Peggy Cohen-Kettenis is a Dutch psychologist who helped found an important early clinic that served trans and gender diverse youth and adolescents.
Cohen-Kettenis has also held harmful views about transgender people, particularly around disease models. Cohen-Kettenis published with many anti-trans psychologists, including J. Michael Bailey, Kenneth Zucker, Ray Blanchard, Stephen Levine, Susan Coates, and Richard Green.
Background
Peggy T. Cohen-Kettenis was born in 1948 in Jakarta, Indonesia. Indonesia declared independence from the Dutch on August 17, 1945, and the family left in 1951 when it became dangerous for Dutch colonialists to stay, since Cohen-Kettenis’ seminal parent was a police commissioner. After arriving at The Hague, they moved to Rotterdam, then Utrecht.
Cohen-Kettenis attended Stedelijk Gymnasium Utrecht and Johan de Witt Gymnasium Dordrecht and earned a doctorate fromUtrecht University in 1973.
- Professor of Medical Psychology VUmcVUmc Sep 2002 – Jul 2013
- Professor UMC Utrecht Sep 1987 – Sep 2002
- Nederlands Instituut van Psychologen (NIP) logo Voorzitter Sector G 1997 – 2000
Cohen-Kettenis served as Professor of gender development and psychopathology at the Department of Child and Adolescent Psychiatry, University Medical Center Utrecht.
Transgender research
In 1987, Cohen-Kettenis started the first outpatient clinic in Europe for children and adolescents with gender problems and intersex conditions.
Cohen-Kettenis was a member of the World Professional Association for Transgender Health’s Standards of Care Committee and of the Task Force of the Endocrine Society Clinical Practice Guideline on the endocrine treatment of gender-dysphoric/gender-incongruent persons. She was Chair of APA’s DSM-5 GID subcommittee and member of the WHO ICD-11 Working Group on Sexual Disorders and Sexual Health.
Comments on J. Michael Bailey and Ray Blanchard
Below are critical reactions Louis Gooren and Cohen-Kettenis shared about sexologists J. Michael Bailey and Ray Blanchard, following publication of Baileyâs lurid 2003 book on sex and gender minorities, The Man Who Would Be Queen.
Psychologist Peggy Cohen-Kettenis reacts less negative. She is, after reading parts of the book not surprised about the row, but âwhen Bailey says that sexual preference and gender identity are not two entirely independent dimensions, he is not necessarily wrongâ, she says.
In contrast to Bailey, Cohen-Kettenis expresses herself very diplomatic. As no other she knows the sensitivity of this terrain and the ease with which a âconflict can be created around this issueâ. The psychologist agrees that not all transsexuals are heavily gender-dysphoric in youth. She attributes the dominance of âthe woman captured in a manâs bodyâ image, to itâs endless repetition by the media.
[…] Gooren is scathing about Blanchardâs work. […] Cohen-Kettenis shares Goorenâs objections to terms like homosexual and non-homosexual transsexuals. She would rather differentiate between early and late onset transsexuals. But apart from the terminology, these groups are very similar to those of Bailey and Blanchard.
Primary TSs are more often homosexual while secondary TSs usually have had straight relationships before entering treatment, Cohen-Kettenis explains.
âIn the second group, during puberty cross-dressing is often paired with sexual excitement â she says. âWhen they enter treatment however, the cross dressing is very restfulâ.Cohen-Kettenis estimates half the number of TSs are secondary TSs. Whether all secondary TSs have had a autogynephile history she cannot say. âExtreme gender dysphoria can, I think, come to be in all sorts of ways. Secondary TSs are a very diverse group. We also see people who still are autogynephile.â
Cohen-Kettenis thinks that patient care will not be influenced by this theory. TSs do not have to fear that Cohen would see autogynophilia as a disqualification for treatment. The decisive factor is the suffering of the client, and whether treatment can indeed help to relieve the pain. In this, Blanchard and Bailey agree and mention that autogynophiliacs do not have a higher rate of post-treatment regrets.
