International Perspectives on Evidence-Based Treatment for Gender-Dysphoric Youth

Two refrains are often heard in youth gender medicine: that a female can be born with a male brain (or vice-versa) or that transgender brains are uniquely different from others’ brains. But does structural brain imaging data and neuropsychology support these claims? In this course, participants will be introduced to the types of insights that brain imaging can offer as a tool and the limitations of interpreting these findings in transgender research.

Topics include the challenges of MRI studies, the continuum of brain differences rather than strictly male-female categories, the potential effect of sexual orientation and hormones on brain structures, and the impact of challenging experiences and environment on overall brain development. Participants will also critically evaluate the limitations of current studies, including methodological challenges and failure to replicate findings, and the importance of avoiding linear interpretations of brain imaging data.

This course examines key developments in the history of treating gender dysphoria, tracing the evolution of medical and psychological interventions over the past decades. It explores the shift from adult-focused gender transition treatments to the emergence of childhood and adolescent interventions, emphasizing the role of puberty blockers within the gender-affirmative model for youth. Beginning with the foundational work of gender clinics, the course delves into the ethical and medical debates that have shaped treatment protocols, particularly ‘The Dutch Protocol’ and its global influence. It considers the rise of the concept of the "trans child" and how shifting cultural and academic perspectives contributed to the increasing adoption of early interventions.

Participants will gain an understanding of the empirical foundations and limitations of key studies that have driven contemporary treatment models, along with the broader social and political forces that have influenced their adoption. By engaging with these topics, participants will gain a critical understanding of how gender dysphoria treatment has been shaped by both scientific inquiry and broader cultural and political forces.

This course examines the evolving concept of what it means to be transgender as a young person in the 21st century through social and cultural lenses, focusing on the interaction between comorbidities and gender dysphoria, as well as current therapeutic approaches for addressing gender-related distress. Participants will explore how shifting definitions of youth transgender identity intersect with broader psychological, developmental, and societal factors in youth. Through the testimonies of clinicians currently in practice, participants will learn about complexities of differential diagnosis and how therapeutic approaches aim to address these challenges.

The practice of youth gender medicine relies on several key assumptions: that puberty blockers are safe and reversible, that untreated gender dysphoria leads to elevated suicide risk, and that there are no ethical alternatives to medical transition for youth. But what does the evidence truly reveal? In this course, participants will critically examine these foundational assumptions. Topics include the effects of puberty blockers on brain development, the psychological risks and benefits of medical transition, and the role of therapy in helping young people navigate clinical uncertainties before reaching emotional and cognitive maturity. Join this engaging session to challenge preconceptions and expand your understanding of youth gender medicine.

Clinical practice guidelines (CPGs) are essential tools for translating scientific evidence into high-quality care, but the field of youth gender medicine has yet to fully realize their potential. This course equips participants with the skills to critically evaluate treatment guidelines and their role in shaping care for gender-dysphoric youth. Through an in-depth analysis of two prominent CPGs, this course highlights the challenges and opportunities in promoting evidence-based, ethical, and effective care. Learn how rigorous guideline development can address clinical uncertainties and improve outcomes for young patients, ensuring a more informed and balanced approach to their care.

Over the past decade, Europe has undergone a paradigm shift in the care of gender-dysphoric youth. In December 2024, the UK indefinitely banned puberty blockers for gender dysphoria outside research trials, while Sweden, Finland, and Norway implemented significant restrictions between 2020 and 2024.

This course features two expert lectures. Professor Riittakerttu Kaltiala outlines Finland’s pathway, foregrounding comprehensive assessment, developmental context, and psychotherapy-first care for minors with comorbidities. Professor Mikael Landén charts Sweden’s evidence re-appraisal—from SBU’s assessment to the National Board’s guideline shift—addressing low-certainty findings for puberty suppression, detransition signals, bone health, and uncertain long-term outcomes. Learners will gain deeper insight into the ethical, clinical, and policy issues behind recent changes in these countries, and explore how these developments could shape future care for young people experiencing gender dysphoria.

What prompted European leaders in youth gender transition to pivot from widely used endocrine and surgical treatments to prioritizing psychological care? This course tackles the key debates surrounding gender-affirming hormone treatment for youth. Explore the ethical and clinical challenges involved in balancing patient autonomy, safeguarding, and informed decision-making. 

Guided by leading experts, participants will examine critical topics including the impact of international guidelines, the evidence base for interventions, and the long-term effects of hormonal treatments. This course provides a nuanced perspective on how these issues have shaped Europe’s restrictions on puberty blockers and cross-sex hormones, offering a framework for navigating these complex challenges.