Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Eur Child Adolesc Psychiatry. 2021 Nov;30(11):1755-1767. doi: 10.1007/s00787-020-01640-2. Epub 2020 Sep 29.
Empirical evidence concerning the psychosocial health outcomes after puberty suppression and gender-affirming (GA) medical interventions of adolescents with gender dysphoria (GD) is scarce. The aim of the present study was to describe how dimensions of psychosocial health were distributed among different intervention groups of adolescents with a GD diagnosis from the Hamburg Gender Identity Service before and after treatment. Participants included n = 75 adolescents and young adults from a clinical cohort sample, measured at their initial intake and on average 2 years later (M treatment duration = 21.4 months). All cases were divided into four different intervention groups, three of which received medical interventions. At baseline, both psychological functioning and quality of life scores were significantly below the norm mean for all intervention groups. At follow-up, adolescents in the gender-affirming hormone (GAH) and surgery (GAS) group reported emotional and behavioral problems and physical quality of life scores similar to the German norm mean. However, some of the psychosocial health outcome scores were still significantly different from the norm. Because this study did not test for statistically significant differences between the four intervention groups or before and after treatment, the findings cannot be generalized to other samples of transgender adolescents. However, GA interventions may help to improve psychosocial health outcomes in this sample of German adolescents. Long-term treatment decisions during adolescence warrant careful evaluation and informed, participatory decision-making by a multidisciplinary team and should include both medical interventions and psychosocial support. The present study highlights the urgent need for further ongoing longitudinal research.
关于青春期抑制和性别肯定(GA)医疗干预后性别焦虑症(GD)青少年的心理社会健康结果的经验证据很少。本研究的目的是描述汉堡性别认同服务中心的 GD 诊断青少年在治疗前后不同干预组的心理社会健康维度如何分布。参与者包括来自临床队列样本的 n = 75 名青少年和年轻人,在他们的初始摄入时和平均 2 年后进行测量(M 治疗持续时间 = 21.4 个月)。所有病例分为四个不同的干预组,其中三个接受了医疗干预。在基线时,所有干预组的心理功能和生活质量评分都明显低于常模均值。在随访时,接受性别肯定激素(GAH)和手术(GAS)治疗的青少年报告的情绪和行为问题以及身体生活质量评分与德国常模均值相似。然而,一些心理社会健康结果评分仍然与常模存在显著差异。由于本研究未测试四个干预组之间或治疗前后的统计学差异,因此这些发现不能推广到其他跨性别青少年样本。然而,GA 干预可能有助于改善该德国青少年样本的心理社会健康结果。青春期期间的长期治疗决策需要仔细评估,并由多学科团队进行知情、参与式决策,同时应包括医疗干预和心理社会支持。本研究强调了进一步进行持续纵向研究的迫切需要。