References
Navarro, Danielle (May 6, 2018). Nevertheless, she desisted: A brief review of Steensma et al (2013). https://djnavarro.net/desistance-essay/
Cantor, James (December 15, 2017). Statistics faulty on how many trans- kids grow up to stay trans-? http://www.sexologytoday.org/2017/12/faulty-statistics-on-how-many-trans.html
Singal, Jesse (July 25, 2016). Whatâs Missing From the Conversation About Transgender Kids. New York https://www.thecut.com/2016/07/whats-missing-from-the-conversation-about-transgender-kids.html
Serano, Julia (August 2, 2016). Detransition, Desistance, and Disinformation: A Guide for Understanding Transgender Children Debates. Medium https://juliaserano.medium.com/detransition-desistance-and-disinformation-a-guide-for-understanding-transgender-children-993b7342946e
Vermij, Peter (September 27, 2003). Een man gevangen in een mannenlichaam. NRC https://www.nrc.nl/nieuws/2003/09/27/een-man-gevangen-in-een-mannenlichaam-7655797-a1162822 Translation: Arianne van der Ven.
Selected publications by Cohen-Kettenis
Dan J. Stein, Peter Szatmari, Wolfgang Gaebel, Michael Berk, Eduard Vieta, Mario Maj, Ymkje Anna de Vries, Annelieke M. Roest, Peter de Jonge, Andreas Maercker, Chris R. Brewin, Kathleen M. Pike, Carlos M. Grilo, Naomi A. Fineberg, Peer Briken, Peggy T. Cohen-Kettenis & Geoffrey M. Reed (2020). Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies. BMC Med 18, 21 (2020). https://doi.org/10.1186/s12916-020-1495-2
E Coleman, W Bockting, M Botzer, P Cohen-Kettenis, G DeCuypere, … Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7 International journal of transgenderism 13 (4), 165-232
WC Hembree, PT Cohen-Kettenis, L Gooren, SE Hannema, WJ Meyer, … Endocrine treatment of gender-dysphoric/gender-incongruent persons: an endocrine society clinical practice guideline The Journal of Clinical Endocrinology & Metabolism 102 (11), 3869-3903
WC Hembree, P Cohen-Kettenis, HA Delemarre-Van De Waal, LJ Gooren, … Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline The Journal of Clinical Endocrinology & Metabolism 94 (9), 3132-3154
Steensma, T. D., McGuire, J. K., Kreukels, B. P., Beekman, A. J., & Cohen-Kettenis, P. T. (2013). Factors associated with desistence and persistence of childhood gender dysphoria: a quantitative follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry, 52(6), 582â590.
ALC De Vries, JK McGuire, TD Steensma, ECF Wagenaar, … Young adult psychological outcome after puberty suppression and gender reassignment Pediatrics 134 (4), 696-704
ALC De Vries, TD Steensma, TAH Doreleijers, PT CohenâKettenis Puberty suppression in adolescents with gender identity disorder: A prospective followâup study The journal of sexual medicine 8 (8), 2276-2283
MSC Wallien, PT Cohen-Kettenis Psychosexual outcome of gender-dysphoric children Journal of the American Academy of Child & Adolescent Psychiatry 47 (12 âŠ
TD Steensma, R Biemond, F de Boer, PT Cohen-Kettenis Desisting and persisting gender dysphoria after childhood: a qualitative follow-up study Clinical child psychology and psychiatry 16 (4), 499-516
CM Wiepjes, NM Nota, CJM de Blok, M Klaver, ALC de Vries, … The Amsterdam cohort of gender dysphoria study (1972â2015): trends in prevalence, treatment, and regrets The journal of sexual medicine 15 (4), 582-590
TD Steensma, JK McGuire, BPC Kreukels, AJ Beekman, … Factors associated with desistence and persistence of childhood gender dysphoria: a quantitative follow-up study Journal of the American Academy of Child & Adolescent Psychiatry 52 (6), 582-590
