Youth assigned female at birth, older age at initial presentation linked to increased likelihood of diagnosis, treatment.
Only 29 percent of children and adolescents with gender dysphoria receive a gender dysphoria-related diagnosis (GDRD), and 25 percent are prescribed gender-affirming hormonal treatment (GAHT), according to a study published online June 7 in Pediatrics.
Stephanie Wagner, M.D., M.P.H., from the Emory University School of Medicine in Atlanta, and colleagues identified a cohort of 958 gender-diverse children and adolescents who did not have a GDRD or GAHT at index. Across demographic groups, the authors compared the rates of first GDRD and first GAHT prescription.
The researchers found that during the average follow-up of 3.5 years, 29 percent of participants received a GDRD and 25 percent were prescribed GAHT. Youth assigned female at birth were more likely than youth assigned male at birth to receive a diagnosis and initiate GAHT (hazard ratio estimates of 1.3 [95 percent confidence interval, 1.0 to 1.7] and 2.5 [95 percent confidence interval, 1.8 to 3.3], respectively).
Those aged 15 years or older at initial presentation more often had progression to diagnosis compared with those aged 10 to 14 years and 3 to 9 years (37 percent versus 28 and 16 percent, respectively). The adjusted hazard ratios for a GDRD were 2.0 (95 percent confidence interval, 1.3 to 3.0) and 2.7 (95 percent confidence interval, 1.8 to 3.9) for ages 10 to 14 years and 15 years and older, respectively, compared with ages 3 to 9 years. The likelihood of receiving a diagnosis or being prescribed a GAHT was lower among racial/ethnic minorities.
“Taken together, these results indicate that even in the presence of similar access to care, utilization and timing of services may differ across groups of gender dysphoric children and adolescents,” the authors write.