Actually, this is a misconception–the idea that patients have to go through a great deal of psychological evaluation (by a genuine psychiatrist) before starting chemical or surgical intervention. Absolutely false.
I’m sorry, but you’re wrong about this. Accessing transgender healthcare is not done overnight, and the psychiatric evaluation is often not only extensive, but excessive.
It is true that the Standards of Care don’t require therapy to access chemical intervention, even though it is recommended. But even with no therapy, any health worker who refers someone to an endocrinologist has to screen the patient for mental illness that could affect decision-making (basically, rule out delusion).
I’m not simply speaking as a theorist here, but as a trans woman who is currently jumping through hoops to get the necessary treatment. I may live in a conservative country on this (Amnesty, EU and UN have repeatedly accused our government of violating human rights in their treatment of transgender patients), but even in America, you can’t just walk into an endocrinologist’s office and ask for HRT. Take a look at any online transgender forum; they’re generally overcrowded by people who are frustrated over going to therapists and counsellors for ages, yet not receiving the medication they need.
In reality, it is far more common for a transgender patient to commit suicide because of delayed care (sooner or later hope will run out), than for a patient who’s not really transgender to receive it. Guidelines need to be relaxed, not further restricted.
The individual in our family had a whole constellation of symptoms–not just the gender dysphoria. But the psychologist (…) he was now firmly convinced he was born in the wrong body.
I’ll try to tread lightly here, and I’m sorry to hear about your family’s situation; I would not wish being transgender upon anyone.
That said, a constellation of symptoms isn’t abnormal; living with a brain that expects the opposite hormones than what the gonads produce, and that wants to express a different social behavior than what society expects, is torture. Sooner or later, it will cause depressions, anxiety and other problems. I had my first serious depression with suicidal ideation at age 12, and my first (voluntary) stay at a psych ward at age 19. My problems became worse when I repressed everything in my mid-teens because I realized this would not be accepted by my Evangelical surroundings, and my life pretty much went downhill after that. As soon as I accepted myself, problems started to go away; my long-term eating disorder disappeared overnight, for example. I now wish I could have accepted this a lot earlier.
But I’m digressing: My point is that the therapist in question may actually have been right about the individual. They may have concluded that those problems were, indeed, caused by gender dysphoria, not the other way around. In that case, there is no reason why the individual shouldn’t receive HRT. As relatives, you don’t always see the whole story.
Where is he now? Socially isolated (…) essentially, he has missed out on life.
When you reached out to the individual, did you use their chosen name, or insist on their given name? Did you use the pronouns they identify with, or were you sticking to the masculine?
I’m not meaning to interrogate you, but yet, I’ve seen so many stories from the other side, about parents and relatives who allegedly tried to reach out, but simultaneously let it shine through that they would not accept them unless they transitioned back. In those cases, I’m sorry to say I can very well understand why they isolate themselves.
Now if you actually did try to accept them, accepted the name change (if there was one), used the right pronouns, and so on, then I commend you and I’m sorry to hear they made the choice not to relate to you. And I’d have to ask you to forgive my skepticism - but I’ve simply seen too many of these stories to automatically side with the parents or relatives.
The same goes for friends and others, by the way - if friends and others simply refuse to accept them for what they are, it is no wonder many transgender people end up isolated. It is also no wonder why suicides happen. Again, I obviously don’t know if that is the case with this individual’s friends, but it wouldn’t be unheard of.
Lastly, even IF the psychiatrists made the wrong conclusions regarding this individual, and IF the treatment really had the effects you claim (and both would be very big ifs, in my experience), it is not representative of this kind of treatment at all. It would be a rare exception. As I mentioned above, suicide because of doctors stalling the process is vastly more common than being “cheered on”.
Anyhow, this thread is not about my family, and I don’t want to hijack it, but please, please PLEASE be very careful who has access to your son to put ideas in his head and PLEASE be careful what messages he’s receiving from internet and media.
I agree about being careful regarding what kind of health professional they bring their child to, absolutely. I would advise against reparative therapy in absolutely all cases.
If a therapist says they believe HRT and SRS are to be avoided at all costs and should never be done, and/or that transgenderism can be cured through therapy, I would advise staying away at all cost. They simply lack the competence needed to deal with such issues.
But obviously, a therapist should be aware of other, generally acute, conditions (psychosis in particular) which could temporarily cause ideas of being of the other gender. It happens, and in those cases the patient isn’t transgender, and should obviously not receive hormone treatment. If the issues however persist after the problem in question has been treated, it would be time to consider if the gender dysphoria could be real.
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