ALC De Vries, PT Cohen-Kettenis Clinical management of gender dysphoria in children and adolescents: the Dutch approach Journal of homosexuality 59 (3), 301-320
TD Steensma, BPC Kreukels, ALC de Vries, PT Cohen-Kettenis Gender identity development in adolescence Hormones and behavior 64 (2), 288-297
ALC De Vries, ILJ Noens, PT Cohen-Kettenis, IA van Berckelaer-Onnes, … Autism spectrum disorders in gender dysphoric children and adolescents Journal of autism and developmental disorders 40, 930-936
PT Cohen-Kettenis, LJG Gooren Transsexualism: a review of etiology, diagnosis and treatment Journal of psychosomatic research 46 (4), 315-333
PT Cohen-Kettenis, SHM Van Goozen Sex reassignment of adolescent transsexuals: a follow-up study Journal of the American Academy of Child & Adolescent Psychiatry 36 (2), 263-271
M Aitken, TD Steensma, R Blanchard, DP VanderLaan, H Wood, … Evidence for an altered sex ratio in clinicâreferred adolescents with gender dysphoria The journal of sexual medicine 12 (3), 756-763
J Drescher, P Cohen-Kettenis, S Winter Minding the body: Situating gender identity diagnoses in the ICD-11 International Review of Psychiatry 24 (6), 568-577
GM Reed, J Drescher, RB Krueger, E Atalla, SD Cochran, MB First, … Disorders related to sexuality and gender identity in the ICDâ11: revising the ICDâ10 classification based on current scientific evidence, best clinical practices, and human ⊠World psychiatry 15 (3), 205-221
SHM Van Goozen, PT Cohen-Kettenis, LJG Gooren, NH Frijda, … Gender differences in behaviour: Activating effects of cross-sex hormones Psychoneuroendocrinology 20 (4), 343-363
YLS Smith, SHM Van Goozen, AJ Kuiper, PT Cohen-Kettenis Sex reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals Psychological medicine 35 (1), 89-99
PT Cohen-Kettenis, F PfÀfflin Transgenderism and intersexuality in childhood and adolescence: Making choices Sage
HA Delemarre-Van De Waal, PT Cohen-Kettenis Clinical management of gender identity disorder in adolescents: a protocol on psychological and paediatric endocrinology aspects European Journal of Endocrinology 155 (Supplement_1), S131-S137
PT Cohen-Kettenis, F PfÀfflin The DSM diagnostic criteria for gender identity disorder in adolescents and adults Archives of sexual behavior 39 (2), 499-513
PT Cohen-Kettenis, A Owen, VG Kaijser, SJ Bradley, KJ Zucker Demographic characteristics, social competence, and behavior problems in children with gender identity disorder: A cross-national, cross-clinic comparative analysis Journal of abnormal child psychology 31, 41-53
PT CohenâKettenis, HA DelemarreâVan De Waal, LJG Gooren The treatment of adolescent transsexuals: changing insights The journal of sexual medicine 5 (8), 1892-1897
ALC de Vries, TAH Doreleijers, TD Steensma, PT CohenâKettenis Psychiatric comorbidity in gender dysphoric adolescents Journal of Child Psychology and Psychiatry 52 (11), 1195-1202
G Heylens, E Elaut, BPC Kreukels, MCS Paap, S Cerwenka, … Psychiatric characteristics in transsexual individuals: multicentre study in four European countries The British Journal of Psychiatry 204 (2), 151-156
W Meyer III, WO Bockting, P Cohen-Kettenis, E Coleman, D Diceglie, … The Harry Benjamin International Gender Dysphoria Association’s standards of care for gender identity disorders, sixth version Journal of Psychology & Human Sexuality 13 (1), 1-30
YLS Smith, SHM Van Goozen, PT Cohen-Kettenis Adolescents with gender identity disorder who were accepted or rejected for sex reassignment surgery: a prospective follow-up study Journal of the American Academy of Child & Adolescent Psychiatry 40 (4), 472-481
