Gender Incongruence in Danish Youth (GenDa): An Observational Cohort Study of Danish Children and Adolescents Referred to a National Gender Identity Service

Puberty

时间窗: 8 years

Tanner stages of puberty (1-5) are obtained by clinical examination

Body fat

时间窗: 8 years

Whole body dual-energy x-ray absorptiometry (DXA) will measure body fat percentage (%)

Reproductive serum hormone levels

时间窗: 8 years

Changes in reproductive hormone levels (%)

Adrenal serum hormone levels

时间窗: 8 years

Changes in adrenal hormone levels (%)

Transabdominal ultrasound of ovaries

时间窗: 8 years

Change in number of follicles (n) during testosterone treatment

Morbidity

时间窗: 8 years

Number of participants with registered ICD10 diagnoses

Substance abuse.

时间窗: 8 years

Number participants with self-reported abuse of alcohol, drugs or medications (interview)

Lean body mass

时间窗: 8 years

Whole body dual-energy x-ray absorptiometry (DXA) will measure lean mass (kg)

Blood pressure

时间窗: 8 years

Changes in blood pressure measurement (mm Hg)

Transabdominal ultrasound of uterus

时间窗: 8 years

Changes of endometrium (thickness in mm) during testosterone treatment

Sperm motility

时间窗: 8 years

Sperm motility (at cryopreservation)

Psychosocial Disability

时间窗: 8 years

Global Assessment of Psychosocial Disability (GAPD, range 0-8)

Suicide risk

时间窗: 8 years

Number of participants with self-reported suicide thoughts or attempts (interview)

Body Mass Index (BMI)

时间窗: 8 years

BMI will be calculated from height and weight (kg/m\^2) measurements

Bone mineral content (BMD)

时间窗: 8 years

Whole body dual-energy x-ray absorptiometry (DXA) will determine BMD Z-score for age and sex

Sperm count

时间窗: 8 years

Sperm Count (at cryopreservation)

Demographic characteristics

时间窗: 8 years

eg. socioeconomic status

Prevalence of Attention Deficit Hyperactive Disorder (ADHD)

时间窗: 8 years

Screening using validated tests: Behavior Rating Inventory of Executive Function (BRIEF): General executive function is measured on a normative scale with T-scores from 20-80. A higher score: more executive difficulties. Attention Deficit/Hyperactive Disorder-Rating Scale (ADHD-RS): Attention Deficit Hyperactive Disorder traits measured on a normative scale with T-scores from 0-78. A higher score: More Attention Deficit Hyperactive Disorder traits

Global level of functioning

时间窗: 8 years

Children's Global Assessment Scale (C-GAS, range 1-100)

Prevalence of psychiatric disorders

时间窗: 8 years

Based on screening for psychopathology using validated tests, as indicated: Schedule for Affective Disorders and Schizophrenia for School-age children (K-SADS): A diagnostic tool used to assess psychiatric disorders in children and adolescents. It is a semi-structured interview guide used to identify psychiatric conditions. Wechsler Intelligence Scale for Children (WISC 4/5) or Wechsler Adult Intelligence Scale (WAIS 4): General cognitive function is measured on a scale from 40-160 which is used as an intelligence quotient. A higher score: A higher cognitive function. Rorschach: A projective psychological test. The test uses a series of ink blots to evaluate a person's mental functions and emotional state by analysing their perceptions of the figures. The test is based on complex and subjective scoring and interpretation.

Prevalence of autism spectrum disorder

时间窗: 8 years

Screening using validated tests: Social Responsiveness Scale (SRS): Autism spectrum disorder (ASD) traits measured on a scale with T-scores from 0-76+. A higher score: More autistic traits. Autism Diagnostic Observation Schedule (ADOS): A structured observational tool to assess ASD. A trait is rated on a scale from 0 to 3. 0 indicates absence of a behaviour and 3 indicates severe occurrence of a behaviour. The total score determines the presence and severity of ASD. The cut-off scores are 10 for autism and 7 for ASD traits. Autism Diagnostic Interview-Revised (ADI-R): A structured interview used to assess ASD traits. Interview questions are scored on a scale from 0-3. 0 indicates absence of a behaviour and 3 indicates severe occurrence of a behaviour. The scores compared with cut-off values determine the presence of ASD. Cut-off values for each trait: Social interaction: cut-off 10; Communication skills: cut-off 8; Restrictive and repetitive behaviour patterns: cut-off 3.

Cultural measures

时间窗: 8 years

Interviews with youngsters and their families to explore: 1) The experiences that are influential in the process of seeking gender-affirming treatment. 2) Treatment expectations and wishes. 3) The cultural understandings of gender, sex, body and identity that inform the decision to seek treatment. 4) The role of the family in the decision to seek treatment.

Personal history of gender incongruence (GI)

时间窗: 8 years

Age at onset of GI and social transitioning (interview)

Establishment of biobank

时间窗: 8 years.

Serum, plasma, DNA at -20 and -80 degrees Celsius.