82 Chapter 5 In addition, two focus groups with clinicians working at the two treatment teams were held. The informants were purposefully selected based on their discipline (all different disciplines working within both teams participated to assure representativeness for the complete treatment team; i.e. three child and adolescent psychiatrists, four child and adolescent psychologists and three paediatric endocrinologists). Procedure Two authors of this study conducted the interviews. Both had interview experience and worked as a clinician at one of the gender identity clinics (MA and LV). They had not been involved in the diagnostic assessments of the adolescents they interviewed. Initial interview questions were formulated after review of the relevant literature and discussion within the research team involving all authors. The interview guide contained no closeended questions (see Appendix B, which can be found at page 223). One of the authors (MV) facilitated the two focus groups. During the focus groups the questions asked in the interviews were presented along with several anonymous quotes from the interviews to get the conversation started. The participants were asked whether they agreed with and/or identified with the quotes. Furthermore, the participants were invited to express possible other views they held on these topics. All interviews and focus groups were conducted in Dutch, and were audio-taped and transcribed verbatim. Written informed consent for participation and tape recording was obtained before each interview and each focus group. The study was approved by the institutional review board of the Amsterdam University Medical Centres, location VUmc, and the Leiden University Medical Centre. Analysis Data analysis was based on hermeneutic analysis (Miles & Huberman, 1994; Stake, 2005). After an initial open reading of the data, two of the authors presented some preliminary (sub)themes (MA and LV). Besides, one of these authors analysed the transcripts by selecting representative quotations for each of the defined themes, taking care to draw quotations from all data sources. Then, the same two authors conducted an additional round of analyses to assess whether the (sub)themes enabled them to accurately subdivide the outcome of the data. They also re-analysed the transcripts to select representative quotations. Then, through a deliberative process, the authors redefined the initial (sub) themes until they reached a consensus. The quotations were initially translated from Dutch into English by one of the authors (LV). The other authors, who are all bilingual, checked, and if necessary, revised these translations (they were also provided with the original Dutch quotations).
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