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Many transgender and gender-diverse people have a gender identity that does not conform to the binary categories of male or female; they have a nonbinary gender. Some nonbinary individuals are most comfortable with an androgynous gender expression. For those who have not yet fully progressed through puberty, puberty suppression with gonadotrophin-releasing hormone agonists can support an androgynous appearance. Although such treatment is shown to ameliorate the gender dysphoria and serious mental health issues commonly seen in transgender and gender-diverse young people, long-term use of puberty-suppressing medications carries physical health risks and raises various ethical dilemmas. In this Ethics Rounds, we analyze a case that raised issues about prolonged pubertal suppression for a patient with a nonbinary gender.

Original publication

DOI

10.1542/peds.2019-1606

Type

Journal article

Journal

Pediatrics

Publication Date

02/2020

Volume

145

Keywords

Adolescent, Anxiety, Bioethical Issues, Bone Density, Clinical Decision-Making, Drug Administration Schedule, Ethics, Medical, Gender Dysphoria, Hip Fractures, Humans, Informed Consent By Minors, Parental Consent, Personal Autonomy, Puberty, Selective Estrogen Receptor Modulators, Sexual and Gender Minorities