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The clinical needs of young people with gender dysphoria (GD) have outpaced the capacity of health services to provide appropriate care. The study aimed to explore the interface of Paediatric Endocrinology and young people with GD, detailing the clinical characteristics and the clinical care provided, in order to inform future service development. Medical records of all young people with GD (n=91, 59 (65%) birth-assigned females and 32 (35%) birth-assigned males) referred to Paediatric Endocrinology during 2011-2019 for puberty suppression were reviewed. Median age at initial assessment was 14.6 years (range 8.8-17.6 years). There was a threefold increase from 2016 (n=22) to 2019 (n=73). Mental health disorders were present in 34 (37%) and autistic spectrum disorder in 21 (23%), while 54 (59%) had at least one comorbidity. Sixty-four (70%) young people fulfilled the criteria for consideration of fertility preservation, with 6 (9%) of them preserving their gametes. Seventy-nine (87%) young people commenced treatment with gonadotrophin-releasing hormone analogue, at a median age of 14.8 years (range 9.7-18.0 years). Six (8%) of those discontinued treatment, following a median duration of 6 months (range 6-18 months). Forty-one young people commenced gender-affirming hormones. One (2%) of those who started gender-affirming hormones discontinued treatment.Conclusions: We have witnessed increasing numbers of young people with GD attending Paediatric Endocrinology, with an over-representation of comorbidities, necessitating provision of an individualised approach to treatment. Addressing young people's acceptability of fertility services and ongoing close collaboration between endocrinology and mental health professionals require innovative models of multidisciplinary care. What is Known: • A worldwide increase in presentation of gender dysphoria has been mirrored in our service, with majority assigned female at birth and post-pubertal. • An over-representation of comorbidities exists, notably mental health disorders and autistic spectrum disorder. What is New: • Coordination of interprofessional care to meet complex needs, at an individual level, while improving efficiency of working, at a systemic level, can be met by the development of specialist centres. • The reasons for low uptake of fertility services demand further exploration.

Ikaite (CaCO3•6H2O) is a metastable calcium carbonate mineral that forms at low temperature and/or high pressure. Ikaite precipitates in sea ice and may play a significant role in air–sea CO2 exchange in ice covered seas and oceans. However, the spatial and temporal dynamics of ikaite in sea ice are poorly understood due to few available measurements and time consuming analytical techniques. Here, we present a new method for quantifying ikaite in sea ice and compare it with a more time-consuming imaging technique currently in use. In short, sea ice cores were melted at low temperatures (−1), lower concentrations in 1.5 m thick first–year sea ice (45 µmol kg−1) and low concentrations in 3.3 m thick multi–year sea ice (3 µmol kg−1). Highest concentrations were observed in the upper ice layers at all stations and layers where sea ice algae were present. The higher abundance of ikaite in young first–year sea ice indicates that its concentrations will likely increase in the Arctic as a result of the recent rapid decline of the multi–year ice cover and increasing presence of seasonal sea ice. As a result, it is likely that ikaite will play a more significant role in air–sea CO2 exchange in ice–covered seas in the future.