ESPE Yearbook of Paediatric Endocrinology

Horm Res Paediatr. 2024 Dec 2:1-27. doi: 10.1159/000542904

Brief summary: This publication, the result of a collaboration between ESPE and Endo-ERN, summarises recent evidence on hormonal treatment of transgender and gender-diverse adolescents and provides practical information and tools for paediatric endocrinologists providing this care. Topics include the importance of multidisciplinary care, counselling prior to treatment, fertility preservation, options for hormonal treatment, long-term follow-up and transition of care, altered treatment wishes, lifestyle counselling, sexual health and contraception and ethical considerations.

In addition to this document, the last year has seen the publication of a number of national guidelines and expert consensus papers on endocrine treatment of transgender adolescents, for example from France (1), Germany (2) and Poland (3), aiming to improve care. At the same time, gender affirming care has been restricted or banned in other countries such as the United States (4). Several National Institute of Health grants for research on transgender health among other topics were cancelled (5), although a judge recently ruled that the terminations had no legally valid basis (6). A presidential action stated that “Female” means a person belonging, at conception, to the sex that produces the large reproductive cell and “Male” means a person belonging, at conception, to the sex that produces the small reproductive cell’ (7). This action, aimed against ‘gender ideology extremism’ does no right to either transgender people or individuals with differences of sex development. Therefore, now more than ever, health care professionals and scientists need to make clear that reality is more complex and nuanced than this and continue to strive for evidence-based care that is accessible to all that need it.

References: 1. German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (DGKJP, 2025): S2k guideline Gender incongruence and gender dysphoria in childhood and adolescence: diagnosis and treatment. AWMF register no. 028-014. version 1.0, 2025. https://register.awmf.org/de/leitlinien/detail/028-014.2. Gawlik-Starzyk A, Dora M, Baran D, et al. Framework guidelines for the process of caring for the health of adolescent transgender (T) and non-binary (NB) people experiencing gender dysphoria - the position statement of the expert panel. Endokrynol Pol. 2025;76(1):1-28. PMID: 40071796.3. Brezin F, Busiah K, Leroy C, et al. Endocrine management of transgender adolescents: Expert consensus of the french society of pediatric endocrinology and diabetology working group. Arch Pediatr. 2024 Nov 16:S0929-693X(24)00176-3. PMID: 39551654.4. Coelho DRA, Chen AL, Keuroghlian AS. Advancing Transgender Health amid Rising Policy Threats. N Engl J Med. 2025 Mar 13;392(11):1041-1044. PMID: 39938113.5. Reardon S. NIH kills existing grants on transgender issues. Science. 2025 Mar 14;387(6739):1136. PMID: 40080590.6. Reardon S. Order to restore NIH grants heartens scientists. Science. 2025 Jun 26;388(6754):1359-1360. PMID: 40570104.7. White House. Presidential action ‘Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government. January 20, 2025 (https://www.whitehouse.gov/presidential-actions/).