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Transsex münchen

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Transsex München

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Background: Many trans individuals undergo medical interventions that result in irreversible loss of fertility. Little is known about their desire to have children and attitudes toward fertility preservation transsex münchen. Aim: To study how the desire for children and the use of fertility preservation options varies among trans women and trans men in different transitioning stages in Germany. Of these, 26 of each sex were just about to start medical treatment. Outcomes: Outcome parameter were the prevalence and determinants of a desire to have children in trans persons. In contrast, in those who had already started treatment, a current desire to have children was equally present in about one fourth of participants of both genders while the interest in having children in the future was ificantly higher in trans women

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View all 13 Articles. People whose gender does not correspond to the binary gender system, i. We conclude with specific proposals that may contribute to establish an improved, up-to-date, gender-sensitive healthcare system. This is especially problematic when it comes to healthcare for non-binary people. People whose gender identity does not correspond to the perceived norm are negatively affected by this lack of knowledge with some of transsex münchen facing severe stress and discomfort. This increased risk of comorbidities could be replicated in several countries worldwide, including data from the Lebanon Ibrahim et al.

Accordingly, this can be conceptualized as internalized transphobia Bockting et al. The notion that mental comorbidities solely arise due to gender incongruence and dysphoria therefore seems decidedly too one-dimensional, ignoring the underlying complexity. Inthe German sexologist Magnus Hirschfeld, founder of the first Institute for Sexology, carried out the worldwide first sex reasment surgery in Berlin Bhinder and Upadhyaya, This was declared unconstitutional only in These standards provided temporal and diagnostic frameworks and concrete guidelines according to which gender-affirming procedures may take place.

Hence, treatment seekers and treatment providers are now able to find individual solutions together on equal terms.

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Access restrictions should no longer exist. Thus, gender-affirming hormone treatment can already be used after diagnosis, at the beginning of the transition. However, the report guidelines of the medical service of the health insurance funds MDS contradict the S3 guidelines by continuing to set strict framework conditions for the treatment costs to be covered by the public health insurance funds. There, the main criterion is the desire of a person to belong to the binary opposite gender.

This may include the desire to change sex characteristics primary or secondary and to be recognized as belonging to this gender. The desire must be constant for 2 years and must not result from mental disorder. The ICD defines transsexualism as a disorder, subclassified in the section of disorders of adult personality and behavior Graubner, This was already successfully implemented in the Diagnostic and Transsex münchen Manual of Mental Transsex münchen DSM-Vaccording to which it is only possible to speak of a disorder when there is relevant suffering due to the gender incongruence dysphoria American Psychiatric Association, Usually, medical services are provided in private practices.

There are hardly any centers that offer multiprofessional treatment. The interdisciplinary care center at the University Hospital of Hamburg plays a pioneering role in this area. Online, there are lists of addresses maintained by interest groups.

They offer various services: psychotherapeutic support, indication letters, medical reports to the TSG and partly interdisciplinary services.

However, letters of indication from experts are necessary in order that services e. Figure 1. Sex asment is based on the external genital, which are usually defined in medical literature as indicators of the so-called biological sex.

However, an increase in prevalence has been reported in several countries: in Germany, for example, a 2. Brunner et al. After the introduction of the new ICD, it should be possible to record comparable prevalence rates of the diagnosis gender dysphoria instead of transsexualism.

The variety of experiences of discrimination within the healthcare system have already been pointed out Franzen and Sauer, ; Grant et al. However, since discrimination refers to distinctions that lead to, produce, or give rise to disadvantage Scherr et al. Stigmatization means the deation and marking of a deviation from a norm which is given or desired within a society Goffman, Stigmatized persons are denied the status of a normal member of society because of an attribution of characteristics marked as a deviation. In the context of medical treatment in Germany, they presumably experience not so much discriminatory disadvantage as transsex münchen of their gender identity.

As a result, the health of this group of people is under-supplied, as they typically leave the health system after negative experiences and seek help elsewhere Mizock and Lewis, The same study reveals the administrative and treatment burdens caused by the MDS review procedure.

