The man I am trying to be is not me

Australian children and adolescents with gender dysphoria: Clinical presentations and challenges experienced by a multidisciplinary team and gender service

“…A number of factors contributed to this particular challenge. First, the voices of various older patients who perceived themselves as being harmed by the treatments that they had sought and received under the gender affirmative model began to be heard in conferences and news reports (BBC, 2019; Bell, 2020b; D’Angelo, 2020b); these narratives highlighted that children, families, and clinicians had no reliable way of ascertaining whether a child’s decision to engage in irreversible medical interventions for gender dysphoria would prove to be “right” or “wrong” in the long term for that particular individual. Second, the evidence base for using puberty blockers and cross-sex hormones—and for their potential long-term side effects—continued to be sparse and contradictory (Bränström and Pachankis, 2020a, 2020b; De Vries et al, 2011, 2014).…”

“…Another point of view—antithetical to that described above—came to be presented by older patients who regretted their treatment under the gender affirmative model (BBC, 2019; BBC News 2020; Bell, 2020a; D’Angelo, 2017; 2020b) and by clinicians who were concerned about the medicalization of gender questioning or distress, the irreversible nature of some gender-affirming interventions, and the lack of a solid evidence base (D’Angelo, 2020a; Entwistle, 2019). This perspective emphasized that children’s conceptions of themselves are still developing through the teenage years and that they can be harmed when clinicians unquestioningly accept the individual child’s assertion of gender identity or when clinicians fail to challenge the child’s beliefs pertaining to that identity or fail to understand the developmental trajectory that had brought the child to what is often a place of distress and suffering.…”

One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria

“…Failure to include detransitioned and desisted individuals in research regarding psychological interventions for GD is a serious oversight. These individuals, whose transgender identification was transient, may have been hurt by therapies that affirmed them as transgender, and may have benefitted from therapies that helped them successfully ameliorate their GD (D’Angelo, 2020b ).…”

Psychiatry’s ethical involvement in gender-affirming care

“…Josh is a 25-year-old man who transitioned from female to male at the age of 18. 19 Psychiatric evaluation found him to be suitable for medical and surgical transition (testosterone therapy, mastectomy, hysterectomy and oophorectomy). In stark contrast to the positive outcome research, transitioning was unfortunately not liberating for Josh.…”