Transgender Health
Our vision is to improve the health and well-being of transgender children and adolescents through innovative, high-quality research.
Referrals of young transgender individuals to specialist gender services have risen dramatically across the western world in recent years. Consistent with this, recent population-based estimates suggest that the prevalence of young people identifying as transgender is around 1%, which is much higher than previously thought.
Providing optimal clinical care for transgender young people is critical. A recent community-based survey of 859 Australian trans youth found a significant proportion had been diagnosed with depression (75%) and anxiety (72%), with 80% of respondents reported having self-harmed and 48% have attempted suicide (Strauss et al, 2017). Many of these young people lacked access to gender-affirming health care, and there is increasing evidence that providing supportive clinical care to transgender youth significantly improves mental health and wellbeing.
The Royal Children’s Hospital Gender Service (RCHGS) provides care to transgender children and adolescents and is one of the largest multidisciplinary clinics of its kind in the world. Previously, our team recently released the first-ever clinical guidelines specific for transgender children and adolescents (Telfer et al, 2018) – as highlighted by a subsequent editorial in The Lancet article below - but there is a need for more robust empirical data to inform clinical practice in this nascent field.
- Royal Children's Hospital Gender Service - Australian Standards of Care and Treatment Guidelines
- The Lancet - Gender-affirming care needed for transgender children
The overall objective of our research program is therefore to produce high-quality research evidence related to child and adolescent transgender health. Importantly, our research activities have been developed in consultation with our community advisory group, consisting of young trans people and their parents. Through our research, our vision is ultimately to improve the healthcare, wellbeing and overall outcomes of trans children and adolescents and their families.
More information
- Gender Service - The Royal Children's Hospital (video resource)
- Gender dysphoria - The Royal Children's Hospital
- Gender identity, gender diversity and gender dysphoria: children and teenagers - Raising Children
- Gender identity, diversity and dysphoria: supporting your child - Raising Children
- When your child is gender diverse: family feelings - Raising Children
- Understanding gender diversity - The Royal Children's Hospital Podcast
News
- Meet Associate Professor Ken Pang
- Clinic boosts transgender young people’s mental health
- Clinic helping transgender kids make the transition
- Four research projects secure federal grants
Positions available
We are currently recruiting high-quality students who wish to undertake postgraduate research in transgender health. Interested applicants should send a statement of research interests, CV, and two references by email to show email address .
Our projects
Trans20
The Trans20 project is a longitudinal cohort study that began in 2017. The broad objective of this project is to determine the long-term biopsychosocial outcomes for transgender individuals attending the RCHGS. Data are collected prospectively as part of routine clinical care and include information not only on gender identity, transition, dysphoria, and gender-related health care but also on mental health, physical health, education, quality of life and family functioning. Using these data, we aim to examine the evolution of gender identity and dysphoria over time, and the role and safety of different interventions, both medical and psychological.
Group therapy for transgender adolescents
Recent referrals of transgender adolescents to specialist gender services worldwide have risen exponentially, resulting in wait times of >1-2 years. This is significant, as the timely delivery of care is likely important for transgender adolescents, not only because of their poor associated mental health but also because transgender individuals have been reported to have the greatest risk of attempted suicide between when they plan to access medical care and when they are able to do so. In response to this challenge of providing timely care, we are examining the role of a novel group therapy intervention to assist transgender adolescents to improve their mental health while waiting to be seen at the RCHGS.
Gender Euphoria
Gender euphoria describes the positive feelings that arise in relation to a person’s gender identity and how they are able to express or affirm this identity. While the concept of gender euphoria has been discussed within the transgender community for many years, it has received little formal study. We have developed a tool to assess gender euphoria and to better understand when and how gender euphoria arises.
Funding and collaborations
Thanks to our key partners, funders, and supporters.
