Gender reassignment pipeline: a psychologist’s experience

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I recently spoke to a female psychologist who worked, as part of her post-graduate training, with a gender-reassignment team back in 2008. These are her experiences.

She was brought in to counsel the patients pre-op. First thing she noticed was that  the patients presented completely differently, depending on whether the surgeon was there or not.

The atmosphere in the clinic was full of buzz and excitement about the surgery, and patients often presented extremely enthusiastically. However, when the surgeon wasn’t there, and the psychologist would ask them how they felt, often they would burst into tears.

It transpired that the surgeon as well as a psychiatrist who worked with him, claimed that their psychological problems would go away as soon as the surgery was done. They often made wild claims such as that their genitals will be completely functional as in the opposite sex.

However, and this refers to mostly female trans people, post-operatively they presented depressed and bewildered, asking why their psychological symptoms remained the same. Often, they would get deeply depressed in the coming months.

Often, this psychologist would receive a referral of a patient that was a “certain surgery, as soon as possible”, but within a couple of appointments, the patients would change their mind and surgery would be put on hold. All she ever did was question them about their feelings, past histories and expectations.

She was sent to a conference a few times, and she noticed that the behaviour of these male clinicians could be consistent with being gay and still in the closet. They could also be quite homophobic and very gung-ho about surgical and medical solutions.

She was offered a quick PhD opportunity for research that would support the prevailing ethos in these clinics ie. that surgery resolves dysphoria, that it is safe, and that there is such a thing as “brain sex” and “born in the wrong body”.

There being no scientific evidence for any of these claims, in fact quite the opposite – she noticed wilful neglect of patient’s psychological needs, unethical behaviour by the clinicians and negative impact the surgery had on many patients – she felt that she couldn’