Gender identity disorder – diagnostic and therapeutic tendencies in Children's Clinical University Hospital, Latvia

As the numbers of gender nonconforming/transgender youth seeking medical care increases worldwide, it is necessary to sumMārise the existing experience and create a systematised, unified approach to patient management and care in Latvia. Limited data exists regarding the current practice, therefore, the aim was to sumMārise the diagnostic and therapeutic experience in Latvia. Medical records of all child and adolescent patients diagnosed with gender identity (ICD-10, F64) or other sexual disorders (ICD-10, F66) from 2015 to 2020 were investigated, information regarding hospitalisation and outpatient treatment care was analysed. During the period of 2015-2020 28 patients have been newly diagnosed with gender identity or other sexual disorders (3, 1, 1, 5, 4, 14 patients per year respectively). 6 patients were assigned male gender at birth. Only 25% (N=7) patients came in contact with psychiatric care with gender identity problems as the primary concern, 5 of them in year 2020. 46,4% (N=13) patients were hospitalised in a psychiatric unit in their first contact with psychiatric care specialists. Overall, 60.1% (N=17) continue treatment in an outpatient clinic after being diagnosed. Mean age of diagnosis was 14,96 years (SD=0,24) and from the collected data, median time from the onset of gender identity related dysphoria to subsequent diagnosis was 3 years (IQR=2.75-5). Hormonal treatment with GnRH analogue to suppress pubertal progression was given to 3 patients. No patients are undergoing cross-hormonal therapy under the hospitals supervision. Number of newly diagnosed gender identity disorder patients is increasing with a substantial surge in year 2020. Patients tend to suffer from a range of psychiatric comorbidities, oftentimes, making them the primary reason for seeking psychiatric care. The diagnoses of gender identity disorders are made fairly late, delaying access to care and increasing subsequent risks. Efforts need to be made to improve diagnostic and care strategies in Latvia.