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Canada’s family doctors are getting new guidance on how to manage the burgeoning number of teens identifying as transgender.

A new review article published Monday urges doctors to take a “thoughtful, affirming” approach and to avoid “influencing the adolescent to move down a path they would not have chosen for themselves.”

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“The youth’s voice is always paramount,” the authors write in a special issue on transgender health appearing in this week’s edition of the Canadian Medical Association Journal.

A recent Canadian study found less than half of transgender youth are comfortable discussing their health care needs with their family doctor.

“Although the consensus in the medical community in the 1960s and 1970s was to view gender variance through a disease model in which associated behaviours, expression and declared identity were deemed pathological and in need of correction,” the authors write in the CMAJ, “the current approach is an affirming one that does not view gender variance as pathological.”