Meyenburg Bernd, Kröger Anne, Neugebauer Rebecca
Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, J. W. Goethe-Universität, <location>Frankfurt/Main</location>
Z Kinder Jugendpsychiatr Psychother. 2015 Jan;43(1):47-55. doi: 10.1024/1422-4917/a000332.
Treatment guidelines for transidentity in children and adolescents are presently under discussion. We present an overview of the various treatment modalities. Further, follow-up data on children and adolescents referred for gender-identity problems are presented. Of the 84 patients seen for the first time more than 3 years before follow-up, 37 mailed in the completed questionnaires. In addition, 33 patients agreed to answer some short follow-up questions. We assessed steps of treatment, gender role, psychopathology, and psychotherapy. We compared differences in psychopathology in patients with vs. without gender role change and in patients with intense vs. less intense psychotherapy. A total of 22 patients had completely changed gender role, and some had started hormonal treatment und sex reassignment surgery. Most patients were satisfied with the treatment results. All patients showed less psychopathology on follow-up, independent of role change or intensity of psychotherapy. In general, the patients reported little psychopathology. Our follow-up results support the present treatment approach. In patients with little psychopathology, low-frequency supportive treatment appears sufficient to obtain safe judgement on hormonal of surgical treatment.
目前正在讨论儿童和青少年跨性别身份的治疗指南。我们概述了各种治疗方式。此外，还提供了因性别认同问题前来就诊的儿童和青少年的随访数据。在随访前3年多首次就诊的84名患者中，37名邮寄了填写完整的问卷。此外，33名患者同意回答一些简短的随访问题。我们评估了治疗步骤、性别角色、精神病理学和心理治疗。我们比较了有性别角色改变和没有性别角色改变的患者以及接受强化心理治疗和接受较弱心理治疗的患者在精神病理学方面的差异。共有22名患者完全改变了性别角色，一些患者开始了激素治疗和性别重置手术。大多数患者对治疗结果满意。所有患者在随访时精神病理学症状均减轻，与性别角色改变或心理治疗强度无关。总体而言，患者报告的精神病理学症状较少。我们的随访结果支持目前的治疗方法。对于精神病理学症状较少的患者，低频支持性治疗似乎足以对激素或手术治疗做出安全判断。