JF Strang, H Meagher, L Kenworthy, ALC de Vries, E Menvielle, … Initial clinical guidelines for co-occurring autism spectrum disorder and gender dysphoria or incongruence in adolescents Journal of Clinical Child & Adolescent Psychology
KJ Zucker Gender identity disorder in children and adolescents Annu. Rev. Clin. Psychol. 1 (1), 467-492
J Olson-Kennedy, PT Cohen-Kettenis, BPC Kreukels, … Research priorities for gender nonconforming/transgender youth: gender identity development and biopsychosocial outcomes Current Opinion in Endocrinology, Diabetes and Obesity 23 (2), 172-179
T F. Beek, PT Cohen-Kettenis, BPC Kreukels Gender incongruence/gender dysphoria and its classification history International Review of Psychiatry 28 (1), 5-12
B Kuiper, P Cohen-Kettenis Sex reassignment surgery: a study of 141 Dutch transsexuals Archives of sexual behavior 17, 439-457
HEH Pol, PT Cohen-Kettenis, NEM Van Haren, JS Peper, RGH Brans, … Changing your sex changes your brain: influences of testosterone and estrogen on adult human brain structure European Journal of Endocrinology 155 (Supplement_1), S107-S114
TC Van de Grift, E Elaut, SC Cerwenka, PT Cohen-Kettenis, … Surgical satisfaction, quality of life, and their association after gender-affirming surgery: a follow-up study Journal of sex & marital therapy 44 (2), 138-148
BPC Kreukels, PT Cohen-Kettenis Puberty suppression in gender identity disorder: the Amsterdam experience Nature Reviews Endocrinology 7 (8), 466-472
D Slabbekoorn, SHM Van Goozen, J Megens, LJG Gooren, … Activating effects of cross-sex hormones on cognitive functioning: a study of short-term and long-term hormone effects in transsexuals Psychoneuroendocrinology 24 (4), 423-447
E Coleman, W Bockting, M Botzer, P Cohen-Kettenis, G DeCuypere, … & Zucker, K.(2012). Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7 International journal of transgenderism 13 (4), 165-232
SHM Van Goozen, PT Cohen-Kettenis, LJG Gooren, NH Frijda, … Activating effects of androgens on cognitive performance: Causal evidence in a group of female-to-male transsexuals Neuropsychologia 32 (10), 1153-1157
MSC Wallien, H Swaab, PT Cohen-Kettenis Psychiatric comorbidity among children with gender identity disorder Journal of the American Academy of Child & Adolescent Psychiatry 46 (10 âŠ
YLS Smith, SHM Van Goozen, AJ Kuiper, PT Cohen-Kettenis Transsexual subtypes: Clinical and theoretical significance Psychiatry research 137 (3), 151-160
TC van de Grift, PT Cohen-Kettenis, TD Steensma, G De Cuypere, … Body satisfaction and physical appearance in gender dysphoria Archives of sexual behavior 45, 575-585
PT Cohen-Kettenis, SHM Van Goozen Pubertal delay as an aid in diagnosis and treatment of a transsexual adolescent European child & adolescent psychiatry 7 (4), 246-248
BPC Kreukels, IR Haraldsen, G De Cuypere, H Richter-Appelt, L Gijs, … A European network for the investigation of gender incongruence: the ENIGI initiative European Psychiatry 27 (6), 445-450
PT Cohen-Kettenis, SEE Schagen, TD Steensma, ALC de Vries, … Puberty suppression in a gender-dysphoric adolescent: a 22-year follow-up Archives of sexual behavior 40, 843-847
ALC de Vries, TD Steensma, PT Cohen-Kettenis, DP VanderLaan, … Poor peer relations predict parent-and self-reported behavioral and emotional problems of adolescents with gender dysphoria: a cross-national, cross-clinic comparative analysis European child & adolescent psychiatry 25, 579-588