Even after a successful transition, psychotherapeutic and somatic care must be ensured. In addition, studies show that after gender-affirming therapy, psychological stress can also occur, which may lead to increased suicidality Rolle et al.

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The lifetime prevalence of suicidality is also affected — amongst other variables — by negative experience with medical providers Haas et al. Psychotherapeutic services should also strive to offer gender-sensitive counseling in order to adequately address internalized transphobia, specific role conflicts, and so forth. Unfortunately, specialized training programs for psychotherapists are hardly established. Therefore, gender sensitive medicine must become a part of the medical curriculum. There seems to be an interest on the part of medical students Turner et al.

Finally, gender sensitive medicine has to be implemented in the standard medical care in Germany Chase et al. It seems imperative that stigma-free and need-oriented trans-specific treatment is provided by trained personnel. Only then can we reasonably expect that the psychological distress due to gender dysphoria can be minimized and fused conflicts can be addressed e.

The guideline furthermore establishes basic principles, addressing medical professionals. There is a consensus that healthcare providers worldwide should adhere to these basic principles, regardless of socio-cultural norms and legal requirements of their respective country. Access to treatment options should be ensured and medical personnel should be further trained transsex münchen gender-sensitive medicine Coleman et al.

In Netherlands treatment options i. Here, too, the long waiting times have been pointed out as problematic and as an obstacle to the access of appropriate services Motmans et al. New healthcare models deviate from the central multidisciplinary gender units, for example by offering gender-affirming healthcare without psychological assessment. The procedure for gender-affirming surgery in Denmark is transsex münchen by the Danish Health Authority and is centralized in three clinics e. Italy is a positive example of a publicly accessible database of medical care professionals.

The situation in Poland stands out as a negative example in a discrepancy to the, as not sufficiently marked, but existing care situation in most European countries. Mental comorbidities could be reduced by individualized support transsex münchen transition. However, this is usually hindered by ificant organizational and institutional barriers. Deficits in the structure of specialized healthcare services in Germany and Europe have been pointed out.

There is a lack of specialized care offers that ensure a safe place for good care and that alleviate individual suffering through a professionally accompanied transition. We elaborated that even after transition, a non-discriminatory integration into the healthcare system remains necessary. Due to exclusively binary gender thinking, medicine is prone to institutional stigmatization.

The multifactorial condition of suffering is modeled in Figure 2. Figure 2.

Multifactorial condition of suffering. We see an urgent need for the establishment of comprehensive gender-affirmative healthcare. In particular, the problem of unacceptably long waiting times must be addressed. It should be pointed out, that through increased cooperation between medical providers and advocacy groups e.

Unfortunately, this development has not yet reached all areas. The original contributions presented in the study are included in the article. Further inquiries can be directed to the corresponding author. NG prepared the first draft of the manuscript. All authors contributed to critically revising and editing the content of the manuscript and approved the final version of the manuscript for submission.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers.

Any product that may be evaluated in this article, or claim that may be transsex münchen by its manufacturer, is not guaranteed or endorsed by the publisher. Also, a special thanks to Philipp Rhein, who helped reviewing the topic transsex münchen a sociological perspective. Adams, N. Varied reports of adult transgender suicidality: synthesizing and describing the peer-reviewed and gray literature. Transgender Health 2, 60— Almazan, A. JAMA Surg. American Psychiatric Association Psychiatric Pub. Google Scholar.

Aranda, G. Effects of sex steroids on cardiovascular risk profile in transgender men under gender affirming hormone therapy. Bailey, L. Suicide risk in the UK Trans population and the role of gender transition in decreasing suicidal ideation and suicide attempt. Mental Health Rev. Bakker, A. The prevalence of transsexualism in The Netherlands.

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Acta Psychiatr. Bauer, G. Reported emergency department avoidance, use, and experiences of transgender persons in Ontario, Canada: from a respondent-driven sampling survey. Bhinder, J. Nikolavsky and S. Blakely Cham: Springer— Bockting, W.