Increasing numbers of children and adolescents are being referred to gender services for gender-related concerns. Various instruments are used with these patients in clinical care, but their clinical validity, strengths, and limitations have not been systematically reviewed. In this systematic review, we searched MEDLINE, PubMed, and PsycINFO databases for available tools that assess gender identity, gender expression, or gender dysphoria in transgender and gender-diverse (TGD) children and adolescents. We included studies published before Jan 20, 2020, that used tools to assess gender identity, expression, or dysphoria in TGD individuals younger than 18 years. Data were extracted from eligible studies using a standardised form. We found 39 studies that met the inclusion criteria, from which we identified 24 tools. The nature of tools varied considerably and included direct observation, child and adolescent self-report, and parent-report tools. Many methods have only been used with small samples, include outdated content, and lack evaluation of psychometric properties. In summary, a paucity of studies in this area, along with sparse reporting of psychometric properties, made it difficult to compare the relative use of tools, and current tools have substantial limitations. Future research is required to validate existing measures and create more relevant, culturally appropriate tools.

越来越多的儿童和青少年因与性别相关的问题而被转介到性别服务机构。在临床护理中对这些患者使用了各种仪器，但尚未系统地审查它们的临床有效性、优势和局限性。在本系统评价中，我们在 MEDLINE、PubMed 和 PsycINFO 数据库中搜索了评估跨性别和性别多样化 (TGD) 儿童和青少年的性别认同、性别表达或性别焦虑的可用工具。我们纳入了 2020 年 1 月 20 日之前发表的研究，这些研究使用工具评估 18 岁以下 TGD 个体的性别认同、表达或烦躁不安。使用标准化表格从符合条件的研究中提取数据。我们发现了 39 项符合纳入标准的研究，从中我们确定了 24 项工具。工具的性质差异很大，包括直接观察、儿童和青少年自我报告以及家长报告工具。许多方法仅用于小样本，包括过时的内容，并且缺乏对心理测量特性的评估。总而言之，该领域的研究很少，加上对心理测量特性的报告很少，因此很难比较工具的相对使用，而且当前的工具有很大的局限性。未来的研究需要验证现有措施并创建更相关、更适合文化的工具。伴随着心理测量特性的稀疏报告，很难比较工具的相对使用，并且当前的工具有很大的局限性。未来的研究需要验证现有措施并创建更相关、更适合文化的工具。伴随着心理测量特性的稀疏报告，很难比较工具的相对使用，并且当前的工具有很大的局限性。未来的研究需要验证现有措施并创建更相关、更适合文化的工具。