Peggy Cohen-Kettenis

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Peggy T. Cohen-Kettenis (born 23 August 1948) is a Dutch psychologist and academic. [1] Since 1993 she has been Special Professor of Gender Development and Child and Adolescent Psychopathology, Utrecht University. [1] As one of the principal architects of the Dutch Protocol, her work has had a major influence on the global understanding and treatment of gender dysphoria in children and adolescents.

Contents

Dutch Protocol

The idea of using puberty blockers originated in the Netherlands and was developed by Cohen-Kettenis, pediatric endocrinologist Henriette Delemarre, child psychiatrist Annelou de Vries, [2] and health psychologist Thomas D. Steensma. The first patient received these drugs in 1987. [3] Cohen-Kettenis collaborated with endocrinologists in Amsterdam, one of whom had experience prescribing gonadotropin-releasing hormone analogs, which were relatively new at the time. At the time, gender dysphoric teenagers had to wait until they were of age for cross-sex hormones, but the team proposed that earlier interventions might benefit carefully selected minors.

In 1998, Cohen-Kettenis and Stefanie van Goozen published the first case study in which a trans boy (B) ("female-to-male transsexual") received puberty blockers. [4] Because a psychiatrist had previously diagnosed B with gender dysphoria, he decided to administer puberty blockers after consulting with a pediatric endocrinologist. [4] This gave B more time to explore his gender identity. At age thirteen, B was referred to the gender clinic for young people, then located in Utrecht. [4] After several conversations with both the trans boy and his parents, a multidisciplinary team decided to continue prescribing puberty blockers. [4] Finally, at age eighteen, B decided to start testosterone treatment. Some time later, B decided to have his breasts and ovaries removed. In a conversation after these interventions, it was indicated that B no longer had gender dysphoria. [4] The questionnaires also showed that there were no psychological, somatic, or personality problems. [4] Based on this case, Cohen-Kettenis and Van Goozen argued that puberty suppression could have physical and psychological benefits in the diagnosis and treatment of transgender adolescents. [4]

First studies

De Vries et al. (2011) published a cohort study of the first 140 adolescents who received puberty blockers and/or gender affirming hormones between 2000 and 2008. [5] The study group consisted of the first 70 adolescents who received puberty blockers: 33 transgender girls and 37 transgender boys. [5] All participants had experienced gender dysphoria since childhood, were supported by their environment, had no comorbidities that could influence the diagnosis, and had reached at least Tanner stage 2 or 3. [5]

The group was examined twice: shortly before starting puberty blockers and shortly before starting gender affirming hormone therapy. [5] Various questionnaires were used to measure IQ, emotional and behavioral problems, depressive symptoms, the intensity of anxiety and anger, general psychological functioning, gender dysphoria, and body satisfaction. [5] Comparing the two measurement points showed that adolescents had significantly fewer emotional and behavioral problems shortly before starting gender-affirming hormones than before starting puberty blockers. [5] The participants also had significantly fewer depressive symptoms and improved their general psychological functioning. [5] No significant improvement in anger, anxiety, or gender dysphoria was measured. [5] Because puberty suppression reduces the associated stress of gender dysphoria, De Vries et al. (2011) concluded that it offers a valuable opportunity to give adolescents time to consider their gender identity and any subsequent medical steps. [5]

In 1996 She published with Ray Blanchard and Kenneth Zucker stating that birth order has some influence over sexual orientation in androphilic trans women . [6]

By 2015 her research stated that some nonbinary people desire gender-affirming health care, including hormone replacement therapy or surgery. [7]

References

  1. 1 2 Utrecht University
  2. The Fractious Evolution of Pediatric Transgender Medicine Frieda Klotz 04.06.2022, Undark Magazine
  3. "How a celebrated Dutch treatment method for transgender youth came under pressure [timeline]". Zembla (in Dutch). BNNVARA. 2023-11-07. Archived from the original on 2023-11-08. Retrieved 2023-11-13.(Google translation)
  4. 1 2 3 4 5 6 7 Cohen-Kettenis, P. T.; van Goozen, S. H. M. (1998). "Pubertal delay as an aid in diagnosis and treatment of a transsexual adolescent". European Child & Adolescent Psychiatry. 7 (4) (Year 7 ed.): 246–248. doi:10.1007/s007870050073. ISSN   1435-165X. PMID   9879847.
  5. 1 2 3 4 5 6 7 8 9 de Vries, Annelou L. C.; Steensma, Thomas D.; Doreleijers, Theo A. H.; Cohen-Kettenis, Peggy T. (2011-08-01). "Puberty Suppression in Adolescents With Gender Identity Disorder: A Prospective Follow-Up Study". The Journal of Sexual Medicine. 8 (8) (Year 8 ed.): 2276–2283. doi:10.1111/j.1743-6109.2010.01943.x. ISSN   1743-6095. PMID   20646177.
  6. Blanchard, Ray; Zucker, Kenneth J.; Cohen-Kettenis, PT; Gooren, LJ; Bailey, JM (October 1996). "Birth order and sibling sex ratio in two samples of Dutch gender-dysphoric homosexual males" . Archives of Sexual Behavior. 25 (5): 495–514. doi:10.1007/BF02437544. PMID   8899142. S2CID   41147086.
  7. Beek, Titia F.; Kreukels, Baudewijntje P.C.; Cohen-Kettenis, Peggy T.; Steensma, Thomas D. (November 1, 2015). "Partial Treatment Requests and Underlying Motives of Applicants for Gender Affirming Interventions" . The Journal of Sexual Medicine. 12 (11): 2201–2205. doi:10.1111/jsm.13033. ISSN   1743-6109. PMID   26553507. Archived from the original on October 1, 2024. Retrieved June 24, 2023.