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Timing of Gender-Affirming Care Linked to Mental Health

Mental health worse with late pubertal stage, older age for youth presenting for gender-affirming care

MONDAY, Sept. 21, 2020 (HealthDay News) — For gender-incongruent (GI) youth presenting for gender-affirming medical care (GAMC), late pubertal stage and older age are associated with worse mental health, according to a study published online Sept. 21 in Pediatrics.

Julia C. Sorbara, M.D., from the Hospital for Sick Children and University of Toronto, and colleagues conducted a cross-sectional chart review of patients presenting to GAMC to examine the potential association between age of presentation and mental health. Three hundred youth were classified as younger presenting youth (YPY; <15 years of age at presentation) or older presenting youth (OPY; ≥15 years of age; 116 and 184 patients, respectively).

The researchers found that compared with YPY, more OPY reported a diagnosis of depression (46 versus 30 percent), had self-harmed (40 versus 28 percent), had considered suicide (52 versus 40 percent), had attempted suicide (17 versus 9 percent), and required psychoactive medications (26 versus 23 percent) after presentation. Late puberty was associated with depressive disorders and anxiety disorders after controlling for covariates (odds ratios, 5.49 and 4.18, respectively), while older age remained associated with psychoactive medication use (odds ratio, 1.31).

“These data suggest that GI youth who present to GAMC later in life are a particularly high-risk subset of a vulnerable population,” the authors write.

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