Baudewijntje P C Kreukels

Baudewijntje P C Kreukels
Amsterdam University Medical Center | VUmc · Department of Medical Psychology

PhD

About

153
Publications
124,066
Reads
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5,315
Citations
Additional affiliations
March 2017 - present
Amsterdam University Medical Center
Position
  • Professor (Associate)
June 2006 - February 2017
Amsterdam University Medical Center
Position
  • Senior Researcher
April 2000 - December 2005
Netherlands Cancer Institute
Position
  • PhD Student

Publications

Publications (153)
Article
Full-text available
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this are...
Article
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Purpose Adolescence is an important period for sexual development, including sexual debut. The purpose of this study was to assess first romantic and sexual experiences and debut age in individuals with differences of sex development (DSD/intersex) and compare these with age-matched and gender-matched population control values. Methods Questionnai...
Chapter
Intersex conditions or disorders/differences of sex development (DSD) are conditions in which the development of chromosomal, gonadal and/or genital characteristics is atypical. Studies in individuals with DSD conditions may provide valuable insights on the roles played by sex chromosomes, sex hormones, sex anatomy and gender of rearing in the deve...
Article
Background: Concerns exist regarding effects of puberty suppression on neurodevelopment. Intelligence is strongly correlated with educational achievement in the general population. This study aimed to examine the association between pre-treatment intelligence and educational achievement after gender-affirming treatment including puberty suppressio...
Article
Full-text available
Background Increasing numbers of adolescents seek help for gender-identity questions. Consequently, requests for medical treatments, such as puberty suppression, are growing. However, studies investigating the neurobiological substrate of gender incongruence (when birth-assigned sex and gender identity do not align) are scarce, and knowledge about...
Article
Full-text available
Sexual-wellbeing is recognized as an important aspect of quality-of-life. Yet, no overview exists of which aspects of sexual-wellbeing have been assessed in trans individuals seeking or undergoing medical treatment, nor is it clear what tools are used to evaluate the effect of medical treatment on sexual-wellbeing. First, to identify which topics p...
Article
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Background: While the importance of sexual pleasure for physical and mental health becomes increasingly evident, research on sexual pleasure in transgender persons is lacking. Recently, the first version of the Amsterdam Sexual Pleasure Index (ASPI Vol. 0.1) was validated in cisgender persons. This questionnaire aims to assess the tendency to exper...
Article
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Gender and sexually diverse adolescents have been reported to be at an elevated risk for suicidal thoughts and behaviors. For transgender adolescents, there has been variation in source of ascertainment and how suicidality was measured, including the time-frame (e.g., past 6 months, lifetime). In studies of clinic-referred samples of transgender ad...
Article
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Over the past decades, great strides have been made to professionalize and increase access to transgender medicine. As the (biomedical) evidence base grows and conceptualizations regarding gender dysphoria/gender incongruence evolve, so too do ideas regarding what constitutes good treatment and decision-making in transgender healthcare. Against thi...
Article
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Transgender people and their next-of-kin may request information on sexual orientation and preferred partners during hormonal affirming process. Although previous research on sexual orientation in transgender people is extensive, this literature may already be outdated and/or the methodology of studies assessing sexual orientation may fall short. T...
Article
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Objectives: To evaluate the experienced barriers of care for treatment-seeking trans individuals (TSTG) in three large European clinics. Methods: An online follow-up questionnaire was filled out by 307 TSTG individuals as part of the research protocol of the European Network for the Investigation of Gender Incongruence (ENIGI). Data was collected...
Article
Background: Increased mortality in transgender people has been described in earlier studies. Whether this increased mortality is still present over the past decades is unknown. Therefore, we aimed to investigate trends in mortality over five decades in a large cohort of adult transgender people in addition to cause-specific mortality. Methods: W...
Article
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Background: While much emphasis has been put on the evaluation of gender-affirming surgery (GAS) approaches and their effectiveness, little is known about the health care needs after completion of these interventions. Aim: To assess post-GAS aftercare needs using a mixed-method approach and relate these to participant characteristics. Methods:...
