Pathological manliness

So many trans women I meet had worked hard to make men of themselves. I joined the Territorial Army, one was in the police firearms unit and had pointed her gun at a man, willing to shoot him if necessary; others were in the armed forces. The police are necessary, but I do not have the personality for that: I know myself well enough now, and am glad my application to join the Prison Service was rejected.

Here is thirdwaytrans pathologising gender identity. He has detransitioned. A therapist would think of a patient as a person with depression rather than a depressive, and encourage the patient to do the same. The patient is so much more than just the condition, but also thinking of the condition as separate- “That’s the depression talking”- is therapeutic. If they identify as “a depressive” they may feel they cannot change and become harder to treat.

He wants to treat gender dysphoria the same way, as separate from the person and not their authentic self. An identity is not authentic, but a summary, a short-cut to explain that “freezes things into place”. He is wrong, there: it can be a jumping-off point, an understanding which enables me to grope for further understanding, at first without words.

I feel he wants to justify his detransition. He has moved on, not “reverted”: it is new maturity, not failure. He says mindfulness is important in detransitioning, because it loosens identities and the holds they place on us. Strange: my Quaker worship was a way into accepting the need to transition.

I feel all decisions are acceptable, if the person knows the consequences. Yes, you can dress female, or transition; you can have testosterone suppressors and oestrogen, if you realise these may cause permanent physical changes and the risk of sterility is high; you can have vaginoplasty; you can revert.

I feel he pathologises the wrong thing. I have not read his whole blog, but I find little difference in this post from the ignorant person who says I am delusional and a man in women’s clothes is disgusting or sick. Transition let me be more me. I moved from tense, defensive and masked to soft, gentle and peaceful; celebrating my femininity rather than loathing it.

Possibly rather than transitioning a person could be freed from the mask of Masculinity. It is that idea that we must be extremely masculine to pass as men that imprisons us.

The rules of Masculinity are not just in my own mind, or my parents’ understanding, but in the wider community; yet a counsellor observed that trans folk have a very narrow concept of what is acceptable behaviour to be “manly” or “womanly”, where the unafflicted have a much wider range.

My identity is Clare, but seeing myself as soft, gentle and peaceful and coming to value that has been liberating, many years after transition. Though Ann saw me as a gentle boy full of humour and love when I was twenty, and others saw me as other than my self-concept of echt manliness.

The psychotherapist, rather than treating gender dysphoria as sickness or delusion, or transition as the only way of treating it, would attempt with the patient to find and value the human being under the shell of manly pretence. My problem is, I could only do that after transition.

Monet Poplars Epte 1891

12 thoughts on “Pathological manliness

  1. Interesting post. I wonder how much of our masculinity or femininity is due to to the human characteristic of wanting to fit in; to be like others, and we tend to move towards the the extremes of gender identity in order to belong to one group or the other. We move to one or other end of the gender spectrum based on the predominant gender characteristics at the time we become socially aware.

    I question because from my own experience, and that of many other autistics, those on the autism spectrum tend to be less distinctly male or female than non-autistics. My guess is that the instincts that usually drive individuals to conform to a group are not as strong or are missing.

    As a child I didn’t identify with any group, whether that was based on gender, or any other factor. I found all groups to confusing, and generally preferred my own company as a consequence. It might explain why many of my peers couldn’t decide if I was a “queer” or a “queen” – derogatory terms used for gay and trans at that time. I didn’t display enough distinctly masculine characteristics, or displayed too many feminine ones for other boys to feel I belonged, and I was totally unaware that gender characteristics even existed.

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    • I am always grateful for your perspective. I thought of asking you.

      Perhaps it is not instincts so much as abilities. The “normal” boy would read from his peers what is acceptable male behaviour, by emotional signs. You would want to be “normal”, but unable to pick up the signs. I don’t want to stereotype you so much as wonder how people get socialised into particular ways of presenting.

      Simon Baron-Cohen, who researches Autism, finds it hyper-masculine, though I don’t know what he thinks about women with the condition.

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  2. Simon Baron-Cohen sees all autism irrespective of gender as being forms of extreme male behaviour (EMB). However his ideas have never gone down well with autistics, and is also now being questioned by many researchers. Baron-Cohen equates empathising ability with femaleness, and systemising ability with maleness, and using that as the two end points of a scale. Neurotypical people perceive autistics as lacking empathy and being overly interested in categorising things, and that is why the EMB thery has persisted.

