In some recent posts I've noticed quite a few references to Gatekeeping, almost always in negative contexts.
My understanding of the definition of Gatekeeping is: Health care providers who intentionally withhold treatment or recommendations that facilitate the progression of transition from Transgender patients based on non-clinical, unprofessional bias.
I read this as: Doctors or therapists with personal issues with Transgender patients, where those issues directly interfere with or contradict established Standards of Care.
I see this as a very separate and specific issue with individual providers that should not be confused or lumped in with the fact that Standards of Care exist, and for good reason.
For every "Well, I never needed to talk to anyone about my feelings and self-medicated my way to happiness!" there are likely five times the number of people who directly benefited from a measured, paced, and medically monitored transition.
I am happy for people that are happy, as we all should be I hope, and there is absolutely a "regardless of how you got there" component to that.
Where that breaks down for me is when folks who have successfully gone from point A to point B in their lives, specifically without the use of therapy or medical supervision, label all activities that do fall within a Standards of Care structure as "Gatekeeping" and unnecessary. There is danger there in the codified dismissal of transitioning under supervision in my opinion, especially in a place where a great many are here seeking definitions and contexts to embrace, often for the first time.
If a medical or mental health provider is exhibiting bias that is obstructionist and unprofessional, report them and then find another provider.
I feel pretty strongly that labeling all medical and mental health interactions that may comprise a Standard of Care as "Gatekeeping" is an intentional political misnomer steeped in a "I did it, so of course it applies to everyone!" posture often combined with a "No-one has the right to tell me what to do!" self-entitled arrogance.
"YMMV" gets tossed around a lot, and I feel that there are fewer things that are more personal or more subjective to any individual than going through a transition. The level of sharing here is appreciated even more in light of that, right up until "YMMV" somehow turns into "ONE SIZE FITS ALL." Any gross simplification of complex mechanisms feels amazingly dangerous when health and well-being are the focus.
Being aware of labeling, broad brush strokes and oversimplified generalizations based on agendas, and an awareness of avoiding such things makes it easier to distinguish opinion based on specific personal experience and opinions that are disingenuously presented as iron-clad facts to further a single, agenda-driven perspective.
Semantics and context both matter in hugely significant ways in environments like this where all we have to interpret is the written word. It is not my intent to start a flame war here, nor judge or disparage anyone's personal path or the choices they have made.
I am talking about how information is presented and communicated and how best to maintain some measure of objectivity in the terminology we use and share.
-Miki
