TY - JOUR T1 - The child transgender patient in primary care: practical advice for a 10-minute consultation JF - BJGP Open JO - Br J Gen Pract Open DO - 10.3399/bjgpopen17X101169 SP - BJGP-2017-0039 AU - Charlotte Cliffe AU - Miriam Hillyard AU - Albert Joseph AU - Azeem Majeed Y1 - 2017/10/04 UR - http://bjgpopen.org/content/early/2017/10/04/bjgpopen17X101169.abstract N2 - Children and adults with gender identity concerns are increasingly presenting for treatment, with referrals to specialist clinics rapidly rising. The percentage of children with gender identity disorder that self-harm or attempt suicide is estimated at 50%, so it is essential that it is recognised early and managed appropriately.1 Gender identity disorder of childhood usually manifests before puberty. The child typically experiences distress resulting from an incongruence between their current gender identity (sense of themselves as ‘male’, ‘female’, or otherwise), and their gender assigned at birth. Behaviour and activities of the child may stereotypically be associated with that of the opposite gender and the child may be preoccupied with wanting to change their name and gender pronoun (‘she’, ‘he’). Depending on the age, they may also have a strong desire to acquire secondary sexual characteristics of the opposite gender. This may cause significant distress and can impact their performance and experiences at school or at home. Six months of persistent gender non-conforming behaviour has been proposed as an indicator that this is more than ‘a phase’, which is common and not necessarily pathological for many individuals in childhood.Tom is 13 years old and … ER -