    However, I suspect that our brains are hyper sensitive (and that can also include being hyper empathetic), and some our behaviour is a result of sensory overload. If that is correct then one could just as convincingly argue that those on the autism spectrum exhibit Extreme Female Behaviour.

    There’s an interesting article on Disabilities Studies Quarterly that discusses EMB in autism and also raises questions and also questions some assumptions about how we perceive being male and female. I find the section titled “Implications: Alternative Screens” particularly relevant as I think of myself as being male only in terms of physical characteristics. I think the EMB theory fails because it makes the assumption that being male or female is binary.

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  3. Hi Clare πŸ™‚ I’m new to your blog, but I just saw that you have been following thirdwaytrans (TWT) and his arguments for detransitioning. Actually, TWT’s views are a bit softer than what you picture them to be; it’s TWT’s followers who are much more radical πŸ™‚

    TWT might (almost) disagree with ‘gender dysphoria’ being a clinical diagnosis of a mental condition, but in effect what he is always sayings is that many (if not all) people with gender dysphoria also come with other mental conditions (some of which are very, very hard to distinguish from the symptoms of gender dysphoria), and that, according to WPATH, such conditions ought to be treated first, and gender dysphoria ought to be treated last. Before I go on explaining why this must be that way, it’s important to point out that TWT had a childhood trauma which the doctors have completely failed to detect (or, if they did, they did nothing about it) twenty years ago, when he first transitioned to female. Because the gender dysphoria symptoms persisted in his (now her!) case, he/she went to several doctors, until at last someone correctly identified the childhood trauma, worked with TWT to overcome it, which eventually succeeded β€” and, at that point, TWT realized that his transition had been pointless, because all gender dysphoria symptoms he experienced were connected to trauma after all. So he detransitioned and reasoned out, rather correctly, that he could have saved himself all the trouble (and half of his life!) if he just had been correctly diagnosed…

    Of course, TWT is also closely aligned to those who claim that ‘gender dysphoria’ is merely a reflexion of childhood trauma of some sort (they call it ’emasculation syndrome’ or something like that), even if that trauma is not recognized as such. They also read too much Blanchard for my taste πŸ˜› but I’m always open to listening to alternative explanations, so long as they make any sense and are consistent with my personal knowledge and experience (even if limited).

    I don’t think that TWT really wants to ‘treat gender dysphoria’, at least not in the way I see it. What he is constantly pointing at is that some doctors and therapists are not going very deep when exploring all possible issues that may lead to gender dysphoria. And it’s rare to see a case where ‘gender dysphoria’ is the only condition the person has, when finally presenting themselves to the doctor β€” very likely, they are depressed as well, or at least anxious, or… any of the many thousands of possibilities resulting from a lifetime of repressing one’s true feelings.

    The problem with most of those mental conditions is that the brain is literally working differently. It’s not just merely a way of thinking, or of feeling, that changes. The actual brain is not working correctly. But people experiencing those conditions actually don’t notice that something might be wrong with them β€” for them, everything seems perfectly ‘normal’. I like to give an example that everybody will understand: imagine that you’re both gender dysphoric but also paranoid. You view the world as a place where ‘they’ are out there to get you, and your only chance is to change your gender, to escape their clutches. Now, because you genuinely believe in that narrative β€” you’re not making it up β€” you will, indeed, truly believe that transition is your only choice to escape ‘them’, and you exhibit all the symptoms that are clearly associated with gender dysphoria. Eventually you will conclude that the doctors you consult with, and who attempt to treat your paranoia instead of granting you the desired transition, are just part of ‘them’ as well β€” they’re trying to trick you to believe them. You escape the system, go abroad, get the required hormonal therapy and surgery in a country where nobody asks who you are. Finally, on the ‘day after’, you breathe with relief: now you’re female, now ‘they’ cannot get at you. But suddenly you realise that everybody in the hospital actually knows about you β€” how can you be absolutely sure that none of the staff members work for ‘them’? The paranoia persists and eventually leads to suicide…

    Naturally enough, this is an extreme case, very, very exaggerated, just to illustrate my point, because people are much more aware of how delusional paranoia works: they can understand that a paranoid person truly and firmly believes in their narratives β€” to the point of being able to take their own lives, if necessary. And we can also understand that if such a person exhibits all symptoms of gender dysphoria as well, it makes sense to cure them from paranoia first, because the actual transition will never treat their paranoia β€” it will possibly lessen the effects of gender dysphoria, at best, but the paranoia will only get worse if left untreated. And once it gets treated, one might realize, after all, that there was no point in transitioning β€” the delusion was all about paranoia.

