The role of the pediatrician in the management of the child and adolescent with gender dysphoria

Table 3 The table shows the current therapeutic possibilities in adolescent patients with gender dysphoria

	_EVALUATION [2, 87]	_{HORMONAL TREATMENT} [104, 114, 116, 121]	SURGICAL TREATMENT [46, 114, 123]
TIMING	6 MONTHS	12 MONTHS	2–4 weeks	4–6 weeks	3–6 months	6–12 months
MALE TO FEMALE (MTF)	Gender Dysphoria Diagnosis	GnRH analogue/ Cross-sex steroids	Orchiectomy	Breast augmentation surgery	Feminizing genitoplasty surgery without vagina	Feminizing genitoplasty surgery with vagina
FEMALE TO MALE (FTM)	Gender Dysphoria Diagnosis	GnRH analogue/ Cross-sex steroids	Hysterectomy Annexectomy	Mastectomy	Metoidioplasty	Phalloplasty or penile prosthesis

Legend:
FTM = gender transition of a transgender man who was assigned female at birth (AFAB)
Hysterectomy = surgical removal of the uterus and the cervix in most occasions
Annexectomy = excision of both ovaries and fallopian tubes
Mastectomy = bilateral surgical removing of the entire breast
Metoidioplasty = surgical procedure consisting in the cutting of ligaments around the erectile tissue of the clitoris to release it from the pubis and lengthen it to 4 or 6 cm with the possible incorporation of the urethra
Phalloplasty = surgery consisting in the construction of a penis with a penile prosthesis, in order for an erection to be achieved, and extension of the urethra to allow the patient to urinate standing
MTF = gender transition of a transgender woman who was assigned male at birth (AMAB)
Orchiectomy = surgical procedure consisting in the removal of both testicle
Breast augmentation = surgery technique involving breast implants
Feminizing genitoplasty = plastic surgery consisting in the construction of a vagina, by means of penile inversion or using sigmoid colon or scrotal tissue, clitoris and labia

ISSN: 1824-7288