Peggy T Cohen-Kettenis

Peggy T Cohen-Kettenis
Amsterdam University Medical Center | VUmc

PhD

About

321
Publications
268,497
Reads
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23,637
Citations
Additional affiliations
July 2013 - April 2017
Amsterdam University Medical Center
Position
  • Professor Emeritus
October 1992 - July 2013
Amsterdam University Medical Center
Position
  • Professor (Full)
September 1987 - October 1992
University Medical Center Utrecht
Position
  • Professor (Associate)

Publications

Publications (321)
Article
Full-text available
Many women born with disorders or differences of sex development (DSD) report sexual problems, in particular women who have undergone extensive genital reconstruction. Examining cognitions and emotions that hinder or promote sexuality may facilitate understanding these sexual problems and may contribute to the development of specific interventions....
Article
Full-text available
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
Full-text available
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
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
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
Context: Hormonal interventions in adolescents with gender dysphoria may have adverse effects such as reduced bone mineral accrual. Objective: To describe bone mass development in adolescents with gender dysphoria treated with gonadotropin-releasing hormone analogues (GnRHa), subsequently combined with gender affirming hormones. Design: Observ...
Article
Background: Researchers combined both versions of the original Utrecht Gender Dysphoria Scale (UGDS) to create a single gender spectrum version (UGDS-GS) which measures dissatisfaction with gender identity and expression over time as well as comfort with affirmed gender identity. Aim: This study examined the construct validity of the newly revised,...
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
Full-text available
An update of the chapter on Mental, Behavioral and Neurodevelopmental Disorders in the International Classification of Diseases and Related Health Problems (ICD) is of great interest around the world. The recent approval of the 11th Revision of the ICD (ICD-11) by the World Health Organization (WHO) raises broad questions about the status of nosolo...
Article
Full-text available
Over a decade ago, the participants at the International Consensus Conference on Intersex proposed Disorders of Sex Development (DSD) as an umbrella term for “congenital conditions in which the development of chromosomal, gonadal, or anatomical sex is atypical”. The Group recommended the terminology be sensitive to concerns of individuals having th...
Article
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This article presents an Italian version of the Gender Identity Questionnaire for Children (GIQC) (Cohen-Kettenis et al., 2006; Johnson et al., 2004), a parent-report questionnaire covering a range of gender characteristics of children. We developed the GIQC-Italian version with the translation/back translation method and administered it, with a so...
Article
Full-text available
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
Objective: Changes of sex hormone levels in disorders of sex development (DSD) can affect the body, including the vocal folds, during and after foetal development. The voice is a gender characteristic that may also be affected. There is a lack of knowledge on voice alteration in DSD. To explore this in different forms of DSD, we describe the preval...
Article
In their Translations article in the January issue of the Journal, Turban and van Schalkwyk provide a critical evaluation of the recently published literature on co-occurring gender dysphoria (GD) and autism spectrum disorder (ASD).¹ In addition, they refer to this flux in interest as part of a larger increase in publications on transgender people,...
Article
Introduction: Gender-affirming hormone treatment is known to affect adrenal androgen levels in adult individuals with gender dysphoria (GD). This may be clinically relevant because the adrenal gland plays a critical role in many different metabolic processes. Aim: This study aims to assess the effects of gonadotropin-releasing hormone analogs (G...
Article
Full-text available
Adolescents seeking professional help with their gender identity development often present with psychological difficulties. Existing literature on psychological functioning of gender diverse young people is limited and mostly bound to national chart reviews. This study examined the prevalence of psychological functioning and peer relationship probl...
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
Full-text available
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
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...
Article
Background: Few studies have compared the psychological functioning of individuals with gender dysphoria in Western and non-Western cultures. To our knowledge, this is the first study comparing the mental health of transgender individuals from an Islamic and non-Islamic country (Iran and the Netherlands). Methods: In this study, the psychological f...
Article
Background: Information on the psychosexual outcome of individuals with disorders of sex development (DSDs) and intersex conditions is of great importance for sex assignment at birth of newborns with DSD. Aim: To assess gender change and gender dysphoria in a large sample of individuals with different DSDs. Methods: A cross-sectional study was...