Article
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Background Previous research indicating that women with differences of sexual development (DSD), namely women with Turner syndrome (TS), women with congenital adrenal hyperplasia (CAH), and women with XY-DSD, have an impaired psychosocial and -sexual well-being and quality of life (QOL), was often limited by small samples and inadequate control gro...
Article
Samenvatting Hoewel transgender personen steeds zichtbaarder worden in onze maatschappij en in de zorgverlening, blijkt er bitter weinig onderzoek uitgevoerd naar hun seksualiteitsbeleving. Oudere, vaak kleinschalige studies hebben het seksueel functioneren na een medische transitie vaak verengd tot het al dan niet kunnen beleven van een orgasme. H...
Article
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Gender diverse individuals who do not conform to society’s binary gender expectations are more likely to experience difficulties in acceptance and in recognition of gender, compared to binary-identifying transgender people. This may accentuate the feeling that their gender identity is not socially recognized or validated. This study aimed to invest...
Article
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Background Long-term gender-affirming hormone therapy (GHT) in older transgender individuals could have beneficial effects on cognitive functioning. Cardiovascular risk factors and psychological factors are known determinants of cognition. Despite the rising number of older transgender individuals, only few studies have examined cognitive functioni...
Article
Full-text available
Background In contrast to cisgender persons, transgender persons identify with a different gender than the one assigned at birth. Although research on the underlying neurobiology of transgender persons has been accumulating over the years, neuroimaging studies in this relatively rare population are often based on very small samples resulting in dis...
Article
Full-text available
Background In the DSM-5 diagnosis of childhood Gender Dysphoria, two of the eight criteria focus on body satisfaction of the child. Nevertheless, this subject is understudied. This study aims to describe the body image of children with gender incongruence (GI) in relation to birth assigned sex and the intensity of GI. Method Self-report and parent...
Article
Purpose: The World Health Organization general assembly approved the 11th revision of the International Classification of Diseases (ICD) in 2019 which will be implemented in 2022. Gender identity-related diagnoses were substantially reconceptualized and removed from the mental health chapter so that the distress criterion is no longer a prerequisit...
Article
Full-text available
Studies estimate that gender-diverse persons represent 0.1 to 2% of populations investigated, but no such assessment was performed in Latin America. In a representative sample of Brazil’s adult population (n = 6000), we investigated participants' sociodemographic characteristics and possible associations between these and current gender identity, c...
Article
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Improving transgender people’s quality of life (QoL) is the most important goal of gender-affirming care. Prospective changes in affect can influence QoL. We aim to assess the impact of initiating gender-affirming hormonal treatment (HT) on affect. In the European Network for the Investigation of Gender Incongruence (ENIGI) study, we prospectively...
Article
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Competing theories have posited roles for foetal androgen exposure in the development of human handedness. However, due to practical and ethical considerations, few studies have used hormonal measures to examine this possibility. The current paper reviews this literature and reveals a generally inconsistent pattern of results. We also present data...
Article
Background: Surgery is performed in many individuals with disorders/differences of sex development (DSD). Irreversibility of some surgical procedures, lack of information about the procedures, and lack of follow-up care for physical and psychological outcomes, lead to wish for more knowledge from both surgeons and patients. After the consensus conf...
Article
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Study objective. To extract the sexual health and wellbeing needs of current generations of youth with intersex/Differences of Sex Development (DSD), during transition from pediatric to adult health care. Design. Qualitative narrative analyses, quantitative descriptives and questionnaires. Setting. Peer support networks and outpatient clinics. Part...
Article
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Purpose: Pubertal suppression is standard of care for early pubertal transgender youth to prevent the development of undesired and distressing secondary sex characteristics incongruent with gender identity. Preliminary evidence suggests pubertal suppression improves mental health functioning. Given the widespread changes in brain and cognition that...
