Valoración de la supresión de la pubertad en menores con problemas de identidad de género

  1. José López Guzmán
  2. Carmen González Vázquez
Revista:
Cuadernos de bioética

ISSN: 1132-1989 2386-3773

Año de publicación: 2018

Volumen: 29

Número: 97

Páginas: 247-256

Tipo: Artículo

Otras publicaciones en: Cuadernos de bioética

Resumen

The objective of this article is to reflect on the opportunity and risk of the proposed treatments to address gender identity problems in that sector of the population. In most of the protocols for the care of minors with gender identity problems, the abolition of puberty is proposed as a method of choice. This technique consists in the administration of reversible agonists of GnRH to provoke a suppression of the hormonal expression of the minor and, thus, the development of the sexual characters of their gender. The opportunity or adequacy of the systematic use of reversible GnRH agonists may be questioned for several reasons. The first, because the diagnosis of transsexualism in minors carries a great complexity and difficulty, so there is a wide margin of error. The second, because the suppression of puberty has direct consequences in the development of the child. Thirdly, because the aforementioned treatments have some risks and side effects in minors, some of them not studied and unknown, which, without a doubt, should be weighted. Finally, because the drugs used are neither designed nor experienced, for the care of minors with gender identity problems. Therefore, they are used without being approved by the regulatory agencies of the medicinal product for that purpose. These issues need to be addressed and also transmitted in the information provided to the stakeholders.

Referencias bibliográficas

  • Bertelloni, S., Mul. D. “Treatment of central precocious puberty by GnRH analogs: long-term outcome in men”. Asian Journal of Andrology, 10 (4), (2008), 525-34.
  • Bishop, BM. “Pharmacotherapy considerations in the management of transgender patients: a brief review”. Pharmacotherapy, 35 (12), (2015), 1130-9.
  • Coleman, E et al. Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People. World Professional Association for Transgender Health (WPATH).7th version, 2012.
  • De Vries, A., Noens, I., Cohen-Kettenis, P., van Berckelaer-Omnes, I., Doreleijers, T. “Autism spectrum disorders in gender dysphoric children an adolescents”. Journal of Autism and Developmental Disorders, 40, (2010), 930-936.
  • Delemarre-van de Waal, HA, Cohen-Kettenis, PT. “Clinical management of gender identity disorder in adolescents: a protocol on psychological and paediatric endocrinology aspects”. European Journal of Endocrinology, 155, (2006), S131–S137.
  • Dreger, A. (Publicación en línea) “Gender Mad”. 19 de diciembre de 2015. <http://alicedreger.com/gendermad> (Consulta: 5/02/2017)
  • Glass-Godwin, L, Kalumuck, KE. Puberty and adolescence. Salem Press Encyclopedia of Health, 2016
  • González Vázquez, C., López Guzmán, J. “Medicamentos off-label: cuestiones terminológicas y conceptuales”. Index de Enfermería, 26(4), (2017), 292-294.
  • Hembree, WC, Cohen_Kettenis, P, Delemarre van de Waal, HA y cols. “Endocrine Society. Endocrine treatment of transexual persons: an Endocrine Society Clinical Practice Guidelines”. J Clin Endocrinol Metab, 94 (9), (2009), 3132-3154.
  • Hernández Valencia M. Pubertad precoz”. Revista Mexicana de Medicina de la Reproducción, 4(1), (2011), 3-9.
  • Heyer, W. (Publicación en línea) “The experimento on our children: doctors don’t know who the real trans kids are”. <http://www.thepublicdiscourse.com/2017/06/19512/> (Consulta: 8/07/ 2017)
  • Hruz, PW, Mayer, LS, McHugh, PR. “Growing Pains. Problems with puberty suppression in treating gender dysphoria”. The New Atlantis,52, (2017), 8-10.
  • Ingalhalikar, M., Smith, A.; Parker, D. y col. “Sex differences in the structural connectome of the humanbrain”. PNAS, 111, (2014), 823-828.
  • Lenz, MI. “Papel del factor de crecimiento semejante a la insulina (IGF-1) en la regulación de la función ovárica”. Biosalud, 6, (2007), 149-59.
  • Lorme, K.C., Schulz, K.M., Salas-Ramírez, K.Y., Sisk, C.L.”Pubertal testosterone organizes regional volumen and neuronal number within the medial amígdala of adult male syriam hamsters”. Brain Res, 1460, (2012), 33-40.
  • Maxwell, E., Salch, S., Boliko, M., Anakwe-Charles, G. “Discrepancies in lesbian, gay, bisexual, and transgender patient care and how Pharmacists can support an evolved practice”. American Journal of Pharmaceutical Education, 81 (7), (2017), article 6181.
  • Muñoz, MT, Pozo, J. “Pubertad normal y sus variantes”. Pediatría Integral, XV (6), (2011), 507-18.
  • Rica, I., Grau, G., Rodríguez A., Vela A. “La atención a los menores transexuales”. Rev Esp Endocrinol Pediatr, 6 (Suplemento 2), (2015), 38-44.
  • Rosenthal, S.M., “Transgender youth: current concepts”. Ann Pediatr Endocrinol Metab, 21, (2016), 185-192.
  • Spack, N.P., Edwards-Leeper, L., Feldman, H.A. y cols. “Children and adolescents with gender identity disorder referred to a pediatric medical center”. Pediatrics, 129(3), 2012, 418-25.
  • Temboury, M.C. “Desarrollo puberal normal. Pubertad precoz”. Rev Pediatr Aten Primaria, 11, (2009), 127-42.
  • Tresguerres, JA (Coord.) Fisiología humana, McGrawHill, México, 2005.
  • Vargas, F., Fuentes, M.A., Marco, M.V., Martínez-Aedo, M.J., Ruiz, R. “Pubertad precoz”. Protoc diagn ter pediatr, 1, (2011), 193-204.
  • Wente, M. (Publicación en línea) “Transgender kids: Have we gone too far?” http://www.theglobeandmail.com/opinion/transgender-kids-have-we-gonetoo-far/article16897043/ (Consulta: 15/02/2017)
  • World Professional Association for Transgender Health. “Standars of care for the health of transsexual, transgender and gender nonconforming people”. <http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1351&pk_association_webpage=4380> (Consulta: 18(09/2017)