Article
Background: Over the past decade, the number of people referred to gender identity clinics has rapidly increased. This raises several questions, especially concerning the frequency of performing gender-affirming treatments with irreversible effects and regret from such interventions. Aim: To study the current prevalence of gender dysphoria, how...
Article
Background Studies investigating the influence of perinatal hormone exposure on sexually differentiated traits would greatly benefit from biomarkers of these early hormone actions. Click-evoked otoacoustic emissions show sex differences that are thought to reflect differences in early androgen exposure. Women with complete androgen insensitivity sy...
Article
Full-text available
Objectives: To describe and investigate the hormone treatments in individuals with different forms of disorders of sex development (DSD), and the patients own views on their treatment. Design: Multicentre cross-sectional clinical evaluation, dsd-LIFE in six European countries from 02/2014 to 09/2015. Participants: 1040 adolescents and adults (...
Article
Objectives: It is hypothesized that transpeople show sex-atypical differentiation of the brain. Various structural neuroimaging studies provide support for this notion, but little is known about the sexual differentiation of functional resting-state networks in transpeople. In this study we therefore aimed to determine whether brain functional con...
Article
Full-text available
Objective To update the “Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guideline,” published by the Endocrine Society in 2009. Participants The participants include an Endocrine Society–appointed task force of nine experts, a methodologist, and a medical writer. Evidence This evidence-based guideline was devel...
Article
Full-text available
Objective: To investigate fertility outcome in individuals with different forms of disorders of sex development (DSD), if assisted reproductive technology (ART) was used, and the patients' satisfaction with the information they had received. Design: A cross-sectional multicenter study, dsd-LIFE. Setting: Not applicable. Patient(s): A total o...
Article
Full-text available
Background dsd-LIFE is a comprehensive cross-sectional clinical outcome study of individuals with disorders/differences of sex development (DSD). This study focuses on various rare genetic conditions characterized by impaired gonadal or adrenal functionality. Methods/Design The study aims to assess quality of life (QoL) as a measure of psychosocia...
Article
Full-text available
We assessed the outcomes of gender affirming surgery (GAS or sex reassignment surgery) four to six years after first clinical contact, and the associations between postoperative (dis)satisfaction and Quality of Life (QoL). Our multicenter, cross-sectional follow-up study involved persons diagnosed with Gender Identity Disorder (DSM-IV-TR) who appli...
Article
Introduction Puberty suppression using GnRH agonists, followed by induction of desired sex characteristics using sex steroids, is recommended by current guidelines as the treatment of choice for gender dysphoric adolescents although little evidence is available. Aim To evaluate the efficacy and safety of estrogen treatment for pubertal induction i...
Article
Full-text available
Objectives: The aim of the European Network for the Investigation of Gender Incongruence is to investigate the status of all individuals who had applied for gender confirming interventions from 2007 until 2009, irrespective of whether they received treatment. The current article describes the study protocol, the effect of medical treatment on gend...
Article
Objective: In various Western countries early medical gender-affirmative treatment has become increasingly available for transgender adolescents. Research conducted before the start of medical gender-affirming treatment has focused on psychological and social functioning, and knowledge about the sexual health of this specific young group is lackin...
Article
Full-text available
The World Health Organization (WHO) is revising the tenth version of the International Classification of Diseases and Related Health Problems (ICD-10). This includes a reconceptualization of the definition and positioning of Gender Incongruence of Childhood (GIC). This study aimed to: 1) collect the views of transgender individuals and professional...
Data
The UK Survey (this article reports on the questions marked in yellow). (DOCX)
Data
Additional information on the background of the respondents. (DOCX)
Data
The ICD-11 draft criteria of ‘Gender Incongruence of Childhood’ of the WGSDSH criteria used in this study. (DOCX)
Data
Full-text available
En la próxima undécima revisión de la Clasifcación Internacional de las Enfermedades y Problemas de Salud Relacionados (ICD-11) de la Organización Mundial de la Salud, se han propuesto cambios sustanciales a la clasificación de los trastornos mentales y conductuales relacionados con la sexualidad y la identidad de género de la ICD-10. Estos concier...
Article
Full-text available
Evidence indicates an overrepresentation of youth with co-occurring autism spectrum disorders (ASD) and gender dysphoria (GD). The clinical assessment and treatment of adolescents with this co-occurrence is often complex, related to the developmental aspects of ASD. There are no guidelines for clinical care when ASD and GD co-occur; however, there...
Article
Full-text available