    This does not mean that all gender dysphoric cases are actually consequences of some sort of mental condition (unfortunately, that’s exactly what Blanchard’s followers, and many people commenting on thirdwaytrans, actually believe…). Some of them might be, most will not be. In fact, the best way to figure it out is to treat them first for their anxiety/depression/paranoia/trauma/compulsive behaviour/whatever. If the symptoms of gender dysphoria remain afterwards, then it’s absolutely clear that the person has always been gender dysphoric, and they should get a recommendation for transition. Because they have been cured of whatever mental condition they had, this will also mean that their transition will be comparatively smooth and they will achieve their desired results with a very high success rate.

    On the other hand, someone who enters transition with their other mental conditions untreated… it’s a shot in the dark. It might get better β€” the symptoms of gender dysphoria might disappear, and that, in turn, might lessen the anxiety/depression/trauma effects/etc. But the symptoms might not disappear at all (as in TWT’s case). These people might only then return to the doctor and get treated for their other mental conditions β€” but will now have to deal with two separate things: the issues about living their new lives as the gender as they identify with AND getting treated for whatever ails their minds. This might simply be too much. TWT took twenty years to reach that point. Others might reach it much sooner.

    Although my personal circle of friends who underwent transition, or have just begun it, is rather small, I can see this happening a lot. Two cases that I’m familiar with have serious anxiety problems, but they care little about their anxiety β€” they don’t see it as a ‘real’ disease. What they want is to get through transition as quickly as possible and start living their lives as they always dreamed. But that, in turn, is also a symptom of anxiety! In some cases, I have seen anxious people struggling with the problem of not passing, of getting ‘read’, of being rejected for being transgender, and so forth, and this, of course, has become much more worse now that they have completed transition and are jobless. By contrast, I’m also aware of those who have dealt with all their mental conditions first and only then begun their transition, full of confidence and with a high self-esteem. Many don’t even care about how others view them; they just go on with their lives. So there is a good reason why the WPATH suggests that all mental conditions ought to be treated first, and only if the symptoms of gender dysphoria persist, then the transition should go ahead.

    Activists (and anxious transgender people!) naturally disagree with such an approach, they strongly believe that doctors should not have a saying in one’s desire to transition. But the problem is that one might not be fully functional and being able to make decisions.

    I remember my first therapy sessions. Before the very first of them, I thought that I was possibly wasting the doctor’s time. I have no idea if I’m transgender or not: I’ve got a serious (atypical) depression, and that changes so much the way I look at things, that I cannot trust my own judgement. It took me a long while to understand (indirectly, and mostly with the help of my wife) that my brain wasn’t working as it should β€” actually, it took years until that happened. And when I finally realized that my brain wasn’t working properly, I got scared β€” because I always wondered if I shouldn’t transition or not (long story), and now I was feeling the effects of suppressing and repressing the gender I identify with, and I was almost a classical textbook case. So when my psychologist first asked me if I was transgender, I seriously told her that I had no idea. I had a depression and could not trust my own judgement. I strongly believe that I ought to have been born with a female body, but I have no idea if that belief comes from a decade-long depression (starting before my teens) which just became more and more serious β€” which progressively made me unable to do my job, but also increased the intensity and anxiety from gender dysphoria, which became more and more acutely felt. So which is causing which? Am I depressed because I’m gender dysphoric (that’s my own belief), or am I gender dysphoric for being depressed for so long (which is a possibility)? I have no idea, because depression twists one’s perceptions of the world (and of themselves), so I might just be deluding myself. What are my choices? Simple: I have to get the opinion of an expert, who can figure it out from a detached point of view; and I have to get treatment for depression & anxiety (both of which can be cured) and see if the gender dysphoria persists. But how many people are really willing to trust their doctors like I do? The transgender people I know totally mistrust doctors and therefore mistrust their judgements and their recommendations; some people I know, for instance, never take their anxiolytics, believing that their anxiety is merely anticipation of a forthcoming transition β€” and completely fail to take into account all other symptoms of anxiety β€” like irritation and aggressivity, for example β€” which, in turn, makes everybody shun them, and, ultimately, gets them on a collision course with their doctors.

