Many young people who present themselves as gender dysphoric have mental health problems or have suffered abuse or trauma. Yet instead of probing for these causes of distress, therapists are expected to accept their patient’s self-diagnosis.
The transgender craze shows no signs of loosening its grip on society. The impact on children and adolescents has been empathetically discussed by journalist Abigail Shrier in her superb book, “Irreversible Damage”. But what support is there for therapists who work with these young people, especially professionals who can see the dangers?
These are scary times. In the UK, a protocol of agreement (PE) against “conversion therapy”Prevents counselors from probing their client’s self-diagnosis of transsexualism. Rather, professionals who should help their clients explore and understand their psychological distress are expected to affirm whatever their client tells them. Worst, law Project could lead to criminal proceedings against them.
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In an often feverish environment, a new delivered by Susan and Marcus Evans examines the situation from a professional perspective – the perspective of therapists facing young clients who have been convinced they are somehow in the wrong body. “Gender dysphoria: a therapeutic model for working with children, adolescents and young adults” is neither “for” or “against” the transition. The authors – both experienced practitioners in their field – are cautious, especially with regard to young people. They are eager to understand what is going on, rather than just reacting to circumstances,
“We understand that transition is, for some adults, the best way to lead their life and present themselves to the world,” they write. “Instead, this model focuses on the individual concerned, to explore and understand what motivates and motivates them.. “
It’s a refreshing approach for gender dysphoric patients like me. But that’s what I experienced 10 years ago; Before the MOU got in the way of advisers, I switched to the affirmation model. My own counselor forced me to consider alternative responses to my transsexualism. At the time, I hated it – wanted to transition and at all costs – but at least I had an idea of why I could do it, beyond what I had found on the internet.
At least I was an adult and able to make informed decisions. The Evans mainly deal with young people. Having spent their professional lives in the UK NHS, first as mental health nurses, then as psychoanalytic psychotherapists and clinical professors, they speak with expertise and experience,
“The accuracy of diagnosing mental health in children is notoriously prognostically unreliable, as children change during their development,“, they warn.”Children who are diagnosed with something at a particular age can look very different when they reach maturity.. “
When the affirmation gospel opens the door to puberty blockers, cross-sex hormones, and surgery – irreversibly delaying and disrupting this development – it’s a sobering comment. The book exposes the emptiness of this approach: “There can be an excitement around “getting on with hormones” and a lack of serious discussion that would usually accompany any medical treatment program that negatively affects the body.. “
These authors are experts in their field but they plead their case simply and clearly: “What is so often missing is exploring why the person doesn’t love themselves so much in the first place and locate their discomfort in the sex of their native body.“
After setting out the theory, the authors then move on to a series of case studies. These are fascinating real-life glimpses of real people. The analysis that follows each is clearly explained and would be accessible to a wide audience.
Jane, for example, was a fifteen-year-old girl who was referred for an assessment for her gender dysphoria. At the gender clinic, his body language and manners were overly masculine: rolled up sleeves, denim jacket, Dr. Martens boots. She was sitting in her chair with her thighs wide apart and a defiant look on her face. She said she knew she was male and wanted to make the transition by taking hormones.
Who told her she was a man isn’t clear from the book, but maybe it wasn’t clear to Jane? The theory that we all have an innate gender identity that determines whether we’re male or female – or maybe something else? – is as empty as it is ubiquitous. There is no evidence that anyone has a gender identity but, worse than that, it is a lazy label that masks the underlying and distressing psychological issues.
Evans and Evans carefully reconstruct the clinical approach taken with Jane. They tell of the difficulties she encountered in elementary school, where undiagnosed hearing difficulties led to social isolation; how it affected his speech and his studies. How she became more isolated and spent time surfing the internet instead. There, she stumbled upon ideas about transgender identities, which she said helped explain why she had experienced all of these hardships.
The therapist neither confirmed nor denied Jane’s ideas but continued to think more broadly with her. Jane was not impressed, saying: “What we are doing is a total waste of time, I know what I need. I just need some hormones. “
However, as Jane wanted to cut and run, the therapist was tenacious, telling her, “It’s like you’ve decided that what you are now is intolerable, and there’s no point in talking to me or exploring things. But I think it’s important that we keep trying to figure out what’s going on for you.”
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Because no one can cut and run away from these kinds of issues, they come with us because they are us. The lie that it is different has been told so many times that children believe it. Worse, adults who should know better believe it too. Evans and Evans painstakingly analyzed Jane’s response to therapy and – with professional expertise – made it clear.
There is no simple solution to Jane’s difficulties in life, but human psychology is not straightforward. We are all complex individuals and each of us has a unique experience of what it means to be human. But with the other case studies in the book, a picture develops of young people who need to be understood, without being told that they were somehow born in the wrong body.
This book must be read.
Obviously, it should be of interest to professionals working in the field. Whether their professional order – or even the law – allows them to follow the principles suggested in this book is debatable, but they owe it to their patients to push back the restrictions on their practice. As Evans and Evans state, “patients with gender dysphoria need services protected from political activism; the professionals involved must be able to work in an environment free from political intrusions.“
Parents and teachers of children with gender dysphoria will recognize the behaviors the authors describe and explain. If we are to help young people in distress, we need to know why they may be in distress. But this book is accessible to a lay readership and should be read by a lay readership. Society has a responsibility to children, and we all need to understand what happens to young people who have been captured by this infatuation.
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