TABLE 3.

Global assessment of function scores in the 57 children with gender dysphoria.

Category	Descriptions	Score	Number	Percentage
Superior in all areas	No symptoms; physically able; excellent relationships with family and friends; wide range of extracurricular activities; doing well at school/preschool; developing normally; everyday problems never get out of hand.	91–100	1	1.8%
Good in all areas	Virtually no symptoms; usually copes well; physically able; good relationships; normal play and leisure activities; school/preschool OK; may have problems when stressed but these are short-lived and only occasionally get out of hand.	81–90	3	5.3%
No more than slight problems	Some significant symptoms, only briefly get out of hand; sometimes child gets distressed; short-term or little interference with mobility or relationships or play and leisure activities; school/preschool may be slightly affected or affected for a short time.	71–80	4	7.0%
Some difficulty in a single area but generally doing pretty well	Mild symptoms that recover quickly with treatment; any distress or disability does not stop child doing most things done at that age; some anxiety or irritability or brief mood changes; minor effect on mobility or school/preschool or relationships or play and leisure activities; problems may persist but may only be recognized by those who know the child.	61–70	12	21.1%
Variable problems in some but not all areas	Moderate symptoms have significant disabling effect on child; minor to moderate effect on mobility; school/preschool may be affected; relationships or play and leisure activities may be affected; may need special education; in some situations may seem OK; mainly managed in outpatient clinic or by family doctor.	51–60	13	22.8%
Severe problems in one area OR moderate problems in most areas	Severe symptoms having a major effect on child’s life; restricted mobility; relationships or play and leisure activities are affected; child is distressed or has difficult behavior; some relationships are maintained; learning difficulties or problems with or missing school; likely to have been seen by specialist.	41–50	14	24.6%
Major problems in several areas AND unable to function in one of these areas	Severe, almost constant symptoms; child is distressed, withdrawn, or has strange or aggressive behavior; significant limitations on mobility or school/preschool or relationships or play and leisure activities; specialist management needed.	31–40	9	15.8%
Unable to function in almost all areas	Very severe symptoms; child is very distressed; likely to be confined to bed; unable to go to school/preschool; may be in hospital but child is not entirely dependent on others.	21–30	1	1.8%
Needs nursing supervision	Confined to bed; in hospital; very severe symptoms but stable; needs help with self-care, which a child the same age can do without help.	11–20	0	0%
Needs constant supervision	High (24-h) medical dependency (e.g., in intensive care unit); life-threatening symptoms, including suicidal/homicidal risk.	1–10	0	0%