ESPE Working Group on Gender Dysphoria

The aim of the ESPE Working Group on Gender Dysphoria is to refine the clinical care and treatment of young people, to understand the global perspective and provide education and training for generalist and specialist practitioners.


Programme for the Annual Meeting Symposium in Vienna

The Annual Meeting Symposium for the Gender Dysphoria Working Group will take place on Thursday 19 September 2019 at 08:00-10:00 in Vienna, Austria.  

Programme for the 2019 Annual Meeting Symposium


Report on activities from 2018

We planned and submitted a research application in February and the final one in April 2018 with the purpose of establishing a gender dysphoria registry along the same platform as the i-DSD one and to link in with the ERN. WE also included a project to collect and process information about the growth of transgender children on hormone treatments and a prospective study in 8 European countries. This was not funded although scoring highly, and a reapplication is being considered in 2019.

Activities in 2019 include a WG symposium on joint surgical interventions and development of European treatment guidelines.

The WG symposium in Athens majored on non-binary gender identification and approaches to fertility preservation in transgender adolescents. The programme was attended by around 130 delegates.

ESPE Science Symposium

The WG planned the ESPE Science Symposium London in October 2018 over 1.5 days. This had a variety of international speakers covering basic science, biology and therapeutics. It was attended by around 100 delegates and feedback was excellent.


ESPE Science Symposium

Thursday 18 October 2018


Registration and light lunch


Introduction and welcome: Local team and Steering group

Exploring all the avenues in gender development


Genetic perspective - differences and similarities between gender dysphoria and sex development disorders

Dr Polly Carmichael, Gender Identity Development Service, The Tavistock and Portman NHS Foundation Trust, UK


Cognitive perspective - Physical brain maturation – the developing brain in puberty. Emotional and cognitive development, independence and autonomy

Professor Sarah-Jayne Blakemore, UCL Institute of Cognitive Neuroscience, UK


Questions and discussion


Refreshment break


Endocrine perspective - Pubertal development, sexual behaviour, gender identity and mental health in adolescence                

Professor Riittakerttu Kaltiala-Heino, Adolescent Psychiatry, University of Tampere, Finland


Emotional and social perspective – considering the relationships between gender identity, family functioning and associated mental health difficulties?

Dr Sarah Davidson with invited patients and participants, Gender Identity Development Service, The Tavistock and Portman NHS Foundation Trust, UK


Questions and discussion


Ethical dilemmas in transgender care for children and adolescents.

Introduction to case presentations and discussions

Professor Martine de Vries, Leiden University Medical Centre, Netherlands


Break and buffet tea


Ethical dilemmas in transgender care for children and adolescents.

Discussion groups.

Please contact us if you wish to present a case or scenario.


General discussion around case presentations and scenarios from delegates


Issues surrounding the participation of transgender athletes in sport

Professor Alan Rogol, Charlottesville, Virginia, USA



Free evening, visits to local bars

Friday 19 October 2018


Arrival and refreshments

Gender and the Brain


Exploring the neurobiology of gender dysphoria

Professor Nicos Skordis, Department of Paediatrics, University of Nicosia, Cyprus


Patterns of development which may influence gender identity including autistic spectrum functioning

Dr Annelou de Vries, Centre for Expertise on Gender Dysphoria, Free University VU Medical Centre, Amsterdam, Netherlands


Questions and discussion


Refreshment break 


Influence of endogenous hormones on maturation - how do sex hormones affect gender expression in DSD and gender variance?

Dr Baudewijntje Kreukels, Centre for Expertise on Gender Dysphoria, Free University VU Medical Centre, Amsterdam, Netherlands


Sex hormone manipulation and brain function

Dr Vibe Frokjaer, Department of Neurology, Rigshospitalet, Copenhagen, Denmark


Effect of pubertal blockade with GnRH analogues on neurocognitive function and physiological maturation

Professor Neil Evans, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Scotland 


Questions and discussion



Poster presentations from all student participants and delegates who wish to submit a poster

Pros and cons of endocrine treatment in gender dysphoria


Effects of GnRH analogues and cross-sex hormones on growth and puberty 

Professor Gary Butler, University College London Hospital and Gender Identity Development Service, The Tavistock and Portman NHS Foundation Trust, UK


Longer term outcome of cross-sex hormone treatment 

Dr Leighton Seal, Charing Cross Gender Dysphoria Clinic, UK


Questions and discussion


Refreshment break


Managing the pubertal axis in young people with gender dysphoria – how effective is it and what can be improved?

Prof Martine Cools, Paediatric and Adolescent Endocrinology, University Hospital Gent, Belgium


Risks of hormonal interventions in the short and long term - how is bone, cardiovascular health and cancer morbidity affected?

The adult perspective

Dr Alessandra Fisher, Department of Experimental, Clinical and Biomedical Sciences, Careggi University Hospital, Italy

The child and adolescent perspective

Dr Sabine Hannema, Leiden University Medical Centre, Netherlands


Questions and discussion


Closing remarks




Networking buffet dinner in Marriott Regent’s Park Hotel (included in registration fee)

(10 mins walk from the Tavistock Centre)

Planned activities for 2018-2019

  • Working Group Session at 57th Annual ESPE Meeting in Athens, Greece - 27-29 September 2018.
  • To publish the results of the Working Group Global Survey.
  • To host the 1st ESPE Science Symposium.
  • To establish a I-GD registry linking with the established DSD registry: to apply for a grant for this.
  • To establish more detailed clinical guidelines for subsections of this group eg. endocrine management of young people with non-binary gender identification.
  • To contribute to ESPE e-learning with a module on Gender Dysphoria.

For further information on the activities of this Working Group please contact the Coordinator Gary Butler at gary.butler@ucl.ac.uk 


Working Group Members 


Gary Butler


Sabine Hannema


Martine de Vries

(The Netherlands)

Nicos Skordis


Katharina Main