'Crossing the threshold from adolescence to adulthood requires an in between period of trying out adult roles, conceptualised by Erikson (1968) as a ‘psychosocial moratorium’, essential if the adolescent is not to end up ‘in a “social pocket” from which there is no return’ ' .
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An adolescent in GIDS has all of this to navigate, while simultaneously contemplating – indeed often actively requesting – medical interventions which intervene in puberty and may in many (as yet 'unknown) ways interact with these very developmental processes.'
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In 'young people with adolescent onset GD, significant psychological difficulties (histories of trauma, psychosis, body dysmorphic disorder and severe depression) and expressions of certainty about medical interventions being the only solution – has been observed '
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' A retrospective chart review of referrals to GIDS 2009–2016 (n=4148) showed that the vast majority of referrals were adolescents, with the sex ratio favouring female-bodied young people (1:2.1) in this age group (Carmichael, 2018).'
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'There was a sharp increase in referrals, with referrals for male-bodied adolescents increasing by 55% on average each year and for female-bodied adolescents by 105% over this 7-year period (Carmichael, 2018).'
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'these aspects signify a rapidly shifting context in the profile of many young people presenting to GIDS, which has prompted much discussion within the service and more widely about how best this group should be supported.'
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'A number of concerned parent groups characterise the willingness to provide such intervention to young people as the medicalisation of psychological and social ills.'
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'the majority of the young people had not received a formal diagnosis of GD prior to coming to GIDS, and [...]this contributed to their capacity to engage with an extended and exploratory assessment process through which an individualised formulation could be co-created.'
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'It is possible that for some of the cases identified in the case review, living in the gender role congruent with their biological sex was one factor, which facilitated the opportunity for meaningful exploration [...]phase as opposed to premature ‘foreclosure’ of identity'
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'a number of common themes can be noted, including experiences of teasing/bullying (including of a homophobic nature) prior to the onset of GD, a sense of exclusion and isolation, difficulties in social communication and engaging with peers,
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distress in relation to awareness of a developing sexed body and difficulties separating from parents.'
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