{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:29:44Z","timestamp":1793039384859,"version":"4.5.0"},"reference-count":48,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,10,1]]},"abstract":"\n BACKGROUND:<\/jats:title>\n In recent years, puberty suppression by means of gonadotropin-releasing hormone analogs has become accepted in clinical management of adolescents who have gender dysphoria (GD). The current study is the first longer-term longitudinal evaluation of the effectiveness of this approach.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n A total of 55 young transgender adults (22 transwomen and 33 transmen) who had received puberty suppression during adolescence were assessed 3 times: before the start of puberty suppression (mean age, 13.6 years), when cross-sex hormones were introduced (mean age, 16.7 years), and at least 1 year after gender reassignment surgery (mean age, 20.7 years). Psychological functioning (GD, body image, global functioning, depression, anxiety, emotional and behavioral problems) and objective (social and educational\/professional functioning) and subjective (quality of life, satisfaction with life and happiness) well-being were investigated.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, followed by cross-sex hormones and gender reassignment surgery, provides gender dysphoric youth who seek gender reassignment from early puberty on, the opportunity to develop into well-functioning young adults.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2013-2958","type":"journal-article","created":{"date-parts":[[2014,9,9]],"date-time":"2014-09-09T05:14:04Z","timestamp":1410239644000},"page":"696-704","source":"Crossref","is-referenced-by-count":824,"title":["Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment"],"prefix":"10.1542","volume":"134","author":[{"given":"Annelou L.C.","family":"de Vries","sequence":"first","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenifer K.","family":"McGuire","sequence":"additional","affiliation":[{"name":"Department of Human Development, Washington State University, Pullman, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas D.","family":"Steensma","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva C.F.","family":"Wagenaar","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo A.H.","family":"Doreleijers","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy T.","family":"Cohen-Kettenis","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2014,10,1]]},"reference":[{"key":"2021120903431145700_B1"},{"issue":"4","key":"2021120903431145700_B2","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1007\/s007870050073","article-title":"Pubertal delay as an aid in diagnosis and treatment of a transsexual adolescent.","volume":"7","author":"Cohen-Kettenis","year":"1998","journal-title":"Eur Child Adolesc Psychiatry"},{"issue":"6","key":"2021120903431145700_B3","first-page":"647","volume":"114","author":"Nakatsuka","year":"2012","journal-title":"Seishin Shinkeigaku Zasshi"},{"issue":"1","key":"2021120903431145700_B4","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1080\/19359705.2011.530574","article-title":"Puberty-blocking hormonal therapy for adolescents with gender identity disorder: a descriptive clinical study.","volume":"15","author":"Zucker","year":"2010","journal-title":"J Gay Lesbian Ment Health"},{"issue":"9","key":"2021120903431145700_B5","doi-asserted-by":"crossref","first-page":"578","DOI":"10.5694\/mja12.10222","article-title":"Hormone treatment of gender identity disorder in a cohort of children and adolescents.","volume":"196","author":"Hewitt","year":"2012","journal-title":"Med J Aust"},{"issue":"2","key":"2021120903431145700_B6","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1001\/archpediatrics.2010.275","article-title":"Management of the transgender adolescent.","volume":"165","author":"Olson","year":"2011","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"3","key":"2021120903431145700_B7","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1542\/peds.2011-0907","article-title":"Children and adolescents with gender identity disorder referred to a pediatric medical center.","volume":"129","author":"Spack","year":"2012","journal-title":"Pediatrics"},{"issue":"8","key":"2021120903431145700_B8","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1176\/appi.ajp.2012.169.8.875","article-title":"Treatment of gender identity disorder.","volume":"169","author":"Byne","year":"2012","journal-title":"Am J Psychiatry"},{"issue":"9","key":"2021120903431145700_B9","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.jaac.2012.07.004","article-title":"Practice parameter on gay, lesbian, or bisexual sexual orientation, gender nonconformity, and gender discordance in children and