TF Beek, BPC Kreukels, PT CohenâKettenis, TD Steensma Partial treatment requests and underlying motives of applicants for gender affirming interventions The journal of sexual medicine 12 (11), 2201-2205
J Drescher, PT Cohen-Kettenis, GM Reed Gender incongruence of childhood in the ICD-11: controversies, proposal, and rationale The Lancet Psychiatry 3 (3), 297-304
KJ Zucker, PT Cohen-Kettenis, J Drescher, HFL Meyer-Bahlburg, … Memo outlining evidence for change for gender identity disorder in the DSM-5 Archives of Sexual Behavior 42, 901-914
TC Van De Grift, E Elaut, SC Cerwenka, PT Cohen-Kettenis, … Effects of medical interventions on gender dysphoria and body image: a follow-up study Biopsychosocial Science and Medicine 79 (7), 815-823
SEE Schagen, PT Cohen-Kettenis, HA Delemarre-van de Waal, … Efficacy and safety of gonadotropin-releasing hormone agonist treatment to suppress puberty in gender dysphoric adolescents The journal of sexual medicine 13 (7), 1125-1132
TO Nieder, M Herff, S Cerwenka, WF Preuss, PT Cohen-Kettenis, … Age of onset and sexual orientation in transsexual males and females The journal of sexual medicine 8 (3), 783-791
PT Cohen-Kettenis Gender identity disorder in DSM? Lippincott Williams & Wilkins
TD Steensma, PT Cohen-Kettenis Gender transitioning before puberty? Archives of sexual behavior 40, 649-650
LJJJ Vrouenraets, AM Fredriks, SE Hannema, PT Cohen-Kettenis, … Early medical treatment of children and adolescents with gender dysphoria: An empirical ethical study Journal of Adolescent Health 57 (4), 367-373
PT Cohen-Kettenis, TD Steensma, ALC De Vries Treatment of adolescents with gender dysphoria in the Netherlands Child and Adolescent Psychiatric Clinics 20 (4), 689-700
I Becker, TO Nieder, S Cerwenka, P Briken, BPC Kreukels, … Body image in young gender dysphoric adults: a European multi-center study Archives of sexual behavior 45, 559-574
PT Cohen-Kettenis, SHM Van Goozen, CD Doorn, LJG Gooren Cognitive ability and cerebral lateralisation in transsexuals Psychoneuroendocrinology 23 (6), 631-641
BPC Kreukels, B Köhler, A Nordenström, R Roehle, U Thyen, C Bouvattier, … Gender dysphoria and gender change in disorders of sex development/intersex conditions: results from the dsd-LIFE study The Journal of Sexual Medicine 15 (5), 777-785
PT Cohen-Kettenis, D Klink Adolescents with gender dysphoria Best Practice & Research Clinical Endocrinology & Metabolism 29 (3), 485-495
TD Steensma, J Van der Ende, FC Verhulst, PT CohenâKettenis Gender variance in childhood and sexual orientation in adulthood: A prospective study The Journal of Sexual Medicine 10 (11), 2723-2733
SHM Van Goozen, D Slabbekoorn, LJG Gooren, G Sanders, … Organizing and activating effects of sex hormones in homosexual transsexuals. Behavioral neuroscience 116 (6), 982
AL De Vries, TA Doreleijers, PT Cohen-Kettenis Disorders of sex development and gender identity outcome in adolescence and adulthood: understanding gender identity development and its clinical implications.Pediatric endocrinology reviews: PER 4 (4), 343-351
AS Staphorsius, BPC Kreukels, PT Cohen-Kettenis, DJ Veltman, … Puberty suppression and executive functioning: an fMRI-study in adolescents with gender dysphoria Psychoneuroendocrinology 56, 190-199
C Schneider, S Cerwenka, TO Nieder, P Briken, PT Cohen-Kettenis, … Measuring gender dysphoria: a multicenter examination and comparison of the Utrecht gender dysphoria scale and the gender identity/gender dysphoria questionnaire for ⊠Archives of Sexual Behavior 45, 551-558
