PES Statement Supporting Access to Gender Care
The Pediatric Endocrine Society supports a patient and family/caregiver-centered approach to healthcare for all the conditions we treat. Our goal is provision of the best age-appropriate, evidence-based, and individualized care. To achieve that end, medical decisions should be based on the combination of the available detailed data and clinical experience and expertise in conjunction with patient values and goals. Optimal patient outcomes are achieved when decisions are made collaboratively among patients, families/caregivers, and their health care providers.
Goals for the care of transgender and gender diverse youth are no different. Care of these youth should be individualized and should align with their goals and values. Some of these youth choose to undergo medical interventions while others may not. For those who pursue the use of medications, suitable medications are only prescribed after youth have shown physical manifestations of puberty. Decisions around medication use or discontinuation should be collaborative among patients/families/caregivers and care providers. This shared decision-making process should include extensive conversations and discussions of available evidence, the pros and cons, and the potential risks and benefits. Expectations regarding short and long-term effects should be reviewed.
Despite controversies regarding care of transgender and gender diverse youth, areas of general consensus include:
a. Provision of holistic, comprehensive care.
b. Provision of mental health and community support for youth, parents, and caregivers.
c. Completion of a biopsychosocial evaluation prior to medical intervention.
d. Recognition that medical intervention(s) may be insufficient to address substantial co-occurring mental health and/or psychosocial problems. These issues, if present, must be addressed in parallel.
e. Assurance that youth and families/caregivers are informed about and understand the ramifications of any decisions that are made.
The Pediatric Endocrine Society and many other major medical associations maintain that a youth’s gender identity should be respected. Youth should have access to the option of evidence-based knowledgeable medical intervention. When appropriately ascertained, many individuals benefit from medical care, and those benefits outweigh associated risks. Our commitment to individualized informed care reflects our mission to promote and advance the well-being of all children, adolescents, and emerging young adults.