adolescents.","volume":"51","author":"Adelson","year":"2012","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"9","key":"2021120903431145700_B10","doi-asserted-by":"crossref","first-page":"3132","DOI":"10.1210\/jc.2009-0345","article-title":"Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline.","volume":"94","author":"Hembree","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2021120903431145700_B11","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1080\/15532739.2011.700873","article-title":"Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7.","volume":"13","author":"Coleman","year":"2012","journal-title":"Int J Transgenderism"},{"issue":"4","key":"2021120903431145700_B12","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.chc.2011.08.001","article-title":"Treatment of adolescents with gender dysphoria in the Netherlands.","volume":"20","author":"Cohen-Kettenis","year":"2011","journal-title":"Child Adolesc Psychiatr Clin N Am"},{"issue":"3","key":"2021120903431145700_B13","first-page":"306","article-title":"Review of outcomes after cessation of gonadotropin-releasing hormone agonist treatment of girls with precocious puberty. Pediatr Endocrinol","volume":"11","author":"Thornton","year":"2014","journal-title":"Rev Mar"},{"key":"2021120903431145700_B14","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":"2021120903431145700_B15","doi-asserted-by":"crossref","DOI":"10.1177\/1359104510378303","article-title":"Desisting and persisting gender dysphoria after childhood: a qualitative follow-up study.","author":"Steensma","year":"2011","journal-title":"Clin Child Psychol Psychiatry"},{"issue":"8","key":"2021120903431145700_B16","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 follow-up study.","volume":"8","author":"de Vries","year":"2011","journal-title":"J Sex Med"},{"issue":"2","key":"2021120903431145700_B17","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1023\/B:QURE.0000018486.91360.00","article-title":"The World Health Organization\u2019s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group.","volume":"13","author":"Skevington","year":"2004","journal-title":"Qual Life Res"},{"issue":"1","key":"2021120903431145700_B18","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1207\/s15327752jpa4901_13","article-title":"The Satisfaction With Life Scale.","volume":"49","author":"Diener","year":"1985","journal-title":"J Pers Assess"},{"issue":"2","key":"2021120903431145700_B19","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1023\/A:1006824100041","article-title":"A measure of subjective happiness: preliminary reliability and construct validation.","volume":"46","author":"Lyubomirsky","year":"1999","journal-title":"Soc Indic Res"},{"key":"2021120903431145700_B20","first-page":"3","article-title":"The study of quality of life: concepts and methods","volume-title":"Quality of Life in Child and Adolescent Illness: Concepts, Methods and Findings","author":"Koot","year":"2001"},{"issue":"3\u20134","key":"2021120903431145700_B21","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1023\/A:1024423012063","article-title":"Gender identity and adjustment in middle childhood.","volume":"49","author":"Carver","year":"2003","journal-title":"Sex Roles"},{"issue":"1","key":"2021120903431145700_B22","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1300\/J082v51n01_06","article-title":"Transgender youth: invisible and vulnerable.","volume":"51","author":"Grossman","year":"2006","journal-title":"J Homosex"},{"key":"2021120903431145700_B23"},{"key":"2021120903431145700_B24","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1007\/BF01544272","article-title":"A body image scale for evaluating transsexuals.","volume":"4","author":"Lindgren","year":"1975","journal-title":"Arch Sex Behav"},{"issue":"11","key":"2021120903431145700_B25","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":"2021120903431145700_B26","volume-title":"Manual for the Beck Depression Inventory-II","author":"Beck","year":"1996"},{"key":"2021120903431145700_B27","volume-title":"Manual for the State-Trait Anger Expression Inventory (STAXI)","author":"Spielberger","year":"1988"},{"key":"2021120903431145700_B28","volume-title":"Manual for the State-Trait Anxiety Inventory","author":"Spielberger","year":"1983"},{"key":"2021120903431145700_B29","volume-title":"Manual for the Youth Self-Report","author":"Achenbach","year":"1991"},{"key":"2021120903431145700_B30"},{"key":"2021120903431145700_B31","volume-title":"Manual for the Child Behavior Checklist and Revised Child Behavior Profile","author":"Achenbach","year":"1983"},{"issue":"1","key":"2021120903431145700_B32","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1023\/A:1021769215342","article-title":"Demographic characteristics, social competence, and behavior problems in children with gender identity disorder: a cross-national, cross-clinic comparative