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  • Friday, June 17, 2016
  • 0706-000523 GENDER DYSPHORIA IN YOUNGER CHILDREN: SUPPORT AND CARE IN AN EVOLVING CONTEXT

    June 19, 2016 2:15 PM - June 19, 2016 3:15 PM

    Garden Room

    • Polly Carmichael, PhD, DClinPsy ;
    • Sally Phillott, D Clin Psyc ;
    • Michael Dunsford, BSc ;
    • Amelia Taylor, MA, BA ;
    • Nastasja de Graaf, MSc
    In the UK there has been a large increase in the number of referrals for children under the age of 12 to the Gender Identity Development Service (GIDS). Historically, pre-pubertal children were supported with a ‘watchful waiting’ approach, with evidence suggesting that approximately 2% to 27% of younger children with Gender Dysphoria were likely to persist with their cross-gender identification following puberty. However, more recently the number of children who persist in their wish to live in their non-assigned gender and who present to the service having already transitioned at home or school, has increased. In this mini-symposium we address the new challenges that arise with this increase in referrals of younger children and how we can better support younger children in their preferred pathways. The aim is to explore the outcomes based on the data from several quantitative and qualitative measures regarding children who present at the GIDS before the age of 12, describing their presentation at baseline as well as their journey ahead. We focus on persisting and desisting rates from children under the age of 12, the prevalence rates of natal girls and boys, the number of children that have socially transitioned at home or school and the prevalence of ASD. In addition, we discuss physical and psychosocial outcomes of the first 44 younger adolescents who started on the hypothalamic blocker, following them up with a semi-structured interview after 6 months’ on treatment, and evaluating their functioning at 1 years’ time, using several measures regarding body image and behavioural and emotional functioning. One-third of the referred children under the age of 11 had already made a social transition prior to attending the GIDS.  Of those referred under the age of 11, a greater number of natal boys present with ASD compared to natal girls. Focussing on all referrals under the age of 12 between 2001 and 2011(Mean age = 10.09), 50% of the cases were persisting in their wish to live in their non-assigned gender post-pubertally (at age 16) and were actively expressing the wish to progress with physical treatments. There was a significant difference in persistence rates between natal sex (t=.548, p<0.001), with 75%NF and 25% NM persisting at age 16. Persistence was strongly correlated with the commencement of physical interventions such as the hypothalamic blocker (t=.395, p=.007) and no patient within the sample desisted after having started on the hypothalamic blocker. 90.3% of young people who did not commence the blocker desisted. For the children who commenced the blocker, feeling happier and more confident with their gender identity was a dominant theme that emerged during the semi-structured interviews at 6 months. However, the quantitative outcomes for these children at 1 years time suggest that they also continue to report an increase in internalising problems and body dissatisfaction, especially natal girls. This mini-symposium describes in four papers the different presentations, outcomes and pathways with regards to the children presenting at the GIDS under the age of 12. We will discuss the impact of the findings in relation to how we can better support children who present to gender services.


    Category: Pediatrics and Adolescent Health