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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Trends in Referrals to a Pediatric Transgender Clinic
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Trends in Referrals to a Pediatric Transgender Clinic

机译：对儿科患者诊所的推荐趋势

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OBJECTIVES: We characterized referral trends over time at a transgender clinic within an integrated health system in Northern California. We identified the transition-related requests of pediatric transgender and gender-nonconforming patients and evaluated differences in referrals by age group. METHODS: Medical records were analyzed for all patients <18 years of age in the Kaiser Permanente Northern California health system who were referred to a specialty transgender clinic between February 2015 and June 2018. Trends in treatment demand, demographic data, service requests, and surgical history were abstracted from medical charts and analyzed by using descriptive statistics. RESULTS: We identified 417 unique transgender and gender-nonconforming pediatric patients. The median age at time of referral was 15 years (range 3-17). Most (62%) identified on the masculine spectrum. Of the 203 patients with available ethnicity data, 68% were non-Hispanic. During the study period, the clinic received a total of 506 referrals with a significant increase over time (P < .001). Most referrals were for requests to start cross-sex hormones and/or blockers (34%), gender-affirming surgery (32%), and mental health (27%). Transition-related requests varied by age group: younger patients sought more mental health services, and older patients sought hormonal and surgical services. Eighty-nine patients underwent gender-affirming surgeries, mostly before age 18 and most frequently mastectomies (77%). CONCLUSIONS: The increase in referrals supports the need for expanded and accessible health care services for this population. The transition-related care of patients in this large sample varied by age group, underscoring the need for an individualized approach to gender-affirming care.
机译：目的：我们在加利福尼亚州北部综合卫生系统内的跨性别诊所表征推荐趋势。我们确定了与儿科转型和性别不合适患者的过渡相关请求，并评估年龄组推荐的差异。方法：分析了医疗记录，为北加州北加州北加州北加州北加州北加州北部加州北部加州卫生系统，在2015年2月至2018年6月之间提到了一名特色变性诊所。治疗需求的趋势，人口统计数据，服务请求和外科手术历史从医学图表中抽象出来并通过使用描述性统计分析。结果：我们确定了417名独特的变性和性别不合适的儿科患者。推荐时的中位年龄为15年（范围3-17）。大多数（62％）在男性谱上鉴定。在203名可用种族数据的患者中，68％是非西班牙裔。在研究期间，诊所每次接受506个引用，随着时间的推移显着增加（P <.001）。大多数推荐是用于开始交叉性激素和/或阻塞者（34％），性别肯定的手术（32％）和心理健康（27％）的请求。与年龄组不同的过渡相关请求：年轻患者寻求更多的心理健康服务，老年患者寻求荷尔蒙和外科服务。八十九名患者接受了性别肯定的手术，主要是在18岁之前，最常见的乳房切除术（77％）。结论：推荐的增加支持这一人口的扩大和可访问的医疗保健服务。在这个大型样本中患者的过渡相关护理患者因年龄组而异，强调需要一个个性化的性别肯定护理方法。

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