Proefschrift

161 Dealing with moral challenges in treatment for transgender children and adolescents: evaluating the role of moral case deliberation 9 questionnaire on perceived MCD outcomes (Euro-MCD; Svantesson et al., 2014) and participated in individual interviews and focus groups. The participants in this study were members of the Amsterdam and Leiden transgender teams. Both teams included endocrinologists and specialists in child and adolescent psychiatry and psychology. The Amsterdam team also included surgeons and gynaecologists. The gender identity clinic in Amsterdam had approximately 30 team members when this study was conducted. The team in Leiden had seven members in the same period. Ten to fifteen teammembers participated in eachMCD session. We individually interviewed three specifically selected team members from each team. The interviewees were two child and adolescent psychiatrists, two child and adolescent psychologists, and two endocrinologists. The interviewees had different levels of experience with care for transgender minors. Therefore, the six interviews can be considered representative of the larger group of participants across the two teams in terms of their range of disciplines and experience level. In addition to the interviews, we conducted two focus groups: one with nine members of the Amsterdam team, and one with six members of the Leiden team. Each focus group consisted of a representative part of the multidisciplinary team from which it was derived. In order to make the groups representative, we included members with different disciplines and levels of experience in the field of transgender child and adolescent care. No more information about the participants can be provided here because this could compromise the anonymity of some participants, since certain functions are performed by only one or two members of a given team. The focus groups were used to refine and validate the findings from the interviews. As part of the mixed method design, we conducted a small cross-sectional survey using the Euro-MCD questionnaire at two joint meetings of the Amsterdam and Leiden teams (T0 and T1). Twenty-eight professionals from the Amsterdam team and six from Leiden completed the Euro-MCD questionnaire at T0 (n = 34). Twenty professionals on the Amsterdam team and two from Leiden completed the questionnaire at T1 (n = 22). To protect the privacy of the respondents, their names were not collected. Therefore, it was not possible to match those who participated in this survey twice and no longitudinal data were collected (table 11).

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