Limited options for action? Gender Dysphoria in Child and Adolescent Psychiatric Primary Care – Results of a Survey of Specialists

Abstract

The increase in children and adolescents with needs concerning gender dysphoria (GD) is documented and relevant. Child and adolescent psychiatrists (CAPs) are mainly involved in the care of this patient group. The study analyzes the increasing need for care and the current care situation of this patient group within Germany from the perspective of those treating them. 30 semi-structured telephone interviews with primary care CAPs were conducted and subjected to qualitative content analysis. An increase in demand and a predominance of assigned-female-at-birth patients was observed. The patients mainly report negative previous experiences in the healthcare system. They seek psychotherapeutic and medical treatment and benefit from accepting therapeutic support. Caregivers benefit from empathy and involvement in the therapeutic process. Experiences with detransition are rare. Professional networking is assessed heterogeneously; more structured networking, further training and the expansion of GD-specific care are desired. The quality of psychiatric care for children and adolescents with GD is not yet sufficient. Predominantly negative previous experiences of patients within the healthcare and high demand for further training indicate an urgent need for professional development of treating CAPs. It is shown that the respondents are very interested in improving the complex care of this patient group.