Proefschrift

46 Chapter 3 about the risk of making the wrong treatment decisions, as gender identity could fluctuate during adolescence. Furthermore, adolescents might have poor decision-making abilities. Also, there may be adverse effects on health and on psychological and psychosexual functioning. Proponents of PS on the other hand emphasize the beneficial effects of PS on the adolescents’ mental health, quality of life, and of having a physical appearance that makes it possible to live unobtrusively in the affirmed gender role (Kreukels & CohenKettenis, 2011). Several treatment teams, who work according to the guidelines, are exploring the possibility of lowering their current age limits for early medical treatment, even though they acknowledge the lack of long-term data (Vrouenraets et al., 2015). In the literature on GD, it is mainly the professional view on the treatment that is available. Little is known about the way gender dysphoric adolescents themselves think about early medical intervention. However, to do justice to the developing autonomy of adolescents to make medical decisions, especially when it concerns far-reaching treatments, it seems appropriate to give serious consideration to the opinions of gender dysphoric minors themselves. The aim of our project was to explicate the considerations and opinions of gender dysphoric adolescents in the Netherlands concerning the concept of sex and gender, and the use of PS in GD. Furthermore, we explored whether considerations and opinions on the use of PS of gender dysphoric minors themselves differ from those of professionals working in treatment teams, and if so in what sense. Therefore, we compared the results of the interviews with the adolescents to earlier data concerning the opinions of treatment teams worldwide (Vrouenraets et al., 2015). We paid extra attention to the perception of sex and gender in the media; the increased media-attention regarding transgender individuals as well as the imposed stereotype are discussed. For this purpose, we have performed an empirical ethical study in order to answer the following questions: (1)What are the perceptions and views (direct thoughts or opinions) of gender dysphoric adolescents on PS in GD; (2) What are the (underlying) ideas, assumptions, and views of gender dysphoric adolescents about the concepts ‘best interests’, ‘autonomy’, and ‘sex/gender’?; (3) Do perceptions, views, and ideas on the use of PS of gender dysphoric minors in the Netherlands differ from those of professionals, and if so in what sense?

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