Support is the only healthy approach towards those with gender dysphoria - opinion

Several years ago, a person (I am being deliberately vague for confidentiality reasons) came to me for consultation.

They were referred to me by their physician who told me that the referral was made so that I might help them cope with a very difficult life decision. He was not specific and gave me no more details. 

As a psychologist specializing in treating individuals who experienced trauma, in particular the trauma of sexual abuse, I have seen many individuals who have difficulties in their lives. They often come to me because they have a variety of psychological issues combined with relationship troubles and even medical distresses.

I was anticipating that this new referral would fall into that general category of someone who survived a trauma and needed some help and guidance to create a sense of resilience. That was not the case.

The person I met, a 20-year-old, came to me with a parent. They came to me because they were considering beginning the process of changing their gender. I did a typical and thorough intake. There were no signs of anxiety or depression. There was no history of any trauma that the person experienced. They came from a well-functioning; loving family and they were on a successful academic path leading to a terminal degree in a professional field.

This person had not been bullied in school and reported that they had never discussed their gender dysphoria with anyone other than their parents, not a teacher, nor a school counselor and not even with a friend. Their parent confirmed that even at the age of two years old this now 20-year-old did not follow any of the typical norms of their biological gender. The only reason they came to me was to confirm their desire to undergo a change, to become a different gender than what they were born in, to be transgender.

As I had no experience in this area save for having briefly viewed the treatment of a transgender individual for an anxiety disorder while an intern I referred them on to someone who I thought could help them. This experience left me curious so I began to research the topic of transgenderism. 

My research focused on the statistics and available history of this human phenomenon. Suffice it to say that there is historical information going back to the 1800s about individuals wanting to change the gender they were born in. Surgical procedures were performed for decades well before much was known about the hormones needed to assist in the process of altering one’s gender.

I am not an advocate for making this type of alteration to someone’s biological makeup, certainly that of a minor, without an extensive understanding of the individual’s issue, lifestyle and biological makeup. And even if such a radical intervention is undertaken that it be done with the proper support. However, there seem to clearly be occasions when such an intervention may be warranted.

Statistics within the LGBTQ+ community

Statistically it seems that those who wish to change their biological genitalia and become a member of another gender are about 5% of the world population. Gender dysphoria, as defined by the DSM 5, is experiencing clinically significant distress or impairment related to gender incongruence, which may include desire to change primary and/or secondary sex characteristics. However, not all transgender or gender diverse people experience gender dysphoria. 

Homosexuality occurs in about 10% of the population. When it comes to homosexuality, there are many disbelievers, but it seems clear at this point that boys given dolls to play with or girls having toy hammers and saws in their play trays does not create homosexual tendencies. 

It seems abundantly clear from the available research that individuals who are homosexual are born that way. Sexual trauma may cause questions about one’s ability to engage in a healthy sexual relationship but does not seem to cause someone to become homosexual. 

Similarly, at this point, while the data is not yet conclusive, there is reason to believe that gender dysphoria or the desire to change one’s gender may be related to something that takes place in the womb. There are reports that children are requesting sex change operations and some who have changed their gender are requesting to change back. 

It is hard to know at this point, how high these numbers are. Children may not be capable of the awareness necessary to decide to have a sex change but adults, with the proper evaluations, are.

Regulating or demeaning the struggle that individuals have with their gender identity only causes increased anxiety, depression and pain. Understanding the stress that people have and providing understanding and support is the only healthy approach.

That person who was referred to me recently called to thank me for helping them to get the help they needed.

The writer is a fellow of the American Psychological Association and an APA Presidential Citation Awardee recognized for his work in the field of trauma, abuse and resiliency. He has written several books including The Shidduch Crisis: Causes and Cures and Abuse in the Jewish Community, and is the producer of a soon to be released documentary about sexual abuse. He is a resident of Netanya.