To the Editor: I welcome the article by Hewitt and colleagues,1 but their protocol is problematic. Suppression of puberty improves mental health and general functioning, but not body image and dysphoria.2 For this, cross-sex hormones and/or surgery are the only effective treatments.2
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- 1. Hewitt JK, Paul C, Kasiannan P, et al. Hormone treatment of gender identity disorder in a cohort of children and adolescents. Med J Aust 2012; 196: 578-581. <MJA full text>
- 2. de Vries AL, Steensma TD, Doreleijers TA, Cohen-Kettenis PT. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J Sex Med 2011; 8: 2276-2283.
- 3. Olson J, Forbes C, Belzer M. Management of the transgender adolescent. Arch Pediatr Adolesc Med 2011; 165: 171-176.
- 4. World Professional Association for Transgender Health. Standards of care for the health of transsexual, transgender, and gender nonconforming people. 7th version. http://www.wpath.org/documents/Standards%20of %20Care_FullBook_1g-1.pdf (accessed Jun 2012).
- 5. Spack NP, Edwards-Leeper L, Feldman HA, et al. Children and adolescents with gender identity disorder referred to a pediatric medical center. Pediatrics 2012; 129: 418-425.
- 6. Hembree WC. Guidelines for pubertal suspension and gender reassignment for transgender adolescents. Child Adolesc Psychiatr Clin N Am 2011; 20: 725-732.
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