205 Summary 11 among others, minors’ MDC, decision-making authority, and the role of concurrent psychological, social, and/or medical issues, often without openly stating them (e.g. Dubin et al., 2020; Baron & Dierckxsens, 2021; Lemma, 2018). What was missing in the discussions is an elucidation of the underlying ideas and theories. Additionally, insight into the considerations and ideas of transgender adolescents themselves, their parents, and experienced professionals remains limited. The overall aims of this study were therefore twofold. First, we aimed to gain more insight in the core of the ethical dilemmas that play a role in the care of transgender minors, and the underlying intuitions and considerations of stakeholders in the field regarding early medical treatment. The second, subsequent aim was to provide empirical data regarding these ethical dilemmas that play a role in the care of transgender minors. Herewith to make sure that treatment for transgender minors is not only clinically, but also ethically appropriate. Second, to find common ground between various clinicians around the world regarding early medical treatment. Third, to provide the stakeholders in the field direction to deal with these ethical dilemmas in clinical practice. And fourth, to allow clinicians to safely exercise the clinical judgment to undertake the course of action which is in the child’s best interests, based on objective, scientific data and not (largely) on subjective opinions. Chapter 2 Chapter 2 explicates the considerations, underlying ideas, assumptions, and theories of those who criticize and those who support the use of early medical treatment regarding treatment with PS for transgender minors. Our goal was to get a clearer picture of the similarities and differences between their viewpoints in order to move forward the ethical debate. In total, 36 professionals, working in 17 different treatment teams in 10 different countries from around Europe and North-America, participated in this interview and open-ended questionnaire study. The results show that the considerations of people claiming the risks of the use of early medical treatment, and people supporting it touch on fundamental ethical concepts in paediatrics; concepts such as best interest, autonomy, and the role of the social context. From the literature, interviews, and questionnaires, seven themes emerged which gave rise to different, and sometimes even opposing, views on early medical treatment for transgender adolescents. The first theme is the availability or nonavailability of an explanatory model for gender dysphoria (GD). Even though most informants agree that a combination of factors, such as genetic, hormonal, neurodevelopmental, and psychosocial factors play a role, opinions differ as to whether, and if so, which factor(s) prevail in the aetiology (De Vries & Cohen-Kettenis, 2012; Meyer-Bahlburg, 2010). The second theme regards the nature of GD; most informants find it difficult to articulate their thoughts
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