199 General discussion 10 who could help and support them with this. The children, adolescents, and parents who enter a gender identity clinic nowadays, are generally much better informed through the media, the internet, and peers. In which it is important to mention that this information sometimes leads to children, adolescents, and parents having misconceptions about for example treatment options, with which the clinician must adequately deal. Unlike some decades ago, most who are referred to a gender identity clinic at the present time, have a clear idea of the diagnosis and their treatment wishes. This has an impact on the role expected of clinicians. As a result, a clinician needs to deal with this inner layer differently nowadays compared to one or two decades ago. The clinician needs to find an adequate balance in the force fields between these different layers, of which some are relatively ‘new’, and of which all are continuously in motion concerning their perspective on the ethical dilemmas that play an important role in early medical treatment for transgender minors (M. de Vries, 2020). The ongoing collection of - both qualitative and quantitative - data related to the care and treatment for transgender children and adolescents, and the personalization of care, have important functions in continually evaluating and optimizing the care so that an adequate balance can be found in dealing with these various ‘forces’. Figure 6. The three ‘shells’ that exert their influences on the clinicians’ work at different levels ‘Society’ Transgender minors and their parents ‘Professionals’ Clinicians
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