Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany.
Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Eur Child Adolesc Psychiatry. 2019 Nov;28(11):1487-1498. doi: 10.1007/s00787-019-01308-6. Epub 2019 Mar 15.
Adolescents with gender dysphoria (GD) often face various associated social, emotional, and behavioral difficulties. In such a marginalized group, it is crucial to identify factors that may impact psychological functioning to better accommodate their needs. Therefore, the present study investigated the impact of two specific risk factors, poor peer relations and general family functioning, on the development of psychological problems in adolescents with GD, and their possible interaction effect. The Youth Self-Report, a Peer Relations Scale, and a General Family Functioning scale were assessed in a sample of n = 180 clinically referred adolescents (mean age 15.5; 146 transgender boys with a female birth-assigned sex, and 34 transgender girls with a male birth-assigned sex) with a complete GD diagnosis (fulfillment of the DSM 5 criteria A and B) at their initial admission to the Hamburg Gender Identity Service. Multiple linear regression analysis was conducted to examine the relationship between peer relations, family functioning, and psychological functioning outcomes. Adolescents with GD presented significantly higher Internalizing and Total Problem scores compared to the German reference norm. Externalizing problems were above the norm for transgender boys, but within the normal range for transgender girls. Multiple regression analysis revealed that, overall, adolescents with an advanced age, a female birth-assigned sex, poorer peer relations, and poorer family functioning showed more behavioral and emotional problems. Consequently, incorporating both the family and social environment in transgender care is of high importance to adequately tend to the needs of adolescents with GD.
患有性别认同障碍（GD）的青少年常常面临各种相关的社会、情感和行为困难。在这样一个边缘化群体中，确定可能影响心理功能的因素对于更好地满足他们的需求至关重要。因此，本研究调查了两个特定的风险因素——不良同伴关系和一般家庭功能，对 GD 青少年心理问题发展的影响及其可能的交互作用。本研究使用青少年自我报告、同伴关系量表和一般家庭功能量表，对 n=180 名经临床转诊的青少年（平均年龄 15.5 岁；146 名出生时被指定为女性的跨性别男孩和 34 名出生时被指定为男性的跨性别女孩）进行了评估，这些青少年在首次就诊于汉堡性别认同服务中心时被诊断出患有完整的 GD（符合 DSM 5 标准 A 和 B）。多元线性回归分析用于检验同伴关系、家庭功能和心理功能结果之间的关系。与德国参考标准相比，患有 GD 的青少年的内化和总问题得分明显更高。外化问题在跨性别男孩中高于正常水平，但在跨性别女孩中处于正常范围内。多元回归分析表明，总体而言，年龄较大、出生时被指定为女性、同伴关系较差和家庭功能较差的青少年表现出更多的行为和情绪问题。因此，在跨性别护理中同时考虑家庭和社会环境对于充分满足 GD 青少年的需求非常重要。