SEE Schagen, FM Wouters, PT Cohen-Kettenis, LJ Gooren, SE Hannema Bone development in transgender adolescents treated with GnRH analogues and subsequent gender-affirming hormones The Journal of Clinical Endocrinology & Metabolism 105 (12), e4252-e4263
MSC Wallien, R Veenstra, BPC Kreukels, PT Cohen-Kettenis Peer group status of gender dysphoric children: A sociometric study Archives of Sexual Behavior 39, 553-560
MSC Wallien, KJ Zucker, TD Steensma, PT Cohen-Kettenis 2D: 4D finger-length ratios in children and adults with gender identity disorder Hormones and Behavior 54 (3), 450-454
R Blanchard, KJ Zucker, PT Cohen-Kettenis, LJG Gooren, JM Bailey Birth order and sibling sex ratio in two samples of Dutch gender-dysphoric homosexual males Archives of Sexual Behavior 25, 495-514
E Hoekzema, SEE Schagen, BPC Kreukels, DJ Veltman, … Regional volumes and spatial volumetric distribution of gray matter in the gender dysphoric brain Psychoneuroendocrinology 55, 59-71
ALC De Vries, PT Cohen-Kettenis, H Delemarre-Van De Waal Clinical management of gender dysphoria in adolescents International Journal of Transgenderism 9 (3-4), 83-94
SB Levine, GR Brown, E Coleman, PT Cohen-Kettenis, JJ Hage, … The standards of care for gender identity disorders Journal of psychology & human sexuality 11 (2), 1-34
L Cohen, C De Ruiter, H Ringelberg, PT CohenâKettenis Psychological functioning of adolescent transsexuals: Personality and psychopathology Journal of clinical psychology 53 (2), 187-196
SR Vance Jr, PT Cohen-Kettenis, J Drescher, HFL Meyer-Bahlburg, … Opinions About the DSM Gender Identity Disorder Diagnosis: Results from an International Survey Administered to Organizations Concerned with the Welfare of ⊠International Journal of Transgenderism 12 (1), 1-14
NM de Graaf, PT Cohen-Kettenis, P Carmichael, ALC de Vries, K Dhondt, … Psychological functioning in adolescents referred to specialist gender identity clinics across Europe: a clinical comparison study between four clinics European child & adolescent psychiatry 27, 909-919
TC Van de Grift, PT Cohen-Kettenis, E Elaut, G De Cuypere, …A network analysis of body satisfaction of people with gender dysphoria Body image 17, 184-190
AJ Kuiper, PT Cohen-Kettenis Gender role reversal among postoperative transsexuals International Journal of Transgenderism 2 (3), 1-6
SL Bungener, TD Steensma, PT Cohen-Kettenis, ALC De Vries Sexual and romantic experiences of transgender youth before gender-affirmative treatment Pediatrics 139 (3)
KJ Zucker, R Green, S Coates, B Zuger, PT CohenâKettenis, GM Zecca, … Sibling sex ratio of boys with gender identity disorder Journal of Child Psychology and Psychiatry 38 (5), 543-551
TD Steensma, PT Cohen-Kettenis, KJ Zucker Evidence for a change in the sex ratio of children referred for gender dysphoria: data from the center of expertise on gender dysphoria in Amsterdam (1988â2016) Journal of Sex & Marital Therapy 44 (7), 713-715
LJJJ Vrouenraets, AM Fredriks, SE Hannema, PT Cohen-Kettenis, … Perceptions of sex, gender, and puberty suppression: A qualitative analysis of transgender youth Archives of sexual behavior 45, 1697-1703
S Cerwenka, TO Nieder, P Cohen-Kettenis, G De Cuypere, … Sexual behavior of gender-dysphoric individuals before gender-confirming interventions: a European multicenter study Journal of sex & marital therapy 40 (5), 457-471
Media
Archief Gedragswetenschappen (ADNG) (October 4, 2021). Peggy Cohen-Kettenis (1948) Oral History ADNG. https://www.youtube.com/watch?v=ZDO4FkI5F9o
Resources
LinkedIn (linkedin.com)
Amsterdam UMC (amsterdamumc.org)
- Peggy Cohen-Kettenis
- amsterdamumc.org/en/research/researchers/peggy-cohen-kettenis.htm