Conference Paper
Full-text available
Introduction: Several steps in the transitioning process may affect sexual desire in transgender people. This is often underexposed by those providing gender affirming care. Testosterone therapy in transgender men (TM) generally leads to increasing frequency of desire, masturbation, sexual fantasies and arousal. Studies in transgender women (TW) ar...
Article
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Background: High quality data pertaining to the size of the transgender and gender diverse (TGD) population are scant, however, several recently published studies may provide more reliable contemporary estimates. Aims: To summarize the estimated number and proportion of TGD individuals overall and across age groups, based on most accurate data. Met...
Chapter
Full-text available
Our understanding of the neurobiological basis of gender diversity is limited. Even though more and more neuroimaging studies in adults hint towards sex-atypical and less pronounced sexual differentiation, the picture is far from clear and relatively little is known about the neurobiological correlates of gender incongruence in childhood and youth....
Article
Full-text available
Click-evoked otoacoustic emissions (CEOAEs) are echo-like sounds, generated by the inner ear in response to click-stimuli. A sex difference in emission strength is observed in neonates and adults, with weaker CEOAE amplitudes in males. These differences are assumed to originate from testosterone influences during prenatal male sexual differentiatio...
Article
Introduction: Several steps in the transitioning process may affect sexual desire in transgender people. This is often underexposed by those providing gender-affirming care. Aim: To prospectively assess sexual desire during the first 3 years of hormonal therapy (HT) in transgender people. Methods: This prospective cohort study was part of the...
Article
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STUDY QUESTION: What are the levels of breast development and satisfaction in women with a Disorder/Difference of Sex Development (DSD)? SUMMARY ANSWER: Compared with normative data, women with DSD reached lower Tanner stages and reported less breast satisfaction. WHAT IS KNOWN ALREADY: Women with DSD may have chromosomal and hormonal variations...
Article
Introduction: Studies about sexual functioning in trans persons have mainly focused on sexual functioning after genital gender-affirming surgery, have had small sample sizes, and have not explored the broad range of possible sexual dysfunctions. Measuring sexual functioning in trans persons during transitioning is important to determine the kind o...
Article
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The influence of testosterone on the development of human brain lateralization has been subject of debate for a long time, partly because studies investigating this are necessarily mostly correlational. In the present study we used a quasi-experimental approach by assessing functional brain lateralization in trans boys (female sex assigned at birth...
Article
Accurate estimates of the number and proportion of transgender and gender nonconforming people in a population are necessary for developing data-based policy and for planning and funding of health care delivery and research. The wide range of estimates reported in the literature is attributable primarily to differences in definitions. Other sources...
Article
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Objective: The aim of the study was to evaluate psychiatric symptoms among 1022 persons with various disorders of sex development (DSDs). Methods: The study was a European multicenter cross-sectional clinical evaluation in six countries. The mean (SD) age of participants was 32.1 (13.4) years. The cohort consisted of 325 individuals with Turner...
Article
Full-text available
For various reasons, sexuality of individuals with differences/disorders of sex development (DSD) may be affected. The aim of the study was to describe sexual activity, satisfaction with sex life, satisfaction with genital function, and sexual problems in people with different DSD conditions. Data were collected from 1040 participants in Europe. Ma...
Article
Full-text available
Purpose While sexuality has been reported to be impaired in females with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, sexuality in males with CAH so far has remained largely unconsidered. Patients Accessing one of the largest European male cohorts of patients with CAH in which sexuality in male patients with CAH was asses...
Conference Paper
AIM: Anger is a state of emotions ranging from irritation to intense rage. Aggression is the externalization of anger through destructive/punitive behaviour. The World Professional Association for Transgender Health (WPATH) Standards of Care, Edition 7 (SOC7) guidelines warn about aggression in transgender men (TM) on testosterone treatment. We aim...
Article
Introduction: Anger is a state of emotions ranging from irritation to intense rage. Aggression implies externalizing anger through destructive/punitive behaviour. The World Professional Association for Transgender Health (WPATH) Standards of Care, Edition 7 (SOC7) guidelines warn about aggression in transgender men (TM) on testosterone treatment....
