.700873","article-title":"Standards of care (SOC) for the health of transsexual, transgender, and gender nonconforming people, 7th version","volume":"13","author":"Coleman","year":"2012","journal-title":"Int J Transgender"},{"key":"2023012309110804900_bb0030","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.psyneuen.2013.09.029","article-title":"Transsexual patients' psychiatric comorbidity and positive effect of cross-sex hormonal treatment on mental health: Results from a longitudinal study","volume":"39","author":"Colizzi","year":"2014","journal-title":"Psychoneuroendocrinology"},{"key":"2023012309110804900_bb0035","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.psychres.2014.12.045","article-title":"Dissociative symptoms in individuals with gender dysphoria: Is the elevated prevalence real?","volume":"226","author":"Colizzi","year":"2015","journal-title":"Psychiatry Res"},{"key":"2023012309110804900_bb0040","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1136\/jme.2007.021097","article-title":"Lives in a chiaroscuro. Should we suspend the puberty of children with gender identity disorder?","volume":"34","author":"Giordano","year":"2008","journal-title":"J Med Ethics"},{"issue":"suppl 1","key":"2023012309110804900_bb0045","doi-asserted-by":"crossref","first-page":"S131","DOI":"10.1530\/eje.1.02231","article-title":"Clinical management of gender identity disorder in adolescents: A protocol on psychological and paediatric endocrinology aspects","volume":"155","author":"Delemarre-van de Waal","year":"2006","journal-title":"Eur J Endocrinol"},{"key":"2023012309110804900_bb0050","doi-asserted-by":"crossref","first-page":"2276","DOI":"10.1111\/j.1743-6109.2010.01943.x","article-title":"Puberty suppression in adolescents with gender identity disorder: A prospective study","volume":"8","author":"De Vries","year":"2011","journal-title":"J Sex Med"},{"key":"2023012309110804900_bb0055","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1038\/nrendo.2011.78","article-title":"Puberty suppression in gender identity disorder: The Amsterdam experience","volume":"7","author":"Kreukels","year":"2011","journal-title":"Nat Rev Endocrinol"},{"key":"2023012309110804900_bb0060","first-page":"185","article-title":"Management and therapeutic aims with children and adolescents with gender identity disorders and their families","author":"Di Ceglie","year":"1998","journal-title":"A stranger in my own body: Atypical gender identity development and mental health"},{"key":"2023012309110804900_bb0065","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1111\/j.1743-6109.2008.00870.x","article-title":"The treatment of adolescent transsexuals: Changing insights","volume":"5","author":"Cohen-Kettenis","year":"2008","journal-title":"J Sex Med"},{"key":"2023012309110804900_bb0070","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/00004583-199702000-00017","article-title":"Sex reassignment of adolescent transsexuals: A follow-up study","volume":"36","author":"Cohen-Kettenis","year":"1997","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2023012309110804900_bb0075","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1001\/archpsyc.1983.01790100074010","article-title":"A Children's Global Assessment Scale (CGAS)","volume":"40","author":"Shaffer","year":"1983","journal-title":"Arch Gen Psychiatry"},{"key":"2023012309110804900_bb0080","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s00787-004-0390-2","article-title":"Global assessment of psychosocial functioning in child and adolescent psychiatry. A review of three unidimensional scales (CGAS, GAF, GAPD)","volume":"13","author":"Schorre","year":"2004","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"2023012309110804900_bb0085","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/acps.12043","article-title":"Outcomes of child psychiatric treatment","volume":"128","author":"Lundh","year":"2013","journal-title":"Acta Psychiatr Scand"},{"key":"2023012309110804900_bb0090","first-page":"189","article-title":"Measuring disability across physical, mental and cognitive disorders","author":"Prince","year":"2011","journal-title":"The conceptual evolution of DSM-5"},{"key":"2023012309110804900_bb0095","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1037\/0012-1649.37.4.491","article-title":"Getting older, getting better? Personal striving and psychological maturity across the life span","volume":"37","author":"Sheldon","year":"2001","journal-title":"Dev Psychol"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S174360951534443X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S174360951534443X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/12\/11\/2206\/48586068\/jsm_12_11_2206.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/12\/11\/2206\/48586068\/jsm_12_11_2206.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T14:43:52Z","timestamp":1675953832000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/12\/11\/2206\/6980064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11,1]]},"references-count":18,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2015,11,1]]},"published-print":{"date-parts":[[2015,11,1]]}},"URL":"https:\/\/doi.org\/10.1111\/jsm.13034","relation":{},"ISSN":["1743-6109","1743-6095"],"issn-type":[{"value":"1743-6109","type":"electronic"},{"value":"1743-6095","type":"print"}],"subject":[],"published-other":{"date-parts":[[2015,11]]},"published":{"date-parts":[[2015,11,1]]}}}