The fact that modern patterns of the treatment of trans individuals are not based on controlled or long-term comprehensive follow-up studies has allowed many ethical tensions to persist. These have been intensifying as the numbers of adolescent girls declare themselves to be trans, have gender dysphoria, or are “boys.” This essay aims to assist clinicians in their initial approach to trans patients of any age. Gender identity is only one aspect of an individual’s multifaceted identity. The contributions to the passionate positions in the trans culture debate are discussed along with the controversy over the official, not falsifiable, position that all gender identities are inherently normal. The essay posits that it is relevant and ethical to investigate the forces that may have propelled an individual to create and announce a new identity. Some of these biological, social, and psychological forces are enumerated. Using the adolescent patient as an example, a model for a comprehensive evaluation process and its goals are provided. The essay is framed within a developmental perspective.

现代跨性别者的治疗模式并非基于受控或长期全面的随访研究，这一事实使得许多道德紧张局势持续存在。随着越来越多的青春期女孩宣称自己是跨性别者、患有性别焦虑症或“男孩”，这种情况正在加剧。本文旨在帮助临床医生对任何年龄的跨性别患者采取初步治疗方法。性别认同只是个人多方面身份的一个方面。讨论了跨文化辩论中激烈立场的贡献，以及关于所有性别身份本质上都是正常的官方立场（不可证伪）的争议。本文认为，调查可能推动个人创造和宣布新身份的力量是相关且合乎道德的。列举了其中一些生物、社会和心理力量。以青少年患者为例，提供了综合评估过程及其目标的模型。这篇文章是从发展的角度出发的。