Abstract
Study Objective
To use a retrospective review of sexual and reproductive health (SRH) counseling that
occurred during initial visits of adolescents seeking testosterone gender-affirming
hormone therapy to determine the feasibility of using such visits to manage SRH
Design
Retrospective chart review
Setting
Children's hospital, multidisciplinary gender clinic
Participants
Transgender male and nonbinary patients assigned female at birth (TGD-M) aged 15-17
seen for initiation of testosterone between January 1, 2010, and December 31, 2019
Interventions
Not applicable
Main outcome measure(s)
Counseling on (1) testosterone impact on fertility and (2) fertility preservation;
assessment of (3) desire for gender-affirming surgery, (4) sexual activity, (5) sexual
orientation, and (6) human papilloma virus vaccination as documented during the initial
visit.
Results
Of 195 patients who met the inclusion criteria, only 3 (1.5%) had all 6 measures addressed.
The median number addressed was 4 out of 6 (IQR = 2-5/6), with fertility counseling
(95.9%, n = 187) being most common, followed by assessment of surgery desire (74.4%, n = 145), sexual orientation (69.2%, n = 135), and sexual activity (69.2%, n = 135). The odds of being asked about sexual orientation were 5.3 times higher in
patients who endorsed sexual activity than in those who did not (P < .001; 95% CI, 9.8-10.3).
Conclusion
Providers of adolescent gender-affirming hormone therapy regularly assess and counsel
on certain aspects of SRH as part of their initial visits for those seeking testosterone.
Our data suggest that these initial visits for patients seeking testosterone represent
an opportunity to expand SRH assessment and counseling among TGD-M adolescents.
Key Words
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Article info
Publication history
Published online: September 23, 2022
Accepted:
September 19,
2022
Received in revised form:
September 14,
2022
Received:
May 25,
2022
Footnotes
Conflict of Interest Statement
The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
Identification
Copyright
© 2022 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
