Evidence map›Paper›PMID 41625013›Full record

ArticleInternational journal of transgender health2026

The evolution of pediatric transgender healthcare in Flanders: Trends in referrals, intakes and gender-affirming interventions over the last 15 years.

Silvia Ciancia, Laura Bruneel, Judith Van Schuylenbergh, Daniel Klink, Karlien Dhondt, Robin Heyse, Joz Motmans, Martine Cools

Abstract read
In one paragraph

Article in International journal of transgender health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Silvia CianciaDepartment of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.ORCID https://orcid.org/0000-0003-0874-4648
Laura BruneelCenter for Sexology and Gender, Ghent University Hospital, Ghent, Belgium.
Judith Van SchuylenberghCenter for Sexology and Gender, Ghent University Hospital, Ghent, Belgium.
Daniel KlinkPediatric Endocrinology Service, Department of Pediatrics, Ghent University Hospital, Ghent, Belgium.
Karlien DhondtDepartment of Child & Adolescent Psychiatry, Pediatric Gender Clinic, Ghent University Hospital, Ghent, Belgium.
Robin HeyseCenter for Sexology and Gender, Pediatric Gender Clinic, Ghent University Hospital, Ghent, Belgium.
Joz MotmansCenter for Sexology and Gender, Ghent University Hospital, Ghent, Belgium.ORCID https://orcid.org/0000-0001-7643-4153
Martine CoolsDepartment of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.ORCID https://orcid.org/0000-0002-9552-4899

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: The expanding number of minors questioning their gender identity and seeking care has led to the constitution of pediatric gender clinics in several countries. The activity of the multidisciplinary Pediatric Gender Team at Ghent University Hospital, Belgium started in 2007. We report on the evolution of referrals, psychological intakes, and trends in the start of gender-affirming medical and surgical interventions from 2007 to 2023. Methods: The whole cohort of minors (age <17 years) having a psychological intake between 2007 and 2023 was included. Subgroups were analyzed based on sex registered at birth (female or male, RFAB and RMAB respectively), year and age at the psychological intake (below or above 10 years). Results: Referrals have increased in recent years. Between 2007 and 2023, 890 minors (65.5% RFAB) accessed our service. The ratio RFAB/RMAB has progressively increased, and RFAB with age at first intake >10 represented the greatest proportion. After 12 months, 19.5% were no longer in follow-up at our center; 28.1% of RFAB and 47.2% of RMAB did not start any medical treatment; 66.9% of RFAB and 52.8% of RMAB started gonadal hormone suppression (GHS), achieved with gonadotropin-releasing hormone analogues in 17.7% of RFAB and 34.6% of RMAB, with pro-androgenic progestins in 82.3% of RFAB and with anti-androgens in 65.4% of RMAB. 74.6% of RFAB and 86.4% of RMAB on GHS and older than 16 started gender-affirming hormones. Mastectomy was the most common gender-affirming surgery in RFAB, followed by hystero-gonadectomy. Gender-affirming surgery in RMAB was less frequent; vaginoplasty was the most frequent procedure. Conclusions: The care of minors with gender incongruence requires a multidisciplinary approach due to the complex psychological, social, and physical needs of this group. The timing and therapeutical options must be tailored to each adolescent.

Indexed as

adolescentschildrengender incongruencegonadotropin-releasing hormone analoguesprogestins, gender-affirming hormonestransgender

Identifiers

PMID41625013
PMCPMC12857706

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.