Strittmatter Esther, Holtmann Martin
Gesundheitszentrum Walstedde, Tagesklinik GmbH, Drensteinfurt.
LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm.
Z Kinder Jugendpsychiatr Psychother. 2020;48(2):93-102. doi: 10.1024/1422-4917/a000724.
Gender identities in transition In recent years, the healthcare system has been confronted with an increasing number of children and adolescents with gender nonconformity, gender incongruence, and gender dysphoria. Medical professionals are still debating how to interpret this phenomenon and how best to meet the healthcare needs of this diverse group of young people. Meanwhile, the transgender and gender nonconforming youths themselves face enormous challenges in finding appropriate support and treatment in the mental healthcare system. This article reviews the available epidemiological data, the paradigm shift in the social, legal, and medical systems, the developments in diagnostic classifications (DSM-5, ICD-11) as well as important aspects of the AWMF S3 guideline for adults with gender incongruence and gender dysphoria. In addition, it describes the complexity of working with transgender, gender nonconforming, and gender-questioning youth in the context of the current discourse and the underlying ethical dilemmas. In conclusion, this article outlines the challenges facing child and adolescent psychiatry and psychotherapy in this complex environment.
性别认同转变 近年来,医疗保健系统面临着越来越多性别不一致、性别认同障碍和性别焦虑的儿童及青少年。医学专业人员仍在争论如何解释这一现象以及如何最好地满足这群多样化年轻人的医疗保健需求。与此同时,跨性别和性别不一致的青少年自身在精神卫生保健系统中寻求适当支持和治疗时面临巨大挑战。本文回顾了现有的流行病学数据、社会、法律和医疗系统中的范式转变、诊断分类(《精神疾病诊断与统计手册》第5版、《国际疾病分类》第11版)的发展以及德国医学科学院关于性别认同障碍和性别焦虑成年人的S3指南的重要方面。此外,它描述了在当前的讨论背景下与跨性别、性别不一致和性别存疑的青少年合作的复杂性以及潜在的伦理困境。总之,本文概述了在这一复杂环境中儿童和青少年精神病学及心理治疗所面临的挑战。