The use of metaphors in understanding atypical gender identity development and its psychosocial impact

Gender Dysphoria and Psychological Functioning in Adolescents Treated with GnRHa: Comparing Dutch and English Prospective Studies

“…The number of children and adolescents presenting with gender dysphoria (previously labeled as gender identity disorder) has increased rapidly in Western countries. Over the last 15 years, referrals to the Tavistock and Portman NHS Foundation Trust's Gender Identity Development Service in London multiplied by a factor of 60 (Di Ceglie, 2018;Gender Identity Development Service, 2019), while those to the Center of Expertise on Gender Dysphoria in Amsterdam increased ten-fold (Arnoldussen et al, 2020). It has become standard to administer gonadotropinreleasing hormone analogs (GnRHa) to young adolescents diagnosed with gender dysphoria, in order to suppress puberty.…”

Traits of autism spectrum disorder in school-aged children with gender dysphoria: A comparison to clinical controls.

“…Suppose, for example, one wanted to advocate a watchful waiting or wait-and-see approach with regard to the gender dysphoria, with the assumption that the long-term psychosexual trajectory is unclear (Menvielle, Tuerk, & Perrin, 2005). It is possible, for example, that children with a co-occurring ASD would have a harder time tolerating uncertainty (Di Ceglie, 2018) because of their proneness to both cognitive and affective rigidity. If this is indeed the case, advocates of watchful waiting would have to implement therapeutic strategies for helping such youngsters cope better with such uncertainty.…”

Co-ordinating meaning within a gender identity development service: What can the theory of the co-ordinated management of meaning offer clinicians working with young people, and their families, exploring their gender identities

“…Di Ceglie (2018) uses the metaphor of ‘Scylla and Charybdis’ to describe the delicate balance that must be maintained to avoid being drawn into polarised positions in this field, and some of the costs involved even when one is able to manage this balance.…”

“…Butler, De Graaf, Wren, & Carmichael, 2018) being referred than previously. We are unclear about the reasons for this increase and these shifting patterns (possible hypotheses include greater social visibility, social media influences and the availability of a broader range of gender identities (Di Ceglie, 2018)). We have also noticed a greater number of young people presenting in non-binary and gender fluid ways.…”

“…In this shifting constantly changing context with many unknowns, there can be a wish to hold onto some certainties. Some of the challenges above can present ethical and clinical dilemmas for clinicians, which Di Ceglie (2018) suggests can create anxiety around decision making leading to unhelpful action or inaction. The authors have found that the CMM approach gives us a framework for thinking, an approach to our work and some tools which are invaluable for helping us to engage with families.…”