Transgenderproblematik aus pädiatrisch-endokrinologischer Sicht
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文摘
Gender nonconformity (GN) addresses a condition in which the perceived gender identity mismatches the biological sex or the sex assigned at birth. This mismatch is experienced in different levels of intensity. Even at the age of 2 years old children may show early signs of GN. Whereas in the past attempts were made to encourage children to adopt culturally appropriate gender roles, this has fundamentally changed in recent years. The primary objective is not the shaping of children to match a given role but enabling them to lead a self-determined life. The majority of children with GN do not want to change their sex but many of them explore gender at its margins in a developmental progression towards a gay identity. Infantile GN persists during adolescence and turns into gender dysphoria (GD) with a desire to undergo medical transition in only a small percentage of cases. The care of children and adolescents is fundamentally different from the care of adults with GN. Early diagnosis and support options for those affected and their families aim at preventing the development of psychological disorders. Early hormonal treatment to suppress puberty may not prevent these young people from facing dissatisfaction with their body but prevents a spontaneous development of unwanted and as irreversible perceived secondary sex characteristics which are distressing and may lead to increased psychological comorbidities. In addition, this hormonal treatment potentially facilitates surgical transition later in life permitting minor interventions and improved aesthetic outcome.

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