Transgender medicalization and the attempt to evade psychological distress

Abstract

In this paper the author argues that trans‐identification and its associated medical treatment can constitute an attempt to evade experiences of psychological distress. This occurs on three levels. Firstly, the trans person themselves may seek to evade dysregulated affects associated with such experiences as attachment trauma, childhood abuse, and ego‐alien sexual feelings. Secondly, therapists may attempt to evade feelings, such as fear and hatred, evoked by engaging with these dysregulated affects. Thirdly, we, as a society, may wish to evade acknowledging the reality of such trauma, abuse and sexual distress by hypothesizing that trans‐identification is a biological issue, best treated medically. The author argues that the quality of evidence supporting the biomedical approach is extremely poor. This puts young trans people at risk of receiving potentially damaging medical treatment they may later seek to reverse or come to regret, while their underlying psychological issues remain unaddressed.

Response to ‘Transgender medicalization and the attempt to evade psychological distress’ (Withers 2020) and to Herdzik’s (2021) response to Withers

“…Diese Antwort auf Withers (2020) und Herdzik (2021) ist eine Einladung für uns alle, unsere aktivierten Komplexe für die Arbeit mit Transgenderthemen und die Fluidität der Queer-Erfahrung einzusetzen. Die Vielfältigkeit des Selbst versucht, durch analytische Prozesse erkannt zu werden.…”

“…This reflection is a response to both the Withers (2020) article from JAP, 'Transgender medicalization and the attempt to evade psychological distress' and to Herdzik's (2021) response to Withers (2020).…”

“…How might the analytic dyad co-construct an initial idea around the frame and the possible goals of analysis? I am activated by this article (Withers 2020) and its response (Herdzik 2021) and so I wish to assert that analytic attitude needs to contain some understood elements: it is a listening, it is a place of discernment, it is a co-constructed vessel where discernment and the development of greater consciousness that enables conscious choice may be tended and grown. By understood, I mean that analyst and analysand need to explore the frame together.…”

“…As the responder (Herdzik 2021) to Withers (2020) states, personal choice is indeed paramount around the subject of gender identity. However, personal choice is often not sufficiently conscious.…”

“…The activated complexes at play in both the Withers (2020) article and in the response to it (Herdzik 2021) are treasures for the work if they can be held in a conscious tension and if they can be addressed in an unfolding dialectic. What is activated here offers a potential for the embodiment of new consciousness.…”