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Heiligt der Zweck die Mittel? Korruptes und anderes sozialschädliches Verhalten im Sozialwesen.
(2014)
Merkmale von Kindern und Jugendlichen mit Geschlechtsdysphorie in der Hamburger Spezialsprechstunde
(2014)
Given the increasing demand for counselling in gender dysphoria in childhood in Germany, there is a definite need for empirical data on characteristics and developmental trajectories of this clinical group. This study aimed to provide a first overview by assessing demographic characteristics and developmental trajectories of a group of gender variant boys and girls referred to the specialised Gender Identity Clinic in Hamburg. Data were extracted from medical charts, transcribed and analysed using qualitative content analysis methods. Categories were set up by inductive-deductive reasoning based on the patients' parents' and clinicians' information in the files. Between 2006 and 2010, 45 gender variant children and adolescents were seen by clinicians; 88.9% (n = 40) of these were diagnosed with gender identity disorder (ICD-10). Within this group, the referral rates for girls were higher than for boys (1:1.5). Gender dysphoric girls were on average older than the boys and a higher percentage of girls was referred to the clinic at the beginning of adolescence (> 12 years of age). At the same time, more girls reported an early onset age. More girls made statements about their (same-sex) sexual orientation during adolescence and wishes for gender confirming medical interventions. More girls than boys revealed self-mutilation in the past or present as well as suicidal thoughts and/or attempts. Results indicate that the presentation of clinically referred gender dysphoric girls differs from the characteristics boys present in Germany; especially with respect to the most salient age differences. Therefore, these two groups require different awareness and individual treatment approaches.
In Germany, the situation of health care services for children and adolescents with gender dysphoria is insufficient. In 2006 a specialized multiprofessional outpatient clinic was founded at the University Medical Center Hamburg-Eppendorf. Goals were improvement of health services for gender dysphoric children, development of treatment concepts, and gain of knowledge through research. After finishing a thorough interdisciplinary assessment an individualized, case-by-case treatment starts. Besides psychotherapy an interdisciplinary treatment (e. g. puberty suppression and cross-sex hormones) is provided if indicated. During childhood a watchful waiting and carefully observing attitude is necessary. If a marked increase of gender dysphoria occurs during the first phases of puberty development, puberty suppression and later cross sex-hormones might be indicated.
Zum Lernen verdammt
(2014)
In einer Pilotstudie wurden 31 Erzieherinnen (Alter: MW = 41,4; sd = 11,2 Jahre; Berufserfahrung: MW = 18,6; sd = 11,5 Jahre) von 17 Kindern mit Typ-1-Diabetes (Alter: MW = 4,5; sd = 1,3 Jahre; Betreuungszeit pro Woche: MW = 29,8; sd = 8,9 Stunden) zur Betreuungssituation in der Kindertageseinrichtung befragt. Über 70 % der Erzieherinnen verfügten nach eigenen Angaben über ein grundlegendes Krankheits- und Therapiewissen und fühlten sich bei der Betreuung des Kindes „sicher“ (35,5 %) bzw. „eher sicher“ (51,6 %). An einer Diabetesschulung hatten 64,5 % der Befragten teilgenommen; 22,6 % äußerten Schulungsbedarf. Die Erzieherinnen führten beim betreuten Kind ein- bis mehrmals täglich Blutzuckerkontrollen durch (MW = 3,8; sd = 1,6) und verabreichten Insulin (MW = 2,7; sd = 1,6) oder unterstützten das Kind bei diesen Therapieaufgaben. 41,9 % der Erzieherinnen vertraten die Ansicht, dass ihre zeitlichen Ressourcen nicht ausreichen, um ein Kind mit Typ-1-Diabetes angemessen zu betreuen. Während der Betreuungszeit in der Kindertageseinrichtung hatten 64,5 % der Erzieherinnen mehrfach eine Hypo- oder Hyperglykämie des Kindes erlebt. Im Hinblick auf das Verhalten in kritischen Situationen, die Berechnung von BE/KE sowie die Berechnung der Insulindosis äußerte jeweils mehr als ein Viertel der Befragten weiteren Informationsbedarf und Angst vor Behandlungsfehlern. Die Zusammenarbeit mit den Eltern wurde positiv wahrgenommen.
The clinical treatment of children and adolescents with gender dysphoria is still a controversial issue. The aim of this study was to get an overview of the knowledge and experience of international experts and to highlight shared views as well as differences in theoretical convictions and treatment approaches. Half-structured, guide-line based interviews were carried out with international experts in the field. The interviews were analyzed using qualitative content analysis (Mayring, 2010).