title: Partial Treatment Requests and Underlying Motives of Applicants for Gender Affirming Interventions.
abstract: BACKGROUND
  Historically, only individuals with a cross-gender identity who wanted to receive a full treatment, were eligible for "complete sex reassignment" consisting of feminizing/masculinizing hormone treatment and several surgical interventions including genital surgery (full treatment). Currently, it is unclear what motives underlie a request for hormones only or surgery only or a combination of hormones and surgery (e.g., a mastectomy), but no genital surgery (partial treatment).
  
  
  OBJECTIVE
  The aims of this study were (i) to describe treatment requests of applicants at a specialized gender identity clinic in the Netherlands; and (ii) to explore the motives underlying a partial treatment request, including the role of (non-binary) gender identity.
  
  
  METHODS
  Information was collected on all 386 adults who applied for treatment at the Center of Expertise on Gender Dysphoria of the VU University Medical Center in Amsterdam, the Netherlands, in the year 2013. Treatment requests were available for 360 individuals: 233 natal men (64.7%) and 127 natal women (35.3%). Treatment requests were systematically collected during assessment. Individuals were classified as either desiring a full or partial treatment. The motives behind a partial treatment request were collected and categorized as well.
  
  
  RESULTS
  The majority of applicants at our gender identity clinic requested full treatment. Among those who requested partial treatment, the most reported underlying motive was surgical risks/outcomes. Only a small number of applicants requested partial treatment to bring their body into alignment with their non-binary gender identity.
  
  
  CONCLUSIONS
  It becomes clear that partial treatment is requested by a substantial number of applicants. This emphasizes the need for gender identity clinics to provide information about the medical possibilities and limitations, and careful introduction and evaluation of non-standard treatment options.
authors.affiliation: Department of Medical Psychology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Titia F
authors.initials: TF
authors.lastname: Beek
authors.affiliation: Department of Medical Psychology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Baudewijntje P C
authors.initials: BP
authors.lastname: Kreukels
authors.affiliation: Department of Medical Psychology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Peggy T
authors.initials: PT
authors.lastname: Cohen-Kettenis
authors.affiliation: Department of Medical Psychology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Steensma
mesh_terms: D000328:Adult; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D012017:Referral and Consultation / Q000706:statistics & numerical data; D057829:Gender-Affirming Procedures; D063106:Transgender Persons / Q000523:psychology* / Q000706:statistics & numerical data; D014189:Transsexualism / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery
keywords: Gender Affirming Interventions; Gender Identity; Transgender; Treatment Request