Psychological functioning in adolescents referred to specialist gender identity clinics across Europe: a clinical comparison study between four clinics

Abstract

Adolescents seeking professional help with their gender identity development often present with psychological difficulties. Existing literature on psychological functioning of gender diverse young people is limited and mostly bound to national chart reviews. This study examined the prevalence of psychological functioning and peer relationship problems in adolescents across four European specialist gender services (The Netherlands, Belgium, the UK, and Switzerland), using the Child Behavioural Checklist (CBCL) and the Youth Self-Report (YSR). Differences in psychological functioning and peer relationships were found in gender diverse adolescents across Europe. Overall, emotional and behavioural problems and peer relationship problems were most prevalent in adolescents from the UK, followed by Switzerland and Belgium. The least behavioural and emotional problems and peer relationship problems were reported by adolescents from The Netherlands. Across the four clinics, a similar pattern of gender differences was found. Birth-assigned girls showed more behavioural problems and externalising problems in the clinical range, as reported by their parents. According to self-report, internalising problems in the clinical range were more prevalent in adolescent birth-assigned boys. More research is needed to gain a better understanding of the difference in clinical presentations in gender diverse adolescents and to investigate what contextual factors that may contribute to this.

Time trends in referrals to child and adolescent gender identity services: a study in four Nordic countries and in the UK

“…Among children and adolescents social discrimination and peer rejection are commonly discussed as a particular problem related to gender identity and gender expression incongruent with one's sex (36,37), and minors in contact with gender identity services have reported experiences of subjection to bullying and other peer difficulties as commonly as those referred due to mental health issue, and much more commonly than children and adolescents at large (38,39,40,41,42). However, experiences of bullying may also precede the onset of gender dysphoria (40), and recent studies have also paid attention to ample social support and peer acceptance following disclosure of other than cisgender gender identity among young people (34,35).…”

Next Steps in Puberty Research: Broadening the Lens Toward Understudied Populations

“…This underscores the urgent need for strong developmental theory in this area. With the advent and expansion of pediatric gender clinics worldwide, gains have been made to provide individualized multidisciplinary and comprehensive care to transgender youth (de Graaf et al., ; Hsieh & Leininger, ; Leibowitz & Spack, ; Shumer, Nokoff, & Spack, ; Tishelman et al., ; Vance et al., ; de Vries & Cohen‐Kettenis, ). In the United States, the launch of a $5.7 million NIH‐funded effort to study transgender adolescents provides the basis for hope that this area of research will continue to grow rapidly (Reardon, ).…”

Transgender Identity Is Associated With Bullying Involvement Among Finnish Adolescents

“…There are indications even between European countries of variation in transgender youth’s peer relationships and psychological functioning ( de Graaf et al, 2018 ; van der Star et al, 2018 ). One could speculate that such differences are even greater between European and North American adolescents.…”