    It’s hard. It’s really hard. But in conclusion: I don’t think that TWT’s point is that gender dysphoria should be pathologised, but rather that the evaluation of gender dysphoria has to be done in a context where all other mental conditions have to be taken into account as well, even though transgender people might not even be aware of those conditions.

    I’m not really ‘defending’ TWT, and of course I disagree with a lot of his views and opinions (and I struggle in believing that he never got a therapist who diagnosed his childhood trauma during his original transition β€” how bad were those doctors?). But I think that he has made a point. Of course he’s also continuing his own narrative and justifying it, but he also raises the important issue of making sure that all mental conditions are treated first, exactly as per WPATH recommendations, and only afterwards deal with the transition.

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    • I think this is a fairly good summary of my position. I did focus a lot on trauma at first, because that is what was important to my own story and I fall into the all too human assumption that other people are like me. I don’t actually see trauma as being the sole cause of gender dysphoria, nor do I think that all people with gender dysphoria and that transition have trauma. I see gender dysphoria as being caused by multiple factors including biological factors, sexuality, general temperament, trauma and dissociation, and internalized rigid gender roles. Maybe also psychosis or other mental illness in some cases. I don’t think all people have all of these factors.

      The point I try to make is that it would be best to sort through some of these factors prior to transition as particularly acting from trauma or internalized rigid gender roles is not an ideal thing. Even then transition may be the right course as things can have gone too far to do otherwise.

      I definitely don’t believe that transition is caused solely by a fetish or AGP or anything like that, and it is true that sometimes people who like my work do believe that.

      Yes, what happened to me, is partly a product of bad doctoring, the thing that concerns me is the practices of no assessment/evaultions are becoming the norm at least in much of the USA. What happened to me was a violation of the WPATH SOC that existed at that time, but not the standards today.

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      • thirdwaytrans, I’m glad I haven’t misrepresented you! Actually, I originally came across your blog at a time shortly before my first session with a psychologist. At that particular time, I was both struggling under the effects of depression (and the incredible amount of intolerance against people with depression that I met, which baffled me at first!) and the acute feelings of gender dysphoria, although I was very wary of going all the way through transition: I wanted a bit of professional advice first, even if it wasn’t what I wanted to hear. At the same time, and thanks to my own wife, I was starting to become aware that I was not really thinking properly, i.e. some of my reactions β€” analysed after the fact! β€” were irrational and not typical of me. Even though it’s very hard, in this situation, to truly think ‘outside the box’ β€” one does indeed think according to one’s perceptions, and when those change (due to depression, anxiety, etc.), it’s difficult to see the world as before β€” I tried at least to make an effort to stop reading about all those success stories on the Internet. What about the not-so-successful stories? What about misdiagnosis? What about those who refused any treatment and jumped straight into transition β€” just regretting it later? Did they write about their experience? What went wrong, or what did they think that went wrong? The truth is, few have bothered their story.

        You were one of the exceptions, and while I might not be an assiduous reader of all of your blog, it definitely reinforced my idea that transitioning without medical support is really a bad idea but one should also be very careful about what doctors are saying. Doctors are human and they make mistakes (as they did in your case), but it’s also true that, as both sides (doctor and patient!) have more knowledge, they can work better together in order to achieve higher success rates. It should not be an open fight between both (unfortunately, I know several cases like that). It requires some mutual understanding, yes, but the patient (even with their perceptions potentially clouded) should at least be aware of some of the consequences of a misdiagnosis and make sure that the doctors are thorough in their evaluation.

        In fact, I was actually very frontal with my psychotherapist (and later with the psychiatrist as well): I told them quite clearly that I had opted to consult with specialists in clinical sexology, because I have no doubt that I have symptoms of gender dysphoria. On the other hand, I’m aware that the depression also clouds my judgment. So first I want to get rid of the depression. While doing so, I wish for the doctors to examine all further possibilities, ‘leave no stone unturned’, treat everything that can be treated, and only if there is no alternative left, then I will accept a recommendation for transition.

