Things I wish my therapist had said while I was pursuing medical transition

February 6, 2017 1:03 am Published by Leave your thoughts

When anyone – but particularly a young person – feels they may be transgender,  current medical practice is to instantly confirm the patient’s new ‘gender’ and embark on the process of transition. The NHS says gender identity disorder is not a mental illness; it treats the condition as a sort of developmental glitch. The protocols offered include radical hormone treatment, sterilisation, major surgeries and cosmetic treatments. Counselling is not a requirement and may even be withheld from young people until they begin medical transition. In any case, it’s hard to find a therapist with sufficient insight & commitment to question the transgender train’s direction of travel; professional bodies vilify self-acceptance work as ‘conversion therapy’.

There is a huge, fast-growing community of transition desisters, resisters and detransitioners. Their voices are quiet: often because of vicious attacks by their former trans support groups, and also because they’re traumatised. They want to get on with life as they are now – changed; healing; honest – and are justifiably scared that they might be used by both pro-trans and conservative activists. They are finding each other, cautiously starting self-help communities. At present these seem to be single sex groups: there are differences between the respective female & male experiences of gender, sex and medical transition.

I’ve been reading for weeks, wondering if I could ever find a way to write on this vast & complex topic; to honour the incredible wisdom these young people have gained so painfully.

A young woman called Cari (Guide On Raging Stars) shared these four powerful artworks. I felt she’s expressed so much, so succinctly, of what lay behind her dysphoria that it’s best to let her images do most of the talking.

Women feel this, too


“Things I wish my therapist had said to me while I was pursuing medical transition” – 4 words: Women feel this, too. Artwork by Cari ‘raging stars’.

Being female’s never been easy. In many parts of the world, and fairly recently in our society, girls can look forward to a life of literal or effective slavery with frequent, painful, life-threatening traumas. The industrially developed world’s more respectful of female lives these days, but not so much of female personhood. We are poked, prodded, pursued, perved at, assaulted, molested, judged, dismissed, used, abused, restricted … and always taught we aren’t good enough. When the underlying cultural message is that females are inferior males, many girls decide they’d rather be a boy.

If gender dysphoria meant discomfort with one’s supposed gender role (it sounds as if it should), the condition would be perfectly logical and extremely normal!

It seems to me that it makes more sense to deal with the social gender issue, rather than de-sexing the female body. Physical de-sexing doesn’t resolve the issues; in many (most?) cases, it only adds to them.

This could be trauma


“Things I wish my therapist had said to me while I was pursuing medical transition” – 4 words: This could be trauma. Artwork by Cari ‘raging stars’.

It is distressingly usual for young women to experience serious physical and emotional harm – from those closest to them. This double whammy undermines a child’s trust in her own body and in the world around her: we are facing a mental health crisis amongst young people, who are more often traumatised than children should ever be.

Dissociation from the self is a classic response to trauma. Common symptoms include depersonalisation, identity alteration and identity confusion.

There are other ways


“Things I wish my therapist had said to me while I was pursuing medical transition” – 4 words: There are other ways. Artwork by Cari ‘raging stars’.

It’s known that a high percentage of ‘gender non-conforming’ children will develop normally if supported to be themselves without physical alterations. We also know that many of those kids will turn out to be homosexual, so your personal definition of ‘gender conforming’ might be helpful here.

What we don’t know is the exact proportion – because desisters don’t go back to the gender clinic! They discover the right community support for them; they get the therapy that wasn’t available while they were trans. They learn it’s fine to be who they are.

UK society has become more & more gendered in the past few decades: children must be pink or blue, and it seems not to have occurred to most adults that normal kids don’t fit neatly at either end of this gender binary: boys can be gentle & artistic; girls can be tough & strong; each child has their own personality. Kids aren’t being shown enough of the many ways to be female or male.

It’s heartbreaking to think of young people being steered to a lifetime of surgery and medication, merely for having the ‘wrong type’ of character for their sex – but it’s happening.

Stop running from yourself


“Things I wish my therapist had said to me while I was pursuing medical transition” – 4 words: Stop running from yourself. Artwork by Cari ‘raging stars’.

Not only does this image convey a thousand words about Cari’s struggles with her younger self, it also opens the basic existential question: Who am I? Like millions of young adults everywhere, I tried ‘running away from myself’ at that age. I had a lot of fun adventures and several disasters. I’m relieved that radical body alteration wasn’t available to me back then – and profoundly impressed by each one of the detransitioners I’ve read.

I’m saddened by the sheer amount of trauma they’ve already lived through, but equally inspired by their wisdom & courage.



Our response to the BBC’s “Transgender Kids: Who Knows Best?”




Our review of Mermaids Gender in the context of young people’s mental health





Female Detransition & Reidentification Survey





Dissociative disorders, commonly arising from trauma: symptoms may include identity alteration and depersonalisation

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This post was written by Cherry Austin

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