Why is the number of young children presenting for treatment increasing between both sexes? The new research should clarify that, among other things

Why has the demand for medical care increased between both genders since 2014? Radboud University is conducting research to find out exactly what is going on here. And also to ask why more and more children between the ages of 11 and 13 are signing up.

People who do not feel at home in the body they were born into can report to a gender clinic. In recent years, more and more people are doing this, resulting in long waiting lists.

Relatively many children

Therefore, Radboud University is conducting an extensive study on the growing demand for gender care. A lesser known part of this is that many children turn to sex clinics. Children between the ages of 11 and 13 who are not affected by these problems until the onset of puberty.

In particular, many children born female for the first time at the age of 11 indicate that they want to live as a boy and that they do not feel happy in the role of a girl or in a girl’s body. Once they are treated in a sex clinic, they and their parents have the option to slow down puberty.

Two years of hormone inhibitors

Then they receive aromatase inhibitors, which stop the development of puberty 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 live as a boy after two years or more, the option is for them to start with male hormones.

“Once a child enters the gender pathway, he or she is completely focused 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, in her opinion, is whether it would be better to help all the children who are now entering such a program.

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A medicine for life

Verhaak is affiliated with the Radboud University Medical Center Sex Clinic, where she has been helping children and adults for the past three years. Together with communication and influence professor Eni Das, she is looking into what exactly is going on with these children for the new research. She is very careful with this. “On the one hand, preventing puberty looks very nice: you save such a child who will have to be operated on later.”

“On the other hand, it is nice to realize that such a girl will have to take medicine for life. Many young children have an unrealistic picture. They think: I will become just like a father. I tell them that they do not like becoming a dad, it is important to discuss this also with children.”

Researchers Chris Verhaak (right) and Eni Das

Caring for both sexes for 25 years

25 years ago, young people in the Netherlands were treated for gender dysphoria: a strong feeling of dissatisfaction with the gender they were born with and raised with. A typical example from the early years of the possibility of this therapy is to draw a picture of a young child, for example a person who lives as a boy of kindergarten age, and who indicates that he is a girl by telling his parents that he does not want to have children. rod.

The desire to be a girl physically also continues in the following years. The fact that treatment has become possible for these children is seen by many as a huge and very valuable advance.

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Not just anything

But now, many years later, the pool of young children who claim to have gender problems is so large that it raises the question of whether all of these children also needed medical attention. Are they all helped with hormonal therapies or gender-specific psychotherapy?

“It may not be the case,” says Chris Verhaak. “A lot is still not clear with these kids. What effect is peer pressure, images in the media and other problems at play, such as autism? It has been said when using puberty inhibitors: If it doesn’t help, it won’t hurt, but puberty inhibitors have a negative effect.” It affects bone density, but it is not random and its effect on sexual development is not yet clear.

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Transgender care waiting lists

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

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

expectation pattern

The study also takes into account that more girls than boys are born reporting to clinics with gender issues during puberty. “When a baby is born, all sorts of expectations arise. For example, that a girl who is born will also act and feel this way and that she will fall in love with boys.”

And that child assumes that, too. If such a child goes into puberty and can no longer keep up with girls who do stereotypical girl things, then that child should be able to keep his or her body there. Or if the child has a body and the reactions to it from the outside world that Not being comfortable with him, that’s hard, especially if this child is sensitive to social pressure.”

Rule out other causes

So before you get involved in a child’s physical development, according to Verhaak, you should have insight into other conditions that can also affect gender problems. “It’s great that the transgender pathway exists, but whatever is there should be used to prevent medical intervention.”

“Those pubertal hormones normally initiate psychosexual development. If you block that, kids won’t have that development. I think that’s a huge concern. What does that mean for these kids and young adults and what does that mean for sexual development later in life?” the age? The fact that people often feel good about it is great, but it can still be hard to moderate.”

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Really need help

However, children who go to sex clinics with their parents struggle. They are pessimistic or withdrawn and feel unhappy. And there are children who improve greatly from treatment. So if you can’t get help at a gender clinic, where can you get help?

Verhaak stresses that it is extremely important that medical care is unisex and still accessible to children. However, she believes that some children benefit better from care outside the medical department. “What we’re seeing is that parents know about waiting lists and as soon as the word sex is mentioned, they immediately enroll their children in sex clinics.”

Go get it done

“I recommend: take these children to regular mental health care, where gender questions will also be discussed in the context of other questions.” She admits this is difficult, because many colleagues in mental health care often feel they know very little about gender issues.

“But that’s no longer possible in this day and age. This is just like a regular psychiatrist saying: I don’t know about homosexuality.” Now that gender issues are an increasingly large part of our society, she believes regular mental health care should work, too.


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