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Discharge outcome analysis of 1089 transgender young people referred to paediatric endocrine clinics in England 2008–2021
  1. Gary Butler1,2,
  2. Kirpal Adu-Gyamfi1,
  3. Kerry Clarkson1,
  4. Ranna El Khairi1,
  5. Sara Kleczewski1,
  6. Alice Roberts1,
  7. Terry Y Segal1,
  8. Karththeepan Yogamanoharan1,
  9. Sabah Alvi3,
  10. Nadia Amin3,
  11. Paul Carruthers3,
  12. Stacey Dover3,
  13. Joanna Eastman3,
  14. Talat Mushtaq3,
  15. Una Masic4,
  16. Polly Carmichael4
  1. 1Department of Paediatric and Adolescent Endocrinology, University College London Hospitals NHS Foundation Trust, London, UK
  2. 2UCL Great Ormond Street Institute of Child Health, London, UK
  3. 3Department of Paediatric Endocrinology, Leeds Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  4. 4Gender Identity Development Service, Tavistock and Portman NHS Trust, London, UK
  1. Correspondence to Professor Gary Butler, Department of Paediatric and Adolescent Endocrinology, University College London Hospitals NHS Foundation Trust, London NW1 2PQ, UK; gary.butler{at}ucl.ac.uk

Abstract

Introduction The destination of transgender and gender variant young people referred by the National Health Service (NHS) Gender Identity Development Service (GIDS) to, and discharged from the two English paediatric endocrine liaison clinics is not known.

Methods 1151 young people referred after full assessment by the GIDS; 827 to University College London Hospital since 2008; 324 to Leeds Children’s Hospital since 2013. Discharge categorisation was by agreed criteria. Eleven emigrated and 51 self-discharged. 1089 had known outcomes.

Results 999/1089 (91.7%) continued identifying as gender variant. 867/999 (86.8%) were discharged to adult gender identity clinics (GICs). 166/867 (19.1%) of these were <16 years and 701/867 (80.9%) ≥16 years at initial endocrine referral. No sex differences were seen. 38/999 (3.8%) opted for non-NHS services.

90/1089 ceased identifying as gender variant. In 32/1089 (2.9%), this was subsequent to their first clinic appointment.

58/1089 (5.3%) stopped treatment either with the gonadotropin releasing hormone analogue (GnRHa) or gender-affirming hormones (GAH) and reverted to their birth gender: <16 years (20/217; 9.2%); ≥16 years (38/872; 4.4%).

Subdividing further, 16/217 (7.4%) <16 years ceased GnRHa and 4/217 (1.8%) after GAH. Of those ≥16 years, 33/872 (3.8%) ceased GnRHa and 5/872 (0.6%) GAH.

Conclusions At discharge, 91.7% continued as transgender or gender variant, 86.8% sought ongoing care through NHS GICs. 2.9% ceased identifying as transgender after an initial consultation prior to any endocrine intervention and 5.3% stopped treatment either with GnRHa or GAH, a higher proportion in the <16 year compared with the ≥16 year groups.

  • adolescent health
  • endocrinology

Data availability statement

Data are available on reasonable request. Data are held securely by each hospital trust in accordance with their data protection policies.

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Data availability statement

Data are available on reasonable request. Data are held securely by each hospital trust in accordance with their data protection policies.

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Footnotes

  • Contributors GB conceived the study, oversaw the data collection and analysis and wrote the main draft. All contributors agreed the categorisation criteria, contributed to data collection and/or analysis and contributed to the manuscript. GB is guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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