Strengthening the biopsychosocial perspective in youth transgender care

Since the beginning of this century, demand for transgender care for children and adolescents in the Netherlands has increased sharply, resulting in long waiting lists and the establishment of a second medical gender-affirming care (MGAC) centre in 2020. Drawing on five years of clinical psychological experience in this second centre, and illustrated by four case examples, we explore ways to optimize care for these young people. We argue that regular child and adolescent mental health services (CAMHS) can play an important role at an early stage, when initial questions about gender arise, by assessing these questions, together with the child and parents, within a broader developmental context. The minority stress theory provides useful tools for early exploration of gender-related questions, and supportive interventions. The growing number of adolescents experiencing gender-related distress highlights the need for CAMHS to integrate gender development more fully into general diagnostics and treatment. This can help determine, with the child and parents, whether medical treatment is the most appropriate response to their concerns.