After establishment of a multidisciplinary gender clinic, the gender identity disorder population increased fourfold. Complex clinical presentations required additional mental health support as the patient population grew. Mean age and Tanner Stage were too advanced for pubertal suppressive therapy to be an affordable option for most patients. Two-thirds of patients were started on cross-sex hormone therapy. Greater awareness of the benefit of early medical intervention is needed. Psychological and physical effects of pubertal suppression and/or cross-sex hormones in our patients require further investigation.
This is the first study of a US cohort of children and adolescents with gender identity disorder.And that is significant. Think about it. Until now, this was too "controversial" to do research on. There was no funding for it. All of the research until now has been in Europe, Australia, Canada, in fact everywhere except the USA.