title: [Trans healthcare : Between depsychopathologization and a needs-based treatment of accompanying mental disorders].
abstract: BACKGROUND
  Historically, the function of psychiatry and psychotherapy in the healthcare treatment of transsexualism has been impaired by the basic assumption that non-conforming gender experiences and behavior are automatically considered as expressions of psychopathology.
  
  
  OBJECTIVE
  In line with revision of the diagnostic criteria and changing standards of care and treatment recommendations, the therapeutic relationship between mental healthcare professionals and transgender individuals is critically discussed aiming at providing a needs-based psychiatric and psychotherapeutic treatment and a patient-centered approach for trans persons.
  
  
  METHODS
  Literature search focusing on the prevalence of trans persons and the presence of accompanying mental disorders. Discussion of professional experiences with mental healthcare of trans persons.
  
  
  RESULTS
  Trans persons without clinically relevant mental distress do not need any kind of psychiatric or psychotherapeutic treatment; however, trans people with clinically relevant mental impairment need safe access to mental healthcare without linking the trans identity a priori to a mental disorder.
  
  
  CONCLUSIONS
  In order to ensure individual trans healthcare in the long term, the therapeutic relationship should take into account both the body knowledge and self-determination of trans persons as well as the clinical expertise of mental healthcare professionals.
authors.affiliation: Institut für Sexualforschung und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland. t.nieder@uke.de.
authors.forename: T O
authors.initials: TO
authors.lastname: Nieder
authors.affiliation: Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Westküstenkliniken Brunsbüttel und Heide, 25746, Heide, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Güldenring
authors.affiliation: Institut für Sexualforschung und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Köhler
authors.affiliation: Institut für Sexualforschung und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Briken
mesh_terms: D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy*; D011599:Psychopathology / Q000379:methods; D063106:Transgender Persons / Q000523:psychology*; D014189:Transsexualism / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Mental healthcare; Participation; Psychiatry; Transgender; Transsexualism