出生時の性別に対する違和感を持つ子どもへの対応と支援─複数診療科での連携を行う専門外来の立場から.

The Okayama University Gender Clinic provides comprehensive care with collaboration from multiple medical departments according to the Japanese Society of Psychiatry and Neurology’s Diagnostic and Therapeutic Guideline for Gender Identity Disorder (JSPN Guideline). 2947 patients (961 trans women [TW], 1986 trans men [TM]) have visited our outpatient office by the end of 2021. Only 175 (6%)were aged 15 and younger, the age group of junior high school students and younger. Looking back, this number began increasing sharply in 2019, when the total number of young cases was 46 or 27% of those seen in 2021. Most of those seen at age 9 or younger are TW. However, the sex ratio is reversed in the age group 10 and older, with a sharp increase in TMs seen. In early childhood, it is not noticeable when girls behave like boys, while it is noticeable when boys behave like girls. This may explain the higher number of TWs seen in this age group. Twenty percent (36/175)of the patients under 15 years of age had been diagnosed with autism spectrum disorder (ASD) at other hospitals, with a particularly high rate of 64% (7/11) of TW under 6 years of age. The reason for this may be that the ASD complication increases the likelihood that the patient will express atypical gender behavior without regard to the evaluation of others. Physical treatment for gender incongruence of childhood includes puberty suppression therapy at Tanner stage 2 or later. At the Okayama University Gender Clinic, 35 patients (27 TM, 8 TW) have been started on this therapy in accordance with JSPN Guideline. This treatment is reversible, and we believe that it should be positively considered for those who wish to receive it. [ABSTRACT FROM AUTHOR]