        And, indeed, they found out quite a lot of things that I had not even suspected myself. The first, of course, was anxiety (which would have been quite easy to spot, but, as said, my own judgement was clouded, and I was not aware of having any anxiety issues β€” even though in two years I had three anxiety attacks and went to the emergencies at the nearest hospital, I did not ‘connect’ those episodes with a pathology of ‘anxiety’, thus proving the point that people with some sort of mental condition are truly not the best judges of their own [other] conditions). But as the psychologist delved deeper in my past (or, rather, allowed me to self-explore my past…), it became clear that there is a lot of ‘garbage’ that I have been carrying with me. Gender dysphoria was probably something I always had, and experiencing the first symptoms of it (as best as I can recall β€” since the lack of memory of early childhood is a symptom of gender dysphoria as well…), I thoroughly repressed them as hard as I could for at least a decade or so, and only slowly I started to accept (to myself) that it was ‘ok to be a crossdresser’. But that took years and years and years β€” way too long β€” and all that constant repression and submission to society’s norms left deep scars in my mind. It will take years to clean up the mess. Actually, one of the first questions of my psychologist was why I didn’t seek for any professional help in the past twenty, or even thirty years β€” instead of letting all the ‘garbage’ pile up and consume me…

        So… to conclude… I struggle with finding a balance in my own (public) opinions. On one hand, I strongly encourage my personal friends, who consider themselves ‘transgender’ in many different ways, to seriously go and talk with a professional or two and seek advice, before they do anything they regret. On the other hand, I’m also aware that doctors make mistakes, and that the ‘right to identity’ ought to be a fundamental right as well, so I support the idea that people ought to make their personal choice about their gender identity as well. But β€” and this is a big ‘but’ β€” this choice has to be made with a clear mind, one that is not clouded by any kind of mental condition which might twist and warp one’s perceptions. In other words, in an ideal world, one ought to be able to decide what gender they legally identify with (or no gender at all) only when they have no symptoms of gender dysphoria at all! This might be a paradox, a contradiction in terms! But the point here is that I believe that gender identity is not truly a choice, and it should not be ‘validated’ by doctors. Instead, the doctors’ job ought to be to help people with gender dysphoria of some degree to get a clear mind by dispelling any clouded perceptions due to trauma/anxiety/depression/etc. in order to allow them the ability to make a decision, fully aware of the consequences.

        I’m aware this is a position that is hard to sustain, since it angers both camps (transgender activists on one side, doctors and the heteronormative society on the other side).

        Oh, and btw, I’m very sorry to hear that the US somehow has changed the WPATH SoC, or at least are ignoring them openly. Although it’s even worse to have had much more stricter SoC in the past and not following them, as it happened in your case…

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    • Welcome, and thank you for commenting: and thank you particularly for sharing so deeply from your own understanding and experience.

      No therapist will tell you to transition. Transition is known to mitigate gender dysphoria, but not to make life perfect. Some people regret and revert. You have to make that decision. If you choose not to decide, you have chosen not to transition.

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  4. Hi,

    I feel like a lot of what you are saying is not actually my position. I have said over and over again that I believe that people should be permitted to choose to transition and that it can improve people’s lives. I definitely see it as one of the possible resolutions to gender dysphoria, it is just not the only resolution.

    Also, I think when I talk about identity, I am talking about identity itself and not specifically about gender identity. I think I am largely reacting to a phenomena in a subset of the younger generation and among a lot of the psychological community where there is almost a worship of identity.

    I actually very much agree with what you describe as what a psychotherapist should do, of helping the person find the human being underneath and letting that go wherever it will. What I am reacting against is the blind “affirmation of identity” without any kind of exploration or caution. This is what happens today, at least in many more liberal cities in the US.

    It can be difficult to talk about this stuff because everything is so politicized and polarized, I certainly don’t think people that transition are sick and disgusting in any way. It is a difficult dilemma which we all have to find our own way through.

