Affirmative care vs mental health, a confused noob

[Kohn]

I recently read a lengthy article in the atlantic emphasizing that various mental health issues can lead an individual to believe that they are experiencing gender dysphoria when in reality they are attempting to find a cure-all for their other issues while ignoring the underlying cause of those feelings. It cited a number of people who have de-transitioned, having experienced no relief of their symptoms after physical intervention. It went on to say that this by no means suggests that people shouldn't transition, but that more care must be taken in differentiating symptoms of various conditions from true gender dysphoria. I understand that this is relatively rare, but am led to believe that it does happen and, as the article suggests, can be exacerbated by cases in which gender clinics are over-ready to write referrals. So I would like to ask how frequently you think post-operative/post-hormonal regret happens and what proportion of adults this affects, as the article refers only to juveniles and adolescents. Further, I would like to ask if anyone knows any trans women who have experienced this as the examples listed in the article were only women who had decided that transition to male had not helped. Lastly, how long in general do people go between starting to figure out their gender identity in early adulthood and starting physical intervention/correction?

[KathyLauren]

Detransitioning is probably less common than the popular media would like us to think.  It does happen, though. 

I suspect it is more common among those who use the "informed consent" model rather than the WPATH model.  It is easy to badmouth the "gatekeeping" that the WPATH model incorporates, but the reason behind all the annoying consultations and referrals and letters is to prevent transitions that don't stick.

[Dena]

It's possible to transition with minimal or no therapy, something I don't recommend. If you think your transgender, most likely you are but that doesn't ensure there isn't an underlying problem. There are member on this site who have other normal conditions like schizophrenia, bipolar, multiple personality, depression not related to GD, relational issue, abused as a child and other issues. One should undertake enough therapy to ensure that if these conditions exist, they are addressed before the decision for surgery is made. If the issues aren't addressed, there is a very real danger that the surgery will be blamed for their problem and they will de-transition. Ideally when you complete surgery, you should be steping into a new problem free life.

There are some conditions that may require life long treatment such a bipolar or schizophrenia however as long as these issues are properly controlled, they shouldn't prevent a transition. How much therapy is required? That somewhat depends on the honesty of the patient and how quickly the issues are resolved. For somebody with serious issues, maybe once a week. For somebody free of issues, possibly a few appointments after the initial diagnosis.

[AnonyMs]

If you mean the recent article "When Children Say They're Trans", that's getting a lot of criticism in the trans community and the author Jesse Singal has a very poor reputation.

[Devlyn]

Nonetheless, this is included in the article:

" A study on "bottom surgery,"or surgery designed to construct a penis or vagina, found that from 1972 to 2015, "only 0.6 percent of transwomen and 0.3 percent of transmen who underwent [these procedures] were identified as experiencing regret."

https://www.theatlantic.com/magazine/archive/2018/07/when-a-child-says-shes-trans/561749/

[Michelle_P]

Nonetheless, this is included in the article:

" A study on "bottom surgery,"or surgery designed to construct a penis or vagina, found that from 1972 to 2015, "only 0.6 percent of transwomen and 0.3 percent of transmen who underwent [these procedures] were identified as experiencing regret."

https://www.theatlantic.com/magazine/archive/2018/07/when-a-child-says-shes-trans/561749/

And it is also worth noting that other surgeries, even for life threatening conditions, have a much higher portion of patients experiencing regret.  About 1 in 5 men regret prostate surgery for cancer, for example.

Gender Confirmation Surgery (GCS) is generally accompanied by psychological screening and medical education for the patient far in excess of almost any other surgery.

[Paige]

Nonetheless, this is included in the article:

" A study on "bottom surgery,"or surgery designed to construct a penis or vagina, found that from 1972 to 2015, "only 0.6 percent of transwomen and 0.3 percent of transmen who underwent [these procedures] were identified as experiencing regret."

https://www.theatlantic.com/magazine/archive/2018/07/when-a-child-says-shes-trans/561749/

It seemed to me that almost all the examples given in this article were of FTM people but the author continually generalized to the whole transgender population.  Did anyone else notice this?

As for the 1972 to 2015 study, it's also been pointed out here many times that much of the early regret stemmed from the lack of societal acceptance.

