of the Clinical Issue Transgender individuals have a gender identity that does not align with their sex assignment at birth (gender incongruence). They account for about approximately 0.4% of the US population (1 million people).1 Some transgender people experience gender dysphoria, distress caused by the discrepancy between gender identity and birth-assigned sex, linked to lifetime suicide attempt rates of 40%.2 Some may start to live or transition into their affirmed gender. This may include social or legal transition, such as changes to attire, name, and pronouns. Some may request hormones, surgery, or both to diminish the secondary sex characteristics associated with their birth sex. Children diagnosed as having GD/GI may start GnRH agonists after beginning puberty to prevent permanent changes, including facial hair, deepening of the voice, and breast growth. Thereafter, they may initiate hormones to acquire the secondary sex characteristics of their affirmed gender. Prospective studies suggest these interventions are associated with improved psychological functioning and reduction in anxiety and depression.3

中文翻译：

---

性别不安/性别不一致者的内分泌治疗

临床问题 跨性别个体的性别认同与其出生时的性别分配不一致（性别不一致）。他们约占美国人口的 0.4%（100 万人）。 1 一些跨性别者会经历性别不安，这是由性别认同和出生性别之间的差异引起的痛苦，与 40% 的终生自杀未遂率相关。2有些人可能开始生活或过渡到他们确定的性别。这可能包括社会或法律过渡，例如服装、姓名和代词的变化。有些人可能需要激素、手术或两者兼而有之，以减少与其出生性别相关的第二性征。诊断为 GD/GI 的儿童可能在青春期开始后开始使用 GnRH 激动剂，以防止永久性变化，包括面部毛发、声音变深、和乳房发育。此后，他们可能会启动荷尔蒙以获取其确认性别的第二性征。前瞻性研究表明，这些干预措施与改善心理功能以及减少焦虑和抑郁有关。 3