The World Health Organization (WHO) is currently updating the tenth version of their diag- nostic tool, the International Classification of Diseases (ICD, WHO, 1992). Changes have been proposed for the diagnosis of Transsexualism (ICD-10) with regard to terminology, placement and content. The aim of this study was to gather the opinions of transgen...
Article
Full-text available
The World Health Organization (WHO) is currently updating the tenth version of their diagnostic tool, the International Classification of Diseases (ICD, WHO, 1992). Changes have been proposed for the diagnosis of Transsexualism (ICD-10) with regard to terminology, placement and content. The aim of this study was to gather the opinions of transgende...
Article
Full-text available
International guidelines recommend the use of Gonadotropin-Releasing Hormone (GnRH) agonists in adolescents with gender dysphoria (GD) to suppress puberty. Little is known about the way gender dysphoric adolescents themselves think about this early medical intervention. The purpose of the present study was (1) to explicate the considerations of gen...
Article
Full-text available
In the World Health Organization's forthcoming eleventh revision of the International Classification of Diseases and Related Health Problems (ICD-11), substantial changes have been proposed to the ICD-10 classification of mental and behavioural disorders related to sexuality and gender identity. These concern the following ICD-10 disorder groupings...
Article
The recognition and acknowledgment that gender identity and birth-assigned sex may be incongruent in children and adolescents have evolved in recent decades. Transgender care for children and adolescents has developed and is now more widely available. Controversies exist, however, around clinical management of gender dysphoria and gender incongruen...
Article
Introduction: Few studies exist on the psychosexual outcome of homogeneous groups of individuals with 5α-reductase deficiency type 2 (5α-RD-2) and the relation between gender changes and parental hostile and benevolent sexism, which are two components of ambivalent sexism that assume a stereotypical approach toward women in an overtly negative way...
Article
The magnitude of sex differences in human brain and behavior and the respective contributions of biology versus socialization remain a topic of ongoing study in science. The preponderance of evidence attests to the notion that sexual differentiation processes are at least partially hormonally mediated, with high levels of prenatal androgens facilit...
Article
Puberty suppression using gonadotropin-releasing hormone agonists (GnRHas) is recommended by current guidelines as the treatment of choice for gender dysphoric adolescents. Although GnRHas have long been used to treat precocious puberty, there are few data on the efficacy and safety in gender dysphoric adolescents. Therefore, the Endocrine Society...
Article
Norms are considered to influence expectations toward gender-related behavior. Deviations from these norms are often perceived negatively by the social environment. The objective of this study was to investigate adults diagnosed with a Gender Identity Disorder (GID), their recalled play behavior, and peer preferences in childhood and adolescence. D...
Article
Full-text available
This study is the third in a series to examine behavioral and emotional problems in children and adolescents with gender dysphoria in a comparative analysis between two clinics in Toronto, Ontario, Canada and Amsterdam, the Netherlands. In the present study, we report Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) data on adolescents a...
Article
Sex differences have been described regarding several aspects of human brain morphology; however, the exact biological mechanisms underlying these differences remain unclear in humans. Women with the complete androgen insensitivity syndrome (CAIS), who lack androgen action in the presence of a 46,XY karyotype, offer the unique opportunity to study...
Poster
Full-text available
Background: Several resting state networks have been described in literature. Today, it is still unclear whether these networks are stable or can be influenced by sex hormones. Transgender persons offer a unique opportunity to study these hormonal influences. Objective: To examine the effects of cross-sex hormone treatment in transgender persons on...
Article
Mental health professionals are repeatedly faced with the dilemma of choosing between stigma of a mental disorder diagnosis and being denied access to care for lack of diagnosis, so we appreciate the points raised by Sam Winter and colleagues and Mauro Cabral and colleagues. However, we disagree with their presentation of the facts. ICD-11's gender...
Article
Full-text available
Background: Sex differences in performance and regional brain activity during mental rotation have been reported repeatedly and reflect organizational and activational effects of sex hormones. We investigated whether adolescent girls with gender dysphoria (GD), before and after 10 months of testosterone treatment, showed male-typical brain activit...
Article
The alteration of sex-specific body features and the establishment of a satisfactory body image are known to be particularly relevant for individuals with Gender Dysphoria (GD). The aim of the study was to first develop new scales and examine the psychometric properties of the Hamburg Body Drawing Scale (Appelt & Strauß 1988). For the second part o...