Adolescent gender dysphoria management: position paper from the Italian Academy of Pediatrics, the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, the Italian Society of Adolescent Medicine and the Italian Society of Child and Adolescent Neuropsychiatry

Table 2 Clinical, biochemical and instrumental assessments before and during treatment with GnRH analogue

Assessments prior and during treatment with GnRHa
Clinical, biochemical and imaging evaluation	Before starting GnRHa	During treatment with GnRHa
Clinical, biochemical and imaging evaluation	Before starting GnRHa	Every 3-6 months	Every 6 months	Every 12 months
Weight, height, height velocity, weight, body mass index	X	X
Bone age (in those who have not completed puberty)	X			X^a
Pubertal assessment	X		X
Blood pressure	X	X
Haemoglobin/haematocrit, ferritin, liver function, renal function, electrolytes	X
LH, FSH, estradiol/testosterone	X		X
Prolactin^a	X		X
Vitamin D, PTH^a, calcium, phosphate, albumin	X		X
BMD (and VFA) by DXA	X			X

LH Luteinizing hormoneD FSH Follicle-stimulating hormone, PTH Parathyroid Hormone, BMD Bone mineral density, DXA Dual-energy X-ray absorptiometry VFA Vertebral fracture assessment
^arecommended but not essential

ISSN: 1824-7288