Fielding J, Bass C. Individuals seeking gender reassignment: marked increase in demand for services. BJPsych Bull. 2018;42:206–10. https://doi.org/10.1192/bjb.2018.30

Article  PubMed  PubMed Central  Google Scholar 

Wiepjes CM, Nota NM, de Blok CJM, Klaver M, de Vries ALC, Wensing-Kruger SA, et al. The Amsterdam Cohort of Gender Dysphoria Study (1972–2015): trends in prevalence, treatment, and regrets. J Sex Med. 2018;15:582–90. https://doi.org/10.1016/j.jsxm.2018.01.016

Article  PubMed  Google Scholar 

Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, et al. Standards of care for the health of transgender and gender diverse people, version 8. Int J Transgender Health. 2022;23:S1–S259. https://doi.org/10.1080/26895269.2022.2100644

Article  CAS  Google Scholar 

Herman JL, Flores AR, O’Neill KK. How many adults and youth identify as transgender in the United States? The Williams Institute. UCLA School of Law: Los Angeles, 2022. https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/

de Graaf NM, Giovanardi G, Zitz C, Carmichael P. Sex ratio in children and adolescents referred to the gender identity development service in the UK (2009-16). Arch Sex Behav. 2018;47:1301–4. https://doi.org/10.1007/s10508-018-1204-9

Article  PubMed  Google Scholar 

Khatchadourian K, Amed S, Metzger DL. Clinical management of youth with gender dysphoria in Vancouver. J Pediatr. 2014;164:906–11. https://doi.org/10.1016/j.jpeds.2013.10.068

Article  CAS  PubMed  Google Scholar 

Kennis M, Duecker F, T’Sjoen G, Sack AT, Dewitte M. Gender affirming medical treatment desire and treatment motives in binary and non-binary transgender individuals. J Sex Med. 2022;19:1173–84. https://doi.org/10.1016/j.jsxm.2022.03.603

Article  PubMed  Google Scholar 

Åhs JW, Dhejne C, Magnusson C, Dal H, Lundin A, Arver S, et al. Proportion of adults in the general population of Stockholm County who want gender-affirming medical treatment. PLOS ONE. 2018;13:e0204606 https://doi.org/10.1371/journal.pone.0204606

Article  CAS  PubMed  PubMed Central  Google Scholar 

Tate CC, Ledbetter JN, Youssef CP. A two-question method for assessing gender categories in the social and medical sciences. J Sex Res. 2013;50:767–76. https://doi.org/10.1080/00224499.2012.690110

Article  PubMed  Google Scholar 

Puckett JA, Cleary P, Rossman K, Mustanski B, Newcomb ME. Barriers to gender-affirming care for transgender and gender nonconforming individuals. Sex Res Soc Policy. 2018;15:48–59. https://doi.org/10.1007/s13178-017-0295-8

Article  Google Scholar 

Gender incongruence and transgender health in the ICD. https://www.who.int/standards/classifications/frequently-asked-questions/gender-incongruence-and-transgender-health-in-the-icd

Fiani CN, Han HJ. Navigating identity: experiences of binary and non-binary transgender and gender non-conforming (TGNC) adults. Int J Transgenderism. 2019;20:181–94. https://doi.org/10.1080/15532739.2018.1426074

Article  Google Scholar 

Tristani-Firouzi B, Veith J, Simpson A, Hoerger K, Rivera A, Agarwal CA. Preferences for and barriers to gender affirming surgeries in transgender and non-binary individuals. Int J Transgender Health. 2022;23:458–71. https://doi.org/10.1080/26895269.2021.1926391

Article  Google Scholar 

Mellin CS, Braun M, Walch A, Cohen JR, Kaufman M, Seligman M, et al. Pediatric gender diversity beyond the binary: an exploration of gender-affirming care for nonbinary and genderqueer youth seen over time at a single institution gender center. Transgender Health. 2023;9:107–17. https://doi.org/10.1089/trgh.2021.0199

Article  Google Scholar 

Ngaage LM, Knighton BJ, Benzel CA, McGlone KL, Rada EM, Coon D, et al. A review of insurance coverage of gender-affirming genital surgery. Plast Reconstr Surg. 2020;145:803–12. https://doi.org/10.1097/PRS.0000000000006591

Article  CAS  PubMed  Google Scholar 

Gadkaree SK, DeVore EK, Richburg K, Lee LN, Derakhshan A, McCarty JC, et al. National variation of insurance coverage for gender-affirming facial feminization surgery. Facial Plast Surg Aesthetic Med. 2021;23:270–7. https://doi.org/10.1089/fpsam.2020.0226

Article  Google Scholar 

Diaddigo SE, Lavalley MN, Asadourian PA, Feuer GB, Warner PE, Rohde CH. Concordance of National Insurance Criteria with WPATH Standards of Care for Gender-Affirming Surgery. Plast Reconstr Surg. 2023 https://doi.org/10.1097/PRS.0000000000011144

James SE, Herman J, Rankin S, Keisling M, Mottet L, Anafi M. The report of the 2015 US transgender survey. Washington, DC, National Center for Transgender Equality. National Center for Transgender Equality, 2016.