Funding
- National Health and Medical Research Council (NHMRC)
- Royal Children’s Hospital Foundation
- Hugh D T Williamson Foundation Trust
Collaborations
- Ada Cheung, University of Melbourne
- Rachel Skinner, University of Sydney
- Kerry Robinson, University of Western Sydney
- Cristyn Davies, University of Sydney
- Simone Buzwell, Swinburne University
- Simona Giordano, University of Manchester, UK
- Thomas Steensma, VUMC, Netherlands
- Nancy Segal, Duke University
Featured publications
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Pang, KC, Kelly, F, Girodano, S, (2022). Parental consent and the treatment of trans youth: the impact of Re Imogen. Letter. Medical Journal of Australia.
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Russell D, Hoq M, Cogill D, Pang KC (2022). Prevalence of mental health problems in transgender children aged 9-10 years in the US, 2018. JAMA Network Open.
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Pang KC, Wiggin J, Telfer M (2022). Gender identity services for children and young people in England. BMJ.
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Kelly, F, Telfer, M, Girodano, S, Pang, KC (2022). Parental consent and the treatment of trans youth: the impact of Re Imogen. Medical Journal of Australia.
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Pang KC, Hoq M, Steensma TD (2022). Negative media coverage as a barrier to accessing care for transgender children and adolescents. JAMA Network Open.
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Pang KC, Nguyen TP, Upreti R (2021). Successful use of minoxidil to promote facial hair growth in an adolescent transgender male. Frontiers in Endocrinology.
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O'Connell MA, Nguyen TP, Ahler A, Skinner SR, Pang KC (2021). Approach to the Patient: Pharmacological Management of Trans and Gender Diverse Adolescents. Journal of Clinical Endocrinology & Metabolism. View article
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Blacklock C, McGlasson C, Chew D, Murfitt K, Hoq M (2021). Challenges in measuring gender identity among transgender, gender diverse, and non-binary young people. Public Health. View article
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Peri A, Ahler A, Gook D, O'Connell MA, Bourne H, Nightingale M, Telfer M, Jayasinghe Y, & Pang KC. (2021). Predicting successful sperm retrieval in transfeminine adolescents after testicular biopsy. Journal of assisted reproduction and genetics. View article
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Pang KC, Giordano S, Sood N, Skinner SR (2021). Regret, informed decision making, and respect for autonomy of transgender young people. The Lancet Child and Adolescent Health. View article
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Xu JY, O’Connell MA, Notini L, Cheung AS, Zwickl S, Pang KC (2021). Selective estrogen receptor modulators (SERMs): a potential option for non-binary gender-affirming hormonal care? Frontiers in Endocrinology. View article
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Tollit MA, May T, Maloof T, Telfer MM, Chew D, Engel M, Pang KC (2021). The clinical profile of patients attending a large, Australian pediatric gender service: a 10-year review. International Journal of Transgender Health. View article
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McDougall R, Notini L, Delany C, Telfer M, Pang KC (2021). Should clinicians make chest surgery available to transgender male adolescents? Bioethics. View article
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Lai TC, Davies C, Robinson K, Feldman D, Elder CV, Cooper C, Pang KC, McDougall R. (2021). Effective fertility counselling for transgender adolescents: a qualitative study of clinician attitudes and practices. BMJ Open. 11(5), e043237. https://doi.org/10.1136/bmjopen-2020-043237
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Dahlgren Allen S, Tollit MA, McDougall R, Eade D, Hoq M & Pang KC (2021). A Waitlist Intervention for Transgender Young People and Psychosocial Outcomes. Pediatrics. View article
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Bloom TM, Nguyen TP, Lami F, Pace CC, Poulakis Z, Telfer M, Taylor A, Pang KC & Tollit MA (2021). Measurement tools for gender identity, gender expression, and gender dysphoria in transgender and gender-diverse children and adolescents: a systematic review. The Lancet Child & Adolescent Health. View article
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McPhate L, Williams K, Winther J, Vance A, Pang KC, May T (2020). Gender Variance in Children and Adolescents with Neurodevelopmental and Psychiatric Conditions from Australia. Archives of Sexual Behaviour. View article
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Notini, L, Earp, B.D, Gillam L, McDougall RJ, Savulescu J, Telfer M, Pang KC (2020). Identity, wellbeing and autonomy in ongoing puberty suppression for non-binary adults: a response to the commentaries. Journal of Medical Ethics. View article
