In 2010, the Ministry of Education, Culture, Sports, Science and Technology (MEXT) in Japan strongly recommended that students with gender identity disorder (GID) who had behavioral health concerns should consult a professional in their schools. Furthermore, in 2015, MEXT subsequently announced that it is important for sexual minority students, including students with GID, to receive more support from professionals through cooperation with medical institutions. However, there has been no nationwide clinical research done on sexual minority youth, so little is known about how to optimally care for them in medical practice.
 This study assessed the current status of medical care for children and adolescents with GID and other atypical sexual development. The authors surveyed certifying physicians and councilors (315 people in total) of The Japanese Society for Child and Adolescent Psychiatry. The question obtained basic demographic and practice information and allowed for free responses on topics such as opinion on consultation and medical care for GID and atypical sexual development in childhood and adolescence.
 One hundred twenty-seven, or 40.3%, of those surveyed responded. The average number of years of total clinical experience was 23.9, and the average number of years of child psychiatric clinical experience was 18.8 years. The number of child psychiatrists who provided consultation for GID and other sexual development including transvestism and gender dysphoria were 88 (68.5%) and 105 (81.9%), respectively. The consultants' most frequent clients, in descending order, were: individuals, parents, and school officials. Seventy-four (57.5%) child psychiatrists provide medical care for patients with GID. In the preschool and elementary school age groups, consultants served many more (assignment) males than (assignment) females with GID, whereas in the higher elementary school and later ages, consultants served more females than males with GID equally often. In junior high school and later ages, consultants served more females than males with GID. Eighty-seven (67.7%) of the child psychiatrists provided medical care for patients with other sexual development. Before and during the middle elementary school ages and in the high school ages, consultants served more males than females with other typical development, whereas in higher grade elementary and junior high school ages, consultants served more females than males with other typical development. The free response sections revealed a diversity of opinions, clinical course, and cooperation with other institutions.
 At present, among child psychiatrists, there are many different perspectives on clinical care for GID and other sexual development. Therefore, it will be necessary to systematically examine current scientific evidence and to establish consensus on best practices for clinical management.