Growing Evidence and Remaining Questions in Adolescent Transgender Care

This week in the Journal , a much-awaited primary report from Chen et al. 1 on 2 years of gender-affirming hormones (GAH) in transgender adolescents appears. The approach to adolescent transgender care with early treatment with puberty blockers, and GAH in youth from 16 years of age, originated in the Netherlands (“the Dutch model”) and became the dominant medical care model for transgender adolescents. 2 Especially over the past decade, marked increases in referrals but limited evidence as to long-term outcomes have led to controversies and debate regarding this approach. Indeed, some European countries are adapting their guidelines and restricting access to care . . .