Article
Introduction: Hormone treatment induces feminization of the body in transwomen and masculinization in transmen. However, the effect of hormone treatment on facial characteristics is still unknown. Aim: We aimed to study whether hormone treatment induces facial feminization and masculinization and how this potential change affects satisfaction an...
Article
In hypogonadal/postmenopausal individuals, hormone therapy has been associated with an increased risk for cardiovascular events (CVEs). A steeply growing population that often receives exogenous hormones is transgender individuals. Although transgender individuals hypothetically have an increased risk of CVEs, there is little known about the occurr...
Poster
Recently, research attention for the sexual life of individuals with Gender Dysphoria (GD, also referred to as transgender individuals), is increasing. Research has shown that the prevalence rates of sexual dysfunction (including the experience of distress) in transgender persons having received Gender Confirming Interventions (GCI) were higher com...
Article
Full-text available
Genital gender-affirming surgery (GAS) aims to alleviate feelings of gender dysphoria and support psychosexual outcomes. However, little is known of sexual activity and satisfaction of transmen after phalloplasty or metoidio-plasty. A clinical follow-up study was conducted in transmen at least one year after genital GAS in order to evaluate measure...
Article
Zusammenfassung Einleitung Geschlechtsdysphorie (GD) bezeichnet einen Leidensdruck, der sich aus der Inkongruenz zwischen körperlichen Geschlechtsmerkmalen und dem Erleben des eigenen Geschlechts ergeben kann (Geschlechtsinkongruenz, GI). Die vorliegende Arbeit beschäftigt sich mit dem Zusammenspiel von medizinischer Behandlung und sozialer Unterst...
Article
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Introduction A critical barrier to outcome assessment in gender-affirming healthcare is the lack of a specific patient-reported outcome measure (PROM). This phase I protocol describes an international collaboration between investigators in Canada, Denmark, the Netherlands and the USA who have coalesced to develop a new PROM (ie, the GENDER-Q) to ev...
Article
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Background: To investigate the association between the structural quality of care and patient satisfaction with care in individuals with disorders/ differences of sex development (DSD). Methods: A multicenter cross-sectional comparative study was conducted in 14 clinics in six European countries. We assessed the level of structural quality of ca...
Article
Purpose: The purpose of this study was to (1) investigate autism spectrum disorder (ASD) symptoms in a sample of adults referred for gender dysphoria (GD) compared to typically developing (TD) populations, (2) see whether males assigned at birth with GD (MaBGDs) and females assigned at birth with GD (FaBGDs) differ in ASD symptom levels, (3) study...
Article
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Sixty-one patients (22 patients with congenital adrenal hyperplasia [CAH] with a mean age of 14.86 years [range, 5–23], 20 patients with 5-α reductase deficiency type 2 [5α-RD-2] with a mean age of 19.5 years [range, 5–29], and 19 patients with complete androgen insensitivity syndrome [CAIS] with a mean age of 18.26 years [range, 5–28]) were evalua...
Article
Benign brain tumours may be hormone sensitive. To induce physical characteristics of the desired gender, transgender individuals often receive cross-sex hormone treatment, sometimes in higher doses than hypogonadal individuals. To date, long-term (side) effects of cross-sex hormone treatment are largely unknown. In the present retrospective chart s...
Article
Full-text available
Background: Previous studies in quality of life (QOL) in individuals with disorders/differences of sex development (DSD) have been restricted to subpopulations of the condition. We describe QOL in adult persons with DSD compared to country specific references and assess the impact of diagnosis. Methods: The multicentre cross-sectional clinical e...
Article
Full-text available
Objective: Disorders/differences of sex development (DSD) refer to congenital conditions with atypical sex development and are associated with psychosexual issues. The aim of this study was to assess body image and self-esteem across the DSD spectrum and to study the impact of diagnosis and mediating characteristics. Method: Data collection was...