An increasing number of transgender and gender-diverse (TGD) youth (early pubertal through to late adolescent, typically 9–10 through to 18 years of age) are seeking medical services to bring their physical sex characteristics into alignment with their gender identity — their inner sense of self as male or female or somewhere on the gender spectrum. Compelling research has demonstrated the clear mental health — even life-saving — benefits of gender-affirming care, but current clinical practice guidelines and standards of care are based on only several short-term and a few medium-term outcomes studies complemented by expert opinion. Nevertheless, although the relative paucity of outcomes data raises concerns, the stance of not intervening until more is known is not a neutral option, and large observational studies evaluating current models of care are necessary and are now underway. This Review highlights key advances in our understanding of transgender and gender-diverse youth, the challenges of providing gender-affirming care, gaps in knowledge and priorities for research.

越来越多的跨性别和性别多样化 (TGD) 青年（青春期早期到青春期晚期，通常为 9-10 到 18 岁）正在寻求医疗服务，以使他们的身体性别特征与他们的性别认同保持一致——他们的作为男性或女性或性别范围内某处的内在自我意识。令人信服的研究已经证明了性别肯定护理对心理健康——甚至是挽救生命——的明显好处，但目前的临床实践指南和护理标准仅基于几项短期和几项中期结果研究，并辅以专家意见. 尽管如此，尽管结果数据的相对缺乏引起了人们的担忧，但在了解更多信息之前不干预的立场并不是一个中立的选择，评估当前护理模式的大型观察性研究是必要的，目前正在进行中。本评论强调了我们对跨性别和性别多样化青年的理解、提供性别肯定护理的挑战、知识差距和研究重点方面的关键进展。