analysis.","volume":"31","author":"Cohen-Kettenis","year":"2003","journal-title":"J Abnorm Child Psychol"},{"key":"2021120903431145700_B33"},{"issue":"5","key":"2021120903431145700_B34","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/S0191-8869(98)00180-9","article-title":"The Satisfaction With Life Scale (SWLS): appraisal with 1700 healthy young adults in The Netherlands.","volume":"26","author":"Arrindell","year":"1999","journal-title":"Pers Individ Dif"},{"issue":"2","key":"2021120903431145700_B35","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1365-2265.2009.03625.x","article-title":"Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes.","volume":"72","author":"Murad","year":"2010","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"1","key":"2021120903431145700_B36","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1017\/S0033291704002776","article-title":"Sex reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals.","volume":"35","author":"Smith","year":"2005","journal-title":"Psychol Med"},{"issue":"2","key":"2021120903431145700_B37","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/BF01543120","article-title":"Effects of adequacy of gender reassignment surgery on psychological adjustment: a follow-up of fourteen male-to-female patients.","volume":"18","author":"Ross","year":"1989","journal-title":"Arch Sex Behav"},{"issue":"4","key":"2021120903431145700_B38","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1023\/A:1024086814364","article-title":"Factors associated with satisfaction or regret following male-to-female sex reassignment surgery.","volume":"32","author":"Lawrence","year":"2003","journal-title":"Arch Sex Behav"},{"issue":"5","key":"2021120903431145700_B39","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1521\/suli.2007.37.5.527","article-title":"Transgender youth and life-threatening behaviors.","volume":"37","author":"Grossman","year":"2007","journal-title":"Suicide Life Threat Behav"},{"issue":"3","key":"2021120903431145700_B40","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jadohealth.2005.03.023","article-title":"Overlooked, misunderstood and at-risk: exploring the lives and HIV risk of ethnic minority male-to-female transgender youth.","volume":"38","author":"Garofalo","year":"2006","journal-title":"J Adolesc Health"},{"issue":"6","key":"2021120903431145700_B41","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1037\/a0020705","article-title":"Gender-nonconforming lesbian, gay, bisexual, and transgender youth: school victimization and young adult psychosocial adjustment.","volume":"46","author":"Toomey","year":"2010","journal-title":"Dev Psychol"},{"issue":"10","key":"2021120903431145700_B42","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1007\/s10964-010-9540-7","article-title":"School climate for transgender youth: a mixed method investigation of student experiences and school responses.","volume":"39","author":"McGuire","year":"2010","journal-title":"J Youth Adolesc"},{"issue":"4","key":"2021120903431145700_B43","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1007\/s10508-011-9758-9","article-title":"Puberty suppression in a gender-dysphoric adolescent: a 22-year follow-up.","volume":"40","author":"Cohen-Kettenis","year":"2011","journal-title":"Arch Sex Behav"},{"issue":"6","key":"2021120903431145700_B44","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.jaac.2013.03.016","article-title":"Factors associated with desistence and persistence of childhood gender dysphoria: a quantitative follow-up study.","volume":"52","author":"Steensma","year":"2013","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2021120903431145700_B45","doi-asserted-by":"crossref","DOI":"10.1038\/nrendo.2011.78","article-title":"Puberty suppression in gender identity disorder: the Amsterdam experience.","author":"Kreukels","year":"2011","journal-title":"Nat Rev Endocrinol"},{"key":"2021120903431145700_B46","volume-title":"Wechsler Intelligence Scale for Children: Manual","author":"Wechsler","year":"1997","edition":"3rd ed."},{"key":"2021120903431145700_B47"},{"key":"2021120903431145700_B48"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/134\/4\/696\/1099088\/peds_2013-2958.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/134\/4\/696\/1099088\/peds_2013-2958.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T19:21:41Z","timestamp":1639077701000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/134\/4\/696\/32932\/Young-Adult-Psychological-Outcome-After-Puberty"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,1]]},"references-count":48,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2014,10,1]]},"published-print":{"date-parts":[[2014,10,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2013-2958","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10,1]]}}}