A new guideline aims to ensure better care for trans* people in the future. There is controversy about puberty blockers.

A young man jumps on a meadow with a rainbow-colored bag

Trans* people who received adequate treatment before puberty have a better health prognosis Photo: Cavan Images/imago

SEDAN taz | For a better life for trans people, 27 specialized organizations as well as a trans association and a parent organization have developed a new guideline: Its goal is to standardize and improve the diagnosis and treatment of children and young people with gender incongruence. That is, children who do not identify with the gender they were assigned at birth. If they are not well advised and treated correctly, serious suffering, so-called dysphoria, can occur.

The goal of the renewed guidelines is to create standards that ensure better health care for trans and nonbinary children and adolescents. Professional associations now have until April 19 to comment on the draft guidelines. The final version is scheduled to appear this year, replacing the guideline that was first created in 1999 and updated in 2013. These standards are valid in Germany, Austria and Switzerland.

Central to the new version is the clarity that gender incongruence is not a mental illness. International health organizations have long agreed on this. “Just the subjective suffering associated with it, [die Geschlechtsdysphorie] “It is considered pathological,” says a statement from the Association of Scientific Medical Societies (AWMF).

The Federal Trans* Association (BVT*) worked on the guidelines and announced on Tuesday that they would support the results of years of discussions. They represented “significant additional development” to no longer pathologize trans and non-binary experiences. The association welcomes that the guidelines separately address discrimination. “Discrimination against trans* people in everyday life and its consequences for psychotherapeutic support become visible and easier to discuss,” says Mari Günther from the BVT* board of directors.

Conflict over “puberty blockers”

A highly debated topic is the use of hormones as “puberty blockers” in adolescents with gender dysphoria. The medication can give young people and treating doctors time to jointly consider additional treatment in case of delayed physical development.

The complicated thing is that, on the one hand, there is a lack of long-term scientific studies. In some countries, this is a reason to use these medications very rarely. Britain only assigns puberty blockers in clinical trials, writes the AWMF.

But the physical self-determination of those under 18 years of age should also be reflected in the new guidelines. Doctor Georg Romer from Münster University Hospital, who played a leading role in the guidelines, highlighted in an interview with the journalistic portal reef reporterA prerequisite for puberty blockers is a “high diagnostic certainty.”

If doctors still refuse or delay the appointment, those affected “normally have a very long and pre-programmed path of suffering ahead of them.” Initial studies showed that people who received appropriate treatment before puberty had a “significantly better health prognosis,” Romer said.