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31 Early medical treatment for transgender children and adolescents: an empirical ethical study 2 offered similar questions in a questionnaire by e-mail. The questionnaire was filled in by 15 professionals. The empirical data were obtained between October 2013 and August 2014. Initial interview topics were formulated after examination of the relevant literature. In accordance with qualitative research techniques, the interview topics evolved as the interviews progressed through an iterative process to ensure that the questions captured all relevant emerging themes (Britten, 1995; Guest, Bunce, & Johnson 2006). The interviews contained general topics and no close ended questions. The informants were child and adolescent psychiatrists, psychologists, and endocrinologists from diverse treatment teams in European and North American countries. Two Dutch ethicists, who are not directly related to a treatment team, were also interviewed. The treatment teams were purposefully selected on the basis of their stance in favour or against PS in the past. Interestingly, at the time this study was initiated, PS was not part of the treatment protocol for adolescents of several treatment teams. However, during this study, PS did become part of the treatment protocol of some of these teams. When interviewing these teams, extra emphasis was placed on the arguments they used to justify these treatment changes. The 36 professionals who participated in this study worked in 10 different countries (figure 1). An extensive description of the analysis of the data is given in Appendix A (which can be found at page 222). Figure 1. Participating informants ure 1. Participating formants Two ethicists from the same country* participated in this study by participating in an interview * The Netherlands. 15 professionals from 11 different treatment teams from five different countries* participated in this study by filling in the questionnaire * Croatia, Finland, Ireland, Italy, and Spain. In total 36 professionals from 17 different treatment teams from ten different countries* participated in this study by either participating in an interview or by filling in the questionnaire * Belgium, Croatia, Denmark, Finland Ireland, Italy, the Netherlands, Spain, The United Kingdom, and the United States. 19 professionals from eight different treatment teams from seven different countries* participated in this study by participating in an interview * Belgium, Denmark, Finland, Italy, the Netherlands, the United Kingdom, and the United States.

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