TY - JOUR
T1 - Consensus Parameter
T2 - Research Methodologies to Evaluate Neurodevelopmental Effects of Pubertal Suppression in Transgender Youth
AU - Chen, Diane
AU - Strang, John F.
AU - Kolbuck, Victoria D.
AU - Rosenthal, Stephen M.
AU - Wallen, Kim
AU - Waber, Deborah P.
AU - Steinberg, Laurence
AU - Sisk, Cheryl L.
AU - Ross, Judith
AU - Paus, Tomas
AU - Mueller, Sven C.
AU - Mccarthy, Margaret M.
AU - Micevych, Paul E.
AU - Martin, Carol L.
AU - Kreukels, Baudewijntje P.C.
AU - Kenworthy, Lauren
AU - Herting, Megan M.
AU - Herlitz, Agneta
AU - Haraldsen, Ira R.J.Hebold
AU - Dahl, Ronald
AU - Crone, Eveline A.
AU - Chelune, Gordon J.
AU - Burke, Sarah M.
AU - Berenbaum, Sheri A.
AU - Beltz, Adriene M.
AU - Bakker, Julie
AU - Eliot, Lise
AU - Vilain, Eric
AU - Wallace, Gregory L.
AU - Nelson, Eric E.
AU - Garofalo, Robert
N1 - Publisher Copyright:
© Diane Chen et al. 2020: Published by Mary Ann Liebert, Inc.
PY - 2020/12
Y1 - 2020/12
N2 - Purpose: Pubertal suppression is standard of care for early pubertal transgender youth to prevent the development of undesired and distressing secondary sex characteristics incongruent with gender identity. Preliminary evidence suggests pubertal suppression improves mental health functioning. Given the widespread changes in brain and cognition that occur during puberty, a critical question is whether this treatment impacts neurodevelopment. Methods: A Delphi consensus procedure engaged 24 international experts in neurodevelopment, gender development, puberty/adolescence, neuroendocrinology, and statistics/psychometrics to identify priority research methodologies to address the empirical question: is pubertal suppression treatment associated with real-world neurocognitive sequelae? Recommended study approaches reaching 80% consensus were included in the consensus parameter. Results: The Delphi procedure identified 160 initial expert recommendations, 44 of which ultimately achieved consensus. Consensus study design elements include the following: a minimum of three measurement time points, pubertal staging at baseline, statistical modeling of sex in analyses, use of analytic approaches that account for heterogeneity, and use of multiple comparison groups to minimize the limitations of any one group. Consensus study comparison groups include untreated transgender youth matched on pubertal stage, cisgender (i.e., gender congruent) youth matched on pubertal stage, and an independent sample from a large-scale youth development database. The consensus domains for assessment includes: mental health, executive function/cognitive control, and social awareness/functioning. Conclusion: An international interdisciplinary team of experts achieved consensus around primary methods and domains for assessing neurodevelopmental effects (i.e., benefits and/or difficulties) of pubertal suppression treatment in transgender youth.
AB - Purpose: Pubertal suppression is standard of care for early pubertal transgender youth to prevent the development of undesired and distressing secondary sex characteristics incongruent with gender identity. Preliminary evidence suggests pubertal suppression improves mental health functioning. Given the widespread changes in brain and cognition that occur during puberty, a critical question is whether this treatment impacts neurodevelopment. Methods: A Delphi consensus procedure engaged 24 international experts in neurodevelopment, gender development, puberty/adolescence, neuroendocrinology, and statistics/psychometrics to identify priority research methodologies to address the empirical question: is pubertal suppression treatment associated with real-world neurocognitive sequelae? Recommended study approaches reaching 80% consensus were included in the consensus parameter. Results: The Delphi procedure identified 160 initial expert recommendations, 44 of which ultimately achieved consensus. Consensus study design elements include the following: a minimum of three measurement time points, pubertal staging at baseline, statistical modeling of sex in analyses, use of analytic approaches that account for heterogeneity, and use of multiple comparison groups to minimize the limitations of any one group. Consensus study comparison groups include untreated transgender youth matched on pubertal stage, cisgender (i.e., gender congruent) youth matched on pubertal stage, and an independent sample from a large-scale youth development database. The consensus domains for assessment includes: mental health, executive function/cognitive control, and social awareness/functioning. Conclusion: An international interdisciplinary team of experts achieved consensus around primary methods and domains for assessing neurodevelopmental effects (i.e., benefits and/or difficulties) of pubertal suppression treatment in transgender youth.
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U2 - 10.1089/trgh.2020.0006
DO - 10.1089/trgh.2020.0006
M3 - Article
C2 - 33376803
AN - SCOPUS:85098084938
SN - 2380-193X
VL - 5
SP - 246
EP - 257
JO - Transgender Health
JF - Transgender Health
IS - 4
ER -