The journal of sexual medicine | 2021
Individual Treatment Progress Predicts Satisfaction With Transition-Related Care for Youth With Gender Dysphoria: A Prospective Clinical Cohort Study.
Abstract
BACKGROUND\nThe number of adolescents presenting with gender dysphoria (GD) in healthcare services has increased significantly, yet specialized services offering transition-related care (TRC) for trans youth is lacking.\n\n\nAIM\nTo investigate satisfaction with TRC, regret, and reasons for (dis)satisfaction with transition-related medical interventions (TRMIs) in trans adolescents who had presented to the Hamburg Gender Identity Service for children and adolescents (Hamburg GIS).\n\n\nMETHODS\nData were collected from a clinical cohort sample of 75 adolescents and young adults diagnosed with GD (81% assigned female at birth) aged 11 to 21\xa0years (M\xa0=\xa017.4) at baseline and follow-up (on a spectrum of ongoing care, on average 2\xa0years after initial consultation). To determine progress of the youth s medical transitions, an individual treatment progress score (ITPS) was calculated based on number of desired vs received TRMIs.\n\n\nOUTCOMES\nMain outcome measures were satisfaction with TRC at the time of follow-up, ITPS, social support, reasons for regret and termination of TRC, and (dis)satisfaction with TRMIs.\n\n\nRESULTS\nParticipants underwent different stages of TRMIs, such as gender-affirming hormone treatment or surgeries, and showed overall high satisfaction with TRC received at the Hamburg GIS. Regression analysis indicated that a higher ITPS (an advanced transition treatment stage) was predictive of higher satisfaction with TRC. Sex assigned at birth, age, and time since initial consultation at the clinic showed no significant effects for satisfaction with TRC, while degree of social support showed a trend. No adolescents regretted undergoing treatment at follow-up. Additional analysis of free-text answers highlighted satisfaction mostly with the physical results of TRMI.\n\n\nCLINICAL IMPLICATIONS\nBecause youth were more satisfied with TRC when their individual transition (ITPS) was more progressed, treatment should start in a timely manner to avoid distress from puberty or long waiting lists.\n\n\nSTRENGTHS AND LIMITATIONS\nThis study is one of the first to report on treatment satisfaction among youth with GD from Europe. The ITPS allowed for a more detailed evaluation of TRMI wishes and experiences in relation to satisfaction with TRC and may close a gap in research on these treatments in adolescent populations. However, all participants were from the same clinic, and strict treatment eligibility criteria may have excluded certain trans adolescents from the study. Low identification rates with non-binary identities prevented comparisons between non-binary and binary genders.\n\n\nCONCLUSION\nThe study highlights the role of TRMI and individual treatment or transition progress for youth s overall high satisfaction with TRC received at the Hamburg GIS. Nieder TO, Mayer TK, Hinz S, et\xa0al. Individual Treatment Progress Predicts Satisfaction With Transition-Related Care for Adolescents With Gender Dysphoria: A Prospective Clinical Cohort Study. J Sex Med 2020;XX:XXX-XXX.