Menstrual Suppression and Contraception in a Cohort of Gender Diverse Adolescents Assigned Female at Birth

To describe the different menstrual suppression and contraceptive treatments provided to a cohort of transgender and gender diverse young people assigned female at birth receiving care at a gender diversity clinic.

This retrospective cohort study was conducted in a pediatric gender diversity clinic. Included participants were young people assigned female at birth aged between 11 - 18 years-old, consecutively seen for a first visit between November 1, 2016, and May 31, 2021, and followed until June 1, 2022. Gender identity, medical gender affirming treatments and outcome measures, including menstrual suppression, were obtained from medical records. Menstrual suppression treatment and contraception use in transgender males and non-binary or questioning participants were compared.

In total, 112 young people were included in the study (median age at first consultation 15.2 years). The majority identified as transgender binary (n = 91, 81%) while other participants identified as non-binary or questioning (n = 21, 19%). Nearly half (44.6%) of participants received gonadotropin-releasing hormone agonists alone at least once during follow-up, with high rates of menstrual suppression. Hormonal contraceptive monotherapy was prescribed to 40.2% of the cohort, with similar proportion among transgender binary (38.5%) and non-binary or questioning (47.6%) participants.

This study provides important data on the menstrual suppression and contraceptive treatments provided to young people assigned female at birth in pediatric gender diversity clinic.