"Trans* is Pluralistic ": Treatment Trajectories for Gender Dysphoria in a German Child and Adolescent Psychiatry Outpatient Clinic
ZEITSCHRIFT FUR SEXUALFORSCHUNG(2022)
Abstract
Introduction Increasing numbers of referrals and heterogeneous trajectories are being reported internationally for the controversially discussed diagnosis of gender incongruence (GI) / gender dysphoria (GD) in childhood and adolescence. Up to now, only a few studies exist that describe referral numbers and treatment trajectories in specialized services in Germany. Objectives The objectives of this study are to evaluate the clinical characteristics of referred trans* children and adolescents as well as the diagnostic procedure and treatment carried out at the Hamburg Gender Identity Service for children and adolescents (Hamburg GIS). Methods Descriptive information on birth-assigned sex, age, social name changes, treatment trajectories (time of the first referral until time of evaluation), GI/GD diagnosis (according to ICD-10) and treatment status of N = 680 children and adolescents (time period: 2013-2018) were assessed retrospectively. Results Out of a total number of 680 referred children and adolescents, the majority was assigned female at birth (74 %; 1:3, M:F) and had already entered adolescence (& GE; 12 years; 87 %). A social name change had mostly occurred by the time of the first referral (66 %). In total, 85 % of the cases were diagnosed with a form of GI/GD. For 75 % of the children and adolescents, treatment trajectories were known, whereas in 25 % of the cases they could not be followed up. There were descriptive differences between the two groups (known vs. unknown treatment pathways) with respect to all characteristics. In total, 66 % of the adolescents with information about their treatment pathways had started receiving some form of gender-affirming medical intervention. Conclusion The results of the present study highlight that trans* children and adolescents presenting to a specialized GI/GD service represent a heterogeneous group with varied characteristics and treatment trajectories. Gender-affirming medical interventions were indicated in many cases, but not in all. This heterogeneity of developmental and treatment trajectories highlights the increasing importance of individualized, case-based approaches in an interdisciplinary treatment setting.
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Key words
childhood and adolescence,gender dysphoria,gender incongruence,transgender,treatment of gender dysphoria
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