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The European Academy of Paediatrics (EAP) acknowledges that there are deeply held beliefs about this issue based on conscience and social norms. Several European countries, led by the UK, have recently reviewed the management of gender dysphoria in children and young people. Recognising the need for far more research into treatments such as pubertal suppression and cross-sex hormones in children and young people, we review the current ethical and legal dilemmas facing children with gender dysphoria, their families and the clinical teams caring for them. We suggest an approach that maintains the child's right to an open future whilst acknowledging that the individual child is the crucial person affected by decisions made and must receive appropriate support in decision-making and care for any associated mental health or psychological issues. Noting that national approaches to this vary and are in flux, the EAP advocates a child-centred individual rights-based analytical approach.<\/jats:p>","DOI":"10.3389\/fped.2024.1298884","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T05:05:10Z","timestamp":1707109510000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["European Academy of Paediatrics statement on the clinical management of children and adolescents with gender dysphoria"],"prefix":"10.3389","volume":"12","author":[{"given":"Joe","family":"Brierley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vic","family":"Larcher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adamos A.","family":"Hadjipanayis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachi","family":"Grossman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"B1","author":"Cass","year":""},{"key":"B2","year":""},{"key":"B3","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/978-1-4614-7441-8_9","article-title":"Models of psychopathology in children and adolescents with gender dysphoria","volume-title":"Gender Dysphoria and Disorders of Sex Development: Progress in Care and Knowledge","author":"Zucker","year":"2014"},{"key":"B4","doi-asserted-by":"publisher","first-page":"262","DOI":"10.2105\/AJPH.93.2.262","article-title":"Prejudice as stress: conceptual and measurement problems","volume":"93","author":"Meyer","year":"2003","journal-title":"Am J Public Health"},{"key":"B5","volume-title":"The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation Forbetter Understanding","year":"2011"},{"key":"B6","year":""},{"key":"B7","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1136\/bmj.p697","article-title":"Norway\u2019s guidance on paediatric gender treatment is unsafe, says review","volume":"380","author":"Block","year":"2023","journal-title":"The British Medical Journal"},{"key":"B8","year":"2020"},{"key":"B9","year":""},{"key":"B10","year":""},{"key":"B11","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1037\/sgd0000381","article-title":"Assessing gender in young children: constructs and considerations","volume":"7","author":"Olezeski","year":"2020","journal-title":"Psychol Sex Orientat Gend Divers"},{"key":"B12","year":""},{"key":"B13","year":""},{"key":"B14","doi-asserted-by":"publisher","first-page":"e20181537","DOI":"10.1542\/peds.2018-1537","article-title":"Ethical issues in gender affirming care for youth","volume":"142","author":"Kimberly","year":"2018","journal-title":"Pediatrics"},{"key":"B15","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1136\/archdischild-2018-314992","article-title":"Assessment and support of children and adolescents with gender dysphoria","volume":"103","author":"Butler","year":"2018","journal-title":"Arch Dis Child"},{"key":"B16","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1016\/j.jaac.2013.03.016","article-title":"Factors associated with desistance and persistance of childhood gender dysphoria: a quantitative follow-up study","volume":"52","author":"Steensma","year":"2013","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1007\/s10508-023-02588-5","article-title":"Is social gender transition associated with mental health Status in children and adolescents with gender dysphoria?","volume":"52","author":"Morandini","year":"2023","journal-title":"Arch Sex Behav"},{"key":"B18","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1136\/medethics-2019-105428","article-title":"Importance of being persistent. 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