Movement Advancement Project. State Equality Profile: Ohio. 2024 https://www.lgbtmap.org/equality_maps/profile_state/OH

Carpenter CS, Eppink ST, Gonzales G. Transgender status, gender identity, and socioeconomic outcomes in the United States. ILR Rev. 2020;73:573–99. https://doi.org/10.1177/0019793920902776

Article  Google Scholar 

Prince DM, Ray-Novak M, Gillani B, Peterson E. Sexual and gender minority youth in foster care: an evidence-based theoretical conceptual model of disproportionality and psychological comorbidities. Trauma Violence Abuse. 2022;23:1643–57. https://doi.org/10.1177/15248380211013129

Article  PubMed  Google Scholar 

Yurcaba J. Ohio Senate overrides governor’s veto of transgender care restriction. NBC News. 2024. https://www.nbcnews.com/nbc-out/out-politics-and-policy/ohio-senate-trans-sports-medical-care-transition-minors-rcna135332

Gillani B, Pope R, Hamilton D, Banik S. Insights, early results, opportunities, and challenges in Project Advocate. Presentation from the TransPride Pittsburgh Health and Wellness Conference. 2021. (Supplementary Material).

Cohen-Kettenis PT, Van Goozen SHM. Sex reassignment of adolescent transsexuals: a follow-up study. J Am Acad Child Adolesc Psychiatry. 1997;36:263–71. https://doi.org/10.1097/00004583-199702000-00017

Article  CAS  PubMed  Google Scholar 

McGuire JK, Berg D, Catalpa JM, Morrow QJ, Fish JN, Nic Rider G, et al. Utrecht Gender Dysphoria Scale - Gender Spectrum (UGDS-GS): Construct validity among transgender, nonbinary, and LGBQ samples. Int J Transgender Health. 2020;21:194–208. https://doi.org/10.1080/26895269.2020.1723460

Article  Google Scholar 

Scheim AI, Bauer GR. The intersectional discrimination index: development and validation of measures of self-reported enacted and anticipated discrimination for intercategorical analysis. Soc Sci Med. 2019;226:225–35. https://doi.org/10.1016/j.socscimed.2018.12.016

Article  PubMed  Google Scholar 

Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Article  CAS  PubMed  PubMed Central  Google Scholar 

Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005;37:360–3.

PubMed  Google Scholar 

Wright JD, Chen L, Suzuki Y, Matsuo K, Hershman DL. National estimates of gender-affirming surgery in the US. JAMA Netw Open. 2023;6:e2330348. https://doi.org/10.1001/jamanetworkopen.2023.30348

Article  PubMed  PubMed Central  Google Scholar 

Skordis N, Butler G, de Vries MC, Main K, Hannema SE. ESPE and PES International Survey of Centers and clinicians delivering specialist care for children and adolescents with gender dysphoria. Horm Res Paediatr. 2018;90:326–31. https://doi.org/10.1159/000496115

Article  CAS  PubMed  Google Scholar 

Nolan IT, Kuhner CJ, Dy GW. Demographic and temporal trends in transgender identities and gender confirming surgery. Transl Androl Urol. 2019;8:184–90. https://doi.org/10.21037/tau.2019.04.09

Article  PubMed  PubMed Central  Google Scholar 

Canner JK, Harfouch O, Kodadek LM, Pelaez D, Coon D, Offodile AC, et al. Temporal trends in gender-affirming surgery among transgender patients in the United States. JAMA Surg. 2018;153:609 https://doi.org/10.1001/jamasurg.2017.6231

Article  PubMed  PubMed Central  Google Scholar 

Faletsky A, Jonczyk MM, Guo L. Legislations mandating insurance coverage are highly effective in delivering surgical care of transgender patients. Plast Reconstr Surg Glob Open. 2022;10:e4496. https://doi.org/10.1097/GOX.0000000000004496

Article  PubMed  PubMed Central  Google Scholar 

El-Hadi H, Stone J, Temple-Oberle C, Harrop AR. Gender-affirming surgery for transgender individuals: perceived satisfaction and barriers to care. Plast Surg. 2018;26:263–8. https://doi.org/10.1177/2292550318767437

Article  Google Scholar 

Health Insurance Coverage of Nonelderly 0-64, 2021. Kaiser Family Foundation, 2022. https://www.kff.org/other/state-indicator/nonelderly-0-64/

American Society Of Plastic Surgeons. Laser Hair Removal. Connect. https://www.plasticsurgery.org/cosmetic-procedures/laser-hair-removal/cost (Accessed 25 Mar 2023).

Tabaac AR, Jolly D, Boskey ER, Ganor O. Barriers to Gender-affirming Surgery Consultations in a Sample of Transmasculine Patients in Boston, Mass. Plast Reconstr Surg Glob Open. 2020. https://doi.org/10.1097/GOX.0000000000003008

Article  PubMed  PubMed Central  Google Scholar