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    • Just to pipe in to let you know that the ‘blind affirmation of identity’ is happening on the other side of the Atlantic as well. Perhaps the difference is that, in general, in Europe most people still prefer to enter transition through their national health service (because at least HRT + surgeries will be free, or at least very, very affordable). That means that the first step for most transgender people is first to try to get the transition sponsored by the welfare state, and, as such, it means going through a long process involving many doctors and specialists in the field. Only if they utterly reject the doctors’ evaluation β€” which obviously happens a lot of times β€” or if they believe that the process is taking too much time (which is an almost universal belief) will they start considering alternatives, either side-stepping the national health system, thwarting it to suit their purposes (it’s not impossible; there might always be some ‘friendly’ doctors to sign the desired papers, so long as you know what to say and are willing to hop from institution to institution until you find the ‘right’ doctor), or even simply going abroad to either Brazil or Thailand to get the desired surgeries for a cheap price β€” and return home and presenting themselves in their ‘new bodies’ (and identities) and demand a change of name and gender on their legal documentation, which almost always gets granted.

      So, yes, it happens on this side of the Atlantic as well. It’s no surprise: we’re bathing in American culture and thought, even if we Europeans pretend otherwise πŸ™‚ As a rule of thumb, Europe follows the lead of the US, especially in these kind of things, even though usually a few steps behind. Sometimes this is good because it allows some room for thought, and the ability to avoid some pitfalls and mistakes. But often there is some pressure to ‘keep up with America’, meaning rushing everything to make sure Europe is at the same level as the US, and this means that, on top of the many mistakes that might have been made on the US side, we add our own mistakes on top of that, because of the ‘rushing’…

      I agree, it’s very hard to discuss such things. They definitely are very polarized, highly political, and it’s tough to build bridges among the different camps. We need more moderates, those who have the ability to think things through at a more leisurely pace and that can offer new solutions to old problems β€” even though these might not sound ‘politically correct’.

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    • I am very glad to have you here. I feel your contribution to understanding trans is useful. Thank you for commenting.

      You have a lot of trans-excluder comments on your blog, harping on about sex offenders transitioning, or the threat to women and girls when trans folk can enter their toilets. This creates an atmosphere of hostility to those of us who consider transition. I suggest you moderate such comments: what do you think?

      I do not misrepresent your post. You talk of disidentifying with schizophrenia, depression and gender dysphoria. You suggest that finding a gender identity not assigned at birth can freeze things into place, rather than liberate. Have you a summary of your actual position, say about 1000 words, rather than blog posts on specific aspects of it?

      Do you really perceive “affirmation of identity without exploration or caution”? It took me years to decide to transition. No-one does it on a whim.

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      • I hear your point about having some rad fem commenters and how that might make things feel hostile for people who are considering transition or have transitioned. I have a wide range of commenters and don’t agree with all of their views. There is always a trade off between free speech and safe spaces, and in my blog I have made the choice to be on the free speech end of things. I would make a different choice if I were running a therapy group for example. This has had its downsides for sure but overall I feel it has been a good choice. I like that there are a wide range of commenters from trans people to feminists to conservatives to liberals and many others.

        When I talk about identity I do want to make clear that the fact that is a cross-gender identity is not an issue. I would say the same thing about a same-gender identity. Indeed I think the impulse to transition often comes from the desire to escape a same-gender identity that is confining or constraining their essential being and I see that as a healthy impulse. The question is whether people escape by adopting a different identity that has its own sets of constraints and whether that is necessary or not. I do see my initial transition as a healthy attempt to escape the persona that I had created largely in response to negative childhood forces, however in retrospect it might have been better if I took that symbolically rather than literally. This was something i could not have known then however.

        You are right that I should create a better summary of my position rather than having it scattered through my blog, there is an overview section but I don’t think it really does a good job of that. That is something I will have to think about.

        Yes, I definitely perceive affirmation of identity without exploration or caution. This is a fairly recent trend, probably in the last five years and centered in the USA, although I have talked to a UK psychologist who reported similar things going on too. Also the idea that assessment itself if transphobic and that gender issues can’t possibly relate to other issues. I am particularly concerned about young people, who yes do have a tendency to be more impulsive and rash. Although there is definitely a truth that hormones work better on the MTF side for younger people, which is also an important consideration which makes things challenging. Also arbitrary gatekeeping with made up criteria doesn’t help things either.

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