Browsing by Subject "nuoruusiän kehitys"

Objective: Individuals whose gender identity differs from their sex assigned at birth are referred to as transgender or trans. During growth from childhood to adolescence, young trans people may experience a disconnect between their gender identity and societal norms, which may contribute to the development of mental health problems or being bullied. Many trans-identifying adolescents aim to access gender-reaffirming treatment, however this requires access to, and thorough assessments performed in, a specialist healthcare setting. An imperative element of gender identity services is an assessment performed by a psychologist, who is required to provide a statement commenting on the readiness of the young person to proceed with gender-affirming treatments. This study explores mental health symptomology and exacerbating life experiences described by young people seeking gender-affirming treatment from gender identity services. A secondary aim is to understand the characteristics of the symptomology that contribute to the psychologist’s statement and conclusions regarding the patient’s readiness to proceed with physiological treatments. The final objective of this study relates to the guidance provided by the Council for Choices in Healthcare (COHERE) in the summer of 2020, which outlines criteria to be considered when referring underage patients to gender health services in Finland. This study explores whether adolescents’ symptom presentation, as assessed using various clinical outcome assessment (COA) instruments, has changed following the introduction of the COHERE guidelines. Methods: Study data (n = 102) was collected during spring 2022, consisting of records of psychologists’ assessments completed at the HUS gender identity services clinic between 2017 and 2022. Several categorical variables were extracted from the psychologist’s reports concerning the youths’ background information, psychological wellbeing, social strains and resources, as well as information on patients’ gender identity formation and expression. Additionally, patient scores across six COA instruments (SCL-90, PQ-92, YSQ, A-DES, TAQ and Minäkuvataulukko) were extracted. Categorical and numerical data were both described using sample statistics. Additionally, relationships between patient scores on instruments and psychologist’s statements, as well as any changes in patient scores following the introduction of the COHERE guidelines, were analysed using the χ2-test. Results and conclusions: A substantial amount of psychiatric symptomology, suicidality and social issues, such as bullying victimization, were recorded as part of the adolescent’s personal histories. However, the same adolescents often reported very few or no psychiatric symptoms as part of COA instruments administered, and on some domains no symptoms were reported by the majority of participants. It appeared that reporting very few or no symptoms on some of the domains was linked to a psychologist’s statement in favour of proceeding with gender affirming treatment. With respect to a change in reporting of symptoms following the introduction of the COHERE guidelines, more, less and the same number of symptoms were reported. However, it is important to note that reporting general psychological distress on the SCL-90 was significantly reduced after the implementation of the COHERE guidelines.