Professor Georg Romer is a professor of child and adolescent psychiatry at the University Clinic of Münster.
Like most specialists for transsexualism, he emphasises that there is no "choice" about it, but it is innate and cannot be "cured".https://www.focus.de/perspektiven/jugend...d_16361283.html
More and more children and young people in Germany feel that they are living in the wrong gender and want a physical change. The child and youth psychiatrist Georg Romer has accompanied over 500 victims on their way to transition. Here he talks about the supposed "transgender hype" and his most complex case.
FOCUS Online: Mr. Romer, studies show that more and more young people do not feel comfortable in their own body. Is that correct? And what are the reasons?
Georg Romer: Yes, this observation is reported by all international specialist centers that offer specialized services for transgender health for young people. The demand from minors has increased massively in recent years, in some cases it has even increased tenfold.
If you take a closer look, that's not particularly surprising. It can be compared with the change in social awareness in the area of homosexuality, here similar processes have been observed over the past 30 years. When I was 14 it would have been unthinkable if someone in the school class had come out as homosexual. Many people could not even accept this for themselves in silence and secrecy. Today it has become more natural. This shifts both the self-discovery processes and the outings to earlier phases of life in childhood and adolescence.
There are serious population-representative data from Sweden which indicate that 0.2 percent of the adult population says very clearly: "I would like to change my body towards the opposite sex with medical help". In the next 20 years we expect that these numbers will also hit the healthcare system accordingly.
We are also observing this development earlier and earlier. Today, young people often want a physical change when they are 13 or 14 years old; in the past, this was usually only the case in their mid-20s. This is a major medical challenge because you have to carefully consider all aspects, including volatile development processes of identity in adolescence. It becomes clear how high the professional requirements are for child and adolescent psychiatry. However, the numbers of the increase are still well below the forecast 0.2 percent of the total population.
Is there a risk that young people will decide too early and too carelessly for a physical procedure? Is there, as some critics feared, possibly even a "transgender hype"?
Romer: Such a danger must be averted in each individual case through medical care. I don't want to rule out the possibility that there might be fads in some youthful subcultures that teenagers who want to try out may jump on for a while, but these people don't end up being treated with us.
Those who come to us with a request for hormone treatment, for example, are usually very differentiated and consider this step very carefully. Precisely because it is about our own body, we usually experience great seriousness in these patients. This also includes the willingness to take the time to deal with doubts about what we support psychotherapeutically. I can't see any hype about trans identity.
What are the dangers if those affected feel a great deal of suffering, but do not confide in their parents out of shame?
Romer: It is important that allowing the development of maturity to run is not a neutral option in itself, but rather involves irreversible changes in the body of trans people in adolescence, which massively increases psychological suffering and carries risks for long-term psychological health. This must be carefully considered before making any treatment decision.
"It must be clear that people with their perceived gender identity are not sick or disturbed"
The struggle with one's own body and one's own sexual identity is often a great burden for transsexual adolescents. What problems do these young people face every day?
Romer: The problems are manifold. It is often the case that social exclusion or even a pathologization of the trans identity can lead to serious psychological problems. Social phobia, low self-esteem, depression and sometimes self-loathing can all result. Here society and parents have the responsibility to take countermeasures in the form of social acceptance. It must be completely clear that people with their perceived gender identity are not sick or even disturbed. This is an important prerequisite for reducing stigma and social suffering.
During and after puberty, however, there is also suffering to the body. When the body changes, transsexual teenagers suffer and often try to hide the changes. That too often leads to psychological problems. At this point, in cases of stable transgender status, it may be indicated to offer young people the possibility of bringing about a physical change in the sense of perceived sexual puberty with medical support, which allows them a psychosexual and social participation in a puberty that is coherent for them.
How should parents react when their child is in the wrong body?
Romer: It is important for parents to understand that gender identity is not an arbitrary choice of the individual, but rather an inherent imprint that cannot be influenced in any direction, either pedagogically or therapeutically. This is often difficult for parents if their child does not have a trans identity until after puberty. “Where did the girl go that I had in front of me all the time?” Is a sentence that we often hear.
In such cases, adolescents sometimes have to be patient with their parents if the development happens too quickly. Here we try to help and accompany. In general, it can be said that repression or rejection have no effect, except for the problems already mentioned for your own child. At the same time, it is important to give self-discovery processes that may still be open-ended with the time they need.
Trans boy at Catholic girls school: "He blossomed in new self-confidence"
What about the education in schools. Does the topic of transsexuality need to be discussed more here?
Romer: We are further ahead than many think with education in schools. In Münster in our special university consultation, we have accompanied around 500 young people on their transition over the past 7 years, some of them in rural areas.
I particularly fondly remember the case of a trans boy coming out to a Catholic girls' high school. He was fully accepted as a boy by both the parents and the entire school and stayed at this school. The testosterone treatment started later and the legal change of civil status were successfully mastered in adolescence and the young man blossomed in new self-confidence. Later he proudly showed me his high school diploma. I suppose that was the first high school diploma issued in a male name at a Catholic girls' high school.
They repeatedly refer to social acceptance. How far is our otherwise so enlightened society on the subject of transsexuality?
Romer: There is still a lot to be done. At its core it is about the acceptance of gender diversity and the overcoming of hetero-normative gender stereotypes. It hardly bothered anyone anymore when a girl with a brushed haircut and khaki pants walks around. This is an important signal because it conveys to girls who, without being trans, want to be more masculine in type, that this is why they will not be pigeonholed in a trans box.
Young men who want to put on make-up, for example, have a harder time. The more tolerant society as a whole deals with atypical gender role behavior in children and adolescents, the easier it will be for trans people to find their way and their place.
The legal situation:
Attempts at therapy aimed at dissuading young people from their perceived gender have been punishable in Germany since May 2020. In addition, the free development of the personality of children and adolescents is protected by Article 2, Paragraph 1 of the Basic Law. The German Ethics Council also points out that the child's general right to personality also includes the right to lead a life according to their own subjectively perceived gender identity and to be recognized in this identity.
About Georg Romer
Georg Romer, Director of the Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy at the University Clinic in Münster. He was one of the first in Germany to offer counseling for transident children and adolescents, initially at the University Medical Center Hamburg-Eppendorf, and since 2013 in Münster.