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      Atención sanitaria a adolescentes con disforia de género Translated title: Health care for adolescents with gender dysphoria

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          RESUMEN

          Fundamentos.

          El tratamiento de la disforia de género (DG) en adolescentes es reciente. Son reducidos los estudios de adolescentes que han recibido tratamiento con análogos. Para garantizar la calidad asistencial y la seguridad del menor es necesario realizar estudios de seguimiento. El objetivo de la presente investigación fue describir las características del proceso de atención médica y psicológica en adolescentes con DG en la Unidad de Tratamiento de Identidad de Género del Principado de Asturias.

          Métodos.

          La muestra se compuso de 20 menores de edad que solicitaron consulta en la UTIGPA desde su apertura en 2007 hasta 2015. Se revisaron de forma retrospectiva las historias clínicas para recoger las variables. Se llevaron a cabo análisis de estadísticos descriptivos.

          Resultados.

          El 10% de los adolescentes abandonó en el proceso de acompañamiento psicológico, el 80% empezó a ser valorado por endocrinología y el 10% continuaba exclusivamente en consultas psicológicas. De los tratados médicamente, el 13,3% fue tratado con análogos y el 86,7% recibió directamente tratamiento hormonal cruzado (THC). Los efectos secundarios más prevalentes fueron los problemas dermatológicos (40%), seguidos de mastodinia sin galactorrea (26,7%) y sofocos (20%). El 20% realizó cirugías de confirmación de género.

          Conclusiones.

          El perfil del adolescente tratado en la unidad de Asturias es un sujeto que comienza tratamiento hormonal tras acompañamiento psicológico y evaluación endocrinológica. Presenta efectos adversos tras el tratamiento. Una vez instaurado el tratamiento hormonal no abandona el proceso.

          ABSTRACT

          Background.

          Dysphoria gender treatment in adolescents is recent. Studies of adolescents treated with analogs are reduced. To ensure the quality of care and safety of the child, follow-up studies are necessary. The aim of the present research was to describe the characteristics of the process of medical and psychological attention in adolescents with the DG in the Gender Identity Treatment Unit of Asturias in the period 2007-2015.

          Methods.

          The sample included 20 minors. The clinical history was made to collect the variables. It was made descriptive analysis.

          Results.

          10% of adolescents abandoned in the process of psychological counseling, 80% began to be valued by endocrinology and 10% continued exclusively in psychological consultations. Of the medical treated adolescents, 13.3% were treated with analogues and 86.7% received cross-hormonal treatment (THC) directly. The most prevalent secondary effects were dermatological problems (40%), followed by mastodynia without galactorrhea (26.7%) and hot flashes (20%). 20% performed gender confirmation surgeries.

          Conclusions.

          The profile of the adolescent treated in the unit of Asturias is a subject that begins hormonal treatment after psychological accompaniment and endocrinological evaluation. The minor has adverse effects after treatment. Once the hormonal treatment has been established, they do not abandon the process.

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          Most cited references22

          • Record: found
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          Young adult psychological outcome after puberty suppression and gender reassignment.

          In recent years, puberty suppression by means of gonadotropin-releasing hormone analogs has become accepted in clinical management of adolescents who have gender dysphoria (GD). The current study is the first longer-term longitudinal evaluation of the effectiveness of this approach.
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            • Article: not found

            Evidence for an altered sex ratio in clinic-referred adolescents with gender dysphoria.

            The number of adolescents referred to specialized gender identity clinics for gender dysphoria appears to be increasing and there also appears to be a corresponding shift in the sex ratio, from one favoring natal males to one favoring natal females.
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              • Record: found
              • Abstract: found
              • Article: not found

              Children and adolescents with gender identity disorder referred to a pediatric medical center.

              To describe the patients with gender identity disorder referred to a pediatric medical center. We identify changes in patients after creation of the multidisciplinary Gender Management Service by expanding the Disorders of Sex Development clinic to include transgender patients.
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                Author and article information

                Journal
                Rev Esp Salud Publica
                Rev Esp Salud Publica
                resp
                Revista Española de Salud Pública
                Ministerio de Sanidad, Consumo y Bienestar social
                1135-5727
                2173-9110
                28 February 2018
                Jan-Dec 2018
                : 92
                : e201802003
                Affiliations
                [1 ] originalUnidad de Tratamiento de Identidad de Género del Principado de Asturias (UTIGPA) orgnameUnidad de Tratamiento de Identidad de Género del Principado de Asturias (UTIGPA)
                [2 ] originalCentro de Salud Mental I “La Magdalena” Área sanitaria III. Hospital Universitario San Agustín de Avilés. Asturias. orgdiv1Centro de Salud Mental I “La Magdalena” Área sanitaria III orgnameHospital Universitario San Agustín de Avilés Asturias
                [3 ] originalHospital Universitario San Agustín de Avilés. Área sanitaria III. Asturias. España. orgnameHospital Universitario San Agustín de Avilés orgdiv1Área sanitaria III Asturias España
                [4 ] originalEloya MS Psicología. Asturias. España. orgnameEloya MS Psicología Asturias España
                [5 ] originalUniversidad Nacional de Educación a Distancia. Asturias. España. orgnameUniversidad Nacional de Educación a Distancia Asturias España
                [6 ] originalServicio de endocrinología. Hospital Universitario San Agustín de Avilés. Asturias. orgdiv1Servicio de endocrinología orgnameHospital Universitario San Agustín de Avilés Asturias
                Author notes
                Correspondencia María Fernández Rodríguez Centro de Salud Mental I “La Magdalena”. Valdés Salas, 4, 33400 Avilés, Asturias maria.fernandezr@sespa.es

                Grupo GIDSEEN: Mari Cruz Almaraz Almaraz (Andalucía), José Antonio Álvarez-Diz (Asturias), Nuria Asenjo Araque (Madrid), Laura Audí Parera (Cataluña), Antonio Becerra Fernández (Madrid), Virginia Bellido Castañeda (País Vasco), Isabel Esteva (Andalucía), María Fernández-Rodríguez (Asturias), Marcelino Gómez-Balaguer (Comunidad Valenciana), Esther Gómez-Gil (Cataluña), Marisa Guadilla (País Vasco). Felipe Hurtado (Comunidad Valenciana), Juan Pedro López-Siguero (Andalucía), María Jesús Lucio (Comunidad de Madrid), Juana Martínez-Tudela (Andalucía), Óscar Moreno-Pérez (Comunidad Valenciana), Jesús Pérez-Luis (Islas Canarias), Susana Ponce de León ( País Vasco), Itxaso Rica ( País Vasco), José-Miguel Rodríguez Molina (Comunidad de Madrid), Carmen Sanisidro (Aragón), Marta Toni García (Navarra), Federico Vázquez (Cataluña), Ángela Vidal Hagemeijer (Cataluña), Angelines Vidales Miguélez (Castilla-León), Aurelia Villar Bonet (Castilla-León).

                Article
                e201802003
                11587327
                29493565
                b0a2e7f7-33f7-4556-b4b2-4eff3af73387

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                History
                : 05 June 2017
                : 10 November 2017
                : 28 February 2018
                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 20, Pages: 1
                Categories
                Original Breve

                disforia de género,personas transgénero,necesidades y demandas de servicios de salud,servicios de salud para las personas transgénero,hormona liberadora de gonadotropina,calidad de vida,adolescencia,gender dysphoria,transgender persons,health services needs and demand,health services for transgender persons,gonadotropin-releasing hormone,quality of life,adolescence

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