Why are more and more young children signing up for gender treatment? New research must, among other things,

Why has there been much more demand for medical genital care since 2014? Radboud University is doing research to find out what exactly is going on here. And also to the question of why more and more children between the ages of 11 and 13 register.

People who don’t feel at home in the body they were born in can sign up for a sex clinic. In recent years, more and more have done so, resulting in long waiting lists.

Relatively many children

Radboud University is therefore conducting a broad study of the increased demand for sex care. A lesser known part of this is that relatively many children turn to the sex clinics. Children between the ages of 11 and 13 who are not affected by these problems before the onset of puberty.

Especially many children born with the female gender indicate for the first time around the age of 11 that they want to go through life as a boy and that they do not feel happy in a girl’s role or in a girl’s body. Once they are treated at a sex clinic, they and their parents have the choice to slow down puberty.

2 years of hormone inhibitors

They then receive hormone inhibitors, which stop puberty from developing into an adult female or male body. Little is known about what this does to psychosexual development. Just like the effect of hormone inhibitors on brain development. If they still want to go through life as a boy after 2 years or more, the choice to start with male hormones follows.

“Once a child is in the genital tract, they completely focus on that. Even if there are other concerns such as tensions in the home situation or a traumatic event,” says medical psychologist Chris Verhaak. But the question, according to her, is whether all the children who now enter such a program are best helped.

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Lifelong medicine

Verhaak is associated with Radboud University Medical Center’s sex clinic, where children and adults have been helped for the past three years. Together with professor of communication and influence Enny Das, she investigates what exactly happens to these children for the new research. She is extremely careful about this. “On the one hand, it seems very nice to inhibit puberty: you save such a child that he has to be operated on later.”

“On the other hand, it’s good to realize that such a girl will have to take medicine all her life. Many young children have an unrealistic image. They think: I’m going to be like dad. I tell them they don’t like becoming a father. It’s important to discuss that, even with children.”

Researchers Chris Verhaak (th.) and Enny Das

Gender care for 25 years

For 25 years, young people in the Netherlands have been treated for gender dysphoria: a strong feeling of dissatisfaction with the gender they were born with and grew up with. The typical examples from the early years that this treatment is possible paint the picture of a young child, for example, one living as a preschool-aged boy, who indicates that he is a girl by telling his parents that he does not will have. a penis.

The desire to be a girl physically also persists in the years that follow. That treatment became possible for these children is seen by many as a breakthrough and very valuable.

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‘It’s not just anything’

But now, so many years later, the group of young children who claim to have gender problems has become so large that it raises the question of whether all these children also need medical attention. Are they all most helped with hormone treatments or gender-specific psychotherapy?

“It simply cannot be,” says Chris Verhaak. “A lot is still unclear with these children. What is the effect of peer pressure, images in the media and other problems that play a role, such as autism? It has been said when using puberty blockers: if it doesn’t help it won’t hurt , but puberty blockers, for example, have a negative effect on bone density, but this is not a random thing, and the influence on sexual development has not yet been clarified.

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Waiting lists for transgender care

The number of people on the waiting list for transgender care has tripled in 3 years. At the start of this year, there were 7,700 people on such a waiting list, three years ago there were 2,500.

A team of researchers from Radboud University is currently investigating the question of what can explain the increase in reports at sex clinics. These are reports from both adults and children. The research will be presented to the Ministry of Health, Welfare and Sports in early 2023.

Expectation pattern

The study also takes into account that more girls born than boys report to the clinics with gender problems during puberty. “When a child is born, all sorts of expectations arise. For example, that a girl born will also behave and feel like that, and that she will fall in love with boys.”

“And that child assumes that too. If such a child reaches puberty and can no longer keep up with girls who do stereotypical ‘girl things’, then that child must be able to stay there. Or if the child has a body and reactions to it from the outside world that it doesn’t feel comfortable with, it’s difficult, especially if that child is sensitive to social pressure.”

Rule out other causes

So before you intervene in a child’s physical development, according to Verhaak, you should have an insight into other conditions that can also affect gender problems. “It’s wonderful that the transgender lane is there, but anything that’s there to prevent medical intervention needs to be used.”

“The puberty hormones usually start psychosexual development. If you inhibit it, the children hardly have that development. I think that is a big concern. What does it mean for those children and young people, and what does it mean for sexual development later on?” in life?” age? That people often feel good about it is wonderful, but it’s still hard to see this.”

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I really need help

Still, the children who report to the sex clinics with their parents suffer. They are gloomy or withdrawn and feel unhappy. And there are children who improve enormously from the treatment. So if you can’t get help at a sex clinic, where can you find help?

Verhaak emphasizes that it is extremely important that medical sex care is and remains available to children. Still, she believes that some of the children benefit better from care outside the medical circle. “What we see is that parents know about the waiting lists, and as soon as the word gender is mentioned, they immediately register their child at the gender clinics.”

Go get it done

“I recommend: Take those children to regular mental health care, where the gender issues will also be discussed in the context of other issues.” She admits that it is difficult because many colleagues in psychiatry often feel that they know too little about gender issues.

“But that’s no longer possible nowadays. It’s like an ordinary psychologist saying: I know nothing about homosexuality.” Now that gender issues are becoming an increasingly large part of our society, she believes that the general mental health service should also come to work.


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