@article{01JJ94S4AEVP5GAYWGYYBPJCZE,
  abstract     = {{Purpose: The expanding number of minors questioning their gender identity and seeking care has led to the constitution of pediatric gender clinics in several countries. The activity of the multidisciplinary Pediatric Gender Team at Ghent University Hospital, Belgium started in 2007. We report on the evolution of referrals, psychological intakes, and trends in the start of gender-affirming medical and surgical interventions from 2007 to 2023. Methods: The whole cohort of minors (age <17 years) having a psychological intake between 2007 and 2023 was included. Subgroups were analyzed based on sex registered at birth (female or male, RFAB and RMAB respectively), year and age at the psychological intake (below or above 10 years). Results: Referrals have increased in recent years. Between 2007 and 2023, 890 minors (65.5% RFAB) accessed our service. The ratio RFAB/RMAB has progressively increased, and RFAB with age at first intake >10 represented the greatest proportion. After 12 months, 19.5% were no longer in follow-up at our center; 28.1% of RFAB and 47.2% of RMAB did not start any medical treatment; 66.9% of RFAB and 52.8% of RMAB started gonadal hormone suppression (GHS), achieved with gonadotropin-releasing hormone analogues in 17.7% of RFAB and 34.6% of RMAB, with pro-androgenic progestins in 82.3% of RFAB and with anti-androgens in 65.4% of RMAB. 74.6% of RFAB and 86.4% of RMAB on GHS and older than 16 started gender-affirming hormones. Mastectomy was the most common gender-affirming surgery in RFAB, followed by hystero-gonadectomy. Gender-affirming surgery in RMAB was less frequent; vaginoplasty was the most frequent procedure. Conclusions: The care of minors with gender incongruence requires a multidisciplinary approach due to the complex psychological, social, and physical needs of this group. The timing and therapeutical options must be tailored to each adolescent.}},
  author       = {{Ciancia, Silvia and Bruneel, Laura and Van Schuylenbergh, Judith and Klink, Daniel and Dhondt, Karlien and Heyse, Robin and Motmans, Joz and Cools, Martine}},
  issn         = {{2689-5269}},
  journal      = {{INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH}},
  keywords     = {{adolescents,children,gender incongruence,gonadotropin-releasing hormone analogues,progestins, gender-affirming hormones,transgender,IDENTITY DEVELOPMENT,CYPROTERONE-ACETATE,CHILDREN,ADOLESCENTS}},
  language     = {{eng}},
  pages        = {{1--11}},
  title        = {{The evolution of pediatric transgender healthcare in Flanders : trends in referrals, intakes and gender-affirming interventions over the last 15 years}},
  url          = {{http://doi.org/10.1080/26895269.2025.2452996}},
  year         = {{2025}},
}

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