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Notini L, Pang KC, Telfer M, McDougall RJ (2020). “No one stays just on blockers forever”: Clinicians’ divergent views and practices regarding puberty suppression for non-binary young people. Journal of Adolescent Health. View article
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Pang KC, de Graaf NM, Chew D, Hoq M, Keith DR, Carmichael P & Steensma TD (2020). Association of media coverage of transgender and gender diverse issues with rates of referral of transgender children and adolescents to specialist gender clinics in the UK and Australia. JAMA Network Open. View article
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Notini, L, Earp, B.D, Gillam L, McDougall RJ, Savulescu J, Telfer M, Pang KC. (2020) Forever young? The ethics of ongoing puberty suppression for non-binary adults. Journal of Medical Ethics. View article
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Cheung AS, Leemaqz S, Wong JWP, Chew D, Ooi O, Cundill P, Silberstein N, Locke P, Grayson R, Zajac JD, Pang KC (2020). Non-Binary and Binary Gender Identity in Australian Trans and Gender Diverse Individuals. Archives of Sexual Behavior. View article
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Lai TC, McDougall R, Feldman D, Elder CV, Pang KC (2020). Fertility Counselling for Transgender Adolescents: a review. Journal of Adolescent Health. View article
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Pang KC, Peri AJS, Chung HE, Telfer M, Elder CV, Grover S, Jayasinghe Y (2020). Rates of Fertility Preservation Use Among Transgender Adolescents. JAMA Pediatrics. View article
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Chew D, Tollit MA Poulakis Z, Zwickl S, Cheung AS, Pang KC (2020). Youths with a non-binary gender identity: a review of their sociodemographic and clinical profile. Lancet Child and Adolescent Health. View article
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Pang KC, Notini L, McDougall R, Gillam L, Savulescu J, Wilkinson D, Clark BA, Olson-Kennedy J, Telfer MM, Lantos JD (2020). Ethics Rounds: Long-term puberty suppression for a non-binary teen. Pediatrics. View article
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Thrower E, Bretherton I, Pang KC, Zajac JD, Cheung AS (2020). Prevalence of autism spectrum disorder and attention-deficit hyperactivity disorder amongst individuals with gender dysphoria: a systematic review. Journal of Autism and Developmental Disorders. View article
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Ferguson G, Simm P, O’Connell M, Pang KC. (2019) Use of puberty blockers in trans and gender diverse adolescents frequently results in loss of bone mineral density. BMJ. View article
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Tollit MA, Pace CC, Telfer MM, Hoq M, Bryson J, Cooper C, Fulkoski N, Pang KC (2019). What are the health outcomes of trans and gender diverse young people in Australia? Study protocol for the Trans20 longitudinal cohort study. BMJ Open. View article
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Pang KC, Telfer MM, Tollit MA, Pace CC (2019). Everyone agrees transgender children require more science. Medical Journal of Australia. View article
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Notini L, McDougall R, Pang KC (2019). Should parental refusal of puberty-blocking treatment be overridden? The role of the harm principle. American Journal of Bioethics. View article
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Notini L, Gillam, Pang KC (2018). Facial feminization surgery: Personal identity, compensatory justice and resource allocation. American Journal of Bioethics. View article
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Pang KC*, Feldman D, Oertel R, Telfer M. (2018) Molecular karyotyping in children and adolescents with gender dysphoria. Transgender Health. View article
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Tollit MA, Feldman D, McKie G, Telfer MM (2018). Patient and Parent Experiences of Care at a Pediatric Gender Service. Transgend Health. View article
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Telfer MM, Tollit MA, Pace CC, Pang KC (2018). Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents. Medical Journal of Australia. View article
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Chew D, Anderson J, Williams K, May T, Pang KC (2018). Hormonal Treatment in Young People with Gender Dysphoria: a systematic review. Pediatrics. View article
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May T, Pang K, Williams KJ (2016). Gender variance in children and adolescents with autism spectrum disorder from the National Database for Autism Research. Int J Transgenderism. View article