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Jiska Ristori, Alessandra D Fisher, Gender-affirming clinical care pathway for adolescents, The Journal of Sexual Medicine, Volume 20, Issue 11, November 2023, Pages 1266–1267, https://doi.org/10.1093/jsxmed/qdad107
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Transgender and gender-diverse (TGD) adolescents represent a broad spectrum of individuals who have a gender identity that is different from the one assigned at birth. Being TGD is a normal and expected trajectory of the human development and is no longer seen as pathological or a mental disorder in the world health community.1 However, being TGD in adolescence is described as a particularly challenging phase of life, if compared with peers of the general population. TGD adolescents seem to be present more often with depression, anxiety, self-harm, suicidality, eating disorders, and substance abuse.1 Such psychological challenges seem to be related to several factors. Most Western cultural backgrounds and social contexts are still characterized by cisnormativity or, worse, by transphobic attitudes, prejudice, and discrimination that negatively affect TGD people in their developing identity and personality. Unfortunately, stigma is reported also within the healthcare system, with professionals not being properly trained on gender care issues and therefore not able to properly respond to TGD people’s needs. In addition, with the onset of puberty, psychological distress may derive also from having to confront with developing physical features that do not match the bodies of their same-gender peers. For example, a transgender girl (assigned male at birth) may be distressed because of the change of voice and growth of body and facial hair or a transgender boy (assigned female at birth) because of breast development.