[Paige]

An interesting counter point of view:

Private Messages Reveal the Cis Journalist Groupthink Behind Trans Media Narratives
https://jezebel.com/private-messages-reveal-the-cis-journalist-groupthink-b-1827041764

[annaleaver]

I recently read a lengthy article in the atlantic emphasizing that various mental health issues can lead an individual to believe that they are experiencing gender dysphoria when in reality they are attempting to find a cure-all for their other issues while ignoring the underlying cause of those feelings. It cited a number of people who have de-transitioned, having experienced no relief of their symptoms after physical intervention. It went on to say that this by no means suggests that people shouldn't transition, but that more care must be taken in differentiating symptoms of various conditions from true gender dysphoria. I understand that this is relatively rare, but am led to believe that it does happen and, as the article suggests, can be exacerbated by cases in which gender clinics are over-ready to write referrals. So I would like to ask how frequently you think post-operative/post-hormonal regret happens and what proportion of adults this affects, as the article refers only to juveniles and adolescents. Further, I would like to ask if anyone knows any trans women who have experienced this as the examples listed in the article were only women who had decided that transition to male had not helped. Lastly, how long in general do people go between starting to figure out their gender identity in early adulthood and starting physical intervention/correction?

From what I've read de-transitioning gets far more media attention relative to the number of cases that would actually warrant it...statistically more trans people live happily having been treated with HRT/post-transition than otherwise.

[Virginia]

VA raising hand as having been misdiagnosed as transsexual. I am a survivor of childhood psychological and sexual abuse and developed a female alter to cope with the trauma. It took 3 years of therapy with two different psychologists after the nightmares and flashbacks began for my doctor to correctly diagnose me with Dissociative Identity Disorder/Multiple Personality Disorder.

You can read more about the devastating effects of my doctor's misdiagnosis in my post, "Childhood Trauma Survivor Misdiagnosed as Transsexual with Gender Dysphoria" at https://www.susans.org/forums/index.php/topic,176195.msg1548804.html#msg1548804 . My female alter Flytrap or I usually chime in on discussions like this so you can learn more by looking through each of our old posts.

[SoupSarah]

Whilst technically the issue of gender dysphoria being the by-product of a mental condition seems to be related to a small number of individuals. For me it was of upmost importance. If you will indulge me I will relate my very recent history.
On being admitted to mental health services in the UK in February this year. My "assessment" interviewer (a trained psychiatrist) fully believed and understood me when I said my "female" side was "another person". That her gender dysphoria was crippling and the fact there were two of us inside one head was causing all the problems. He talked about treatment options for multiple personalities and concluded that he needed to consult with his "boss" and others in the field as I was the first person he had met displaying these symptoms.
4 weeks later I had another assessment. This time with the regional head of the mental health service (the first guys boss). His first words to me were "You are not dissociated, that is very rare. A once in a career patient. Instead we believe you to be a transsexual in denial, and we strongly suggest that you take gender therapy to work through these issues". He persisted for nearly an hour with trying to force me to gender therapy, to accept that I am just a female and have yet to admit it to myself. It was his sole objective.
Luckily?? By this point my condition had progressed by then. I had since the first meeting had a series of "flashbacks" (PTSD like symptom) detailing some horrific childhood sexual abuse that happened to us before the age of 3.
On presenting these "flashbacks" to him, he quickly changed his stance and started exploring our multiplicity.
Just last Wednesday we started trauma therapy, and had a diagnosis for DID.
The point is, I had to wait 5 months for the first appointment, if the NHS had been quicker and more efficient then my "assessment" would of happened before the flashbacks and without anything "concrete" to back up my assertions about multiplicity would now be embarking on gender therapy as opposed to trauma therapy.
I would hope that if that had been the case, the gender therapists would be sufficiently primed to spot people such as me (or "outliers" as some people harshly put it!!). But my doubts that that would actually happen are strong, especially when I talk to some of my transgender friends who seem to skip through gender therapy with little in the way of querying their assertions.
My diagnosis was fundamentally wrong and I believe I was mis-diagnosed solely because cases like mine are diagnosed so rarely. The fact that people like me exist should mean it is considered in all cases because transitioning my gender would be wrong, would probably cause a lot more damage to me and probably would of cost my life.
I understand that people like me (and Virginia above) cause some people in the media to point a big finger at the whole trans* spectrum. That is unfortunate and an issue with those people. It is not our problem that we exist but we are a fact of life, some (maybe a very, very few who knows?) people suffering almost identical symptoms to any other trans person out there are actually victims of some horrific abuse and need a different solution.
We are all human beings and deserve the right to get the correct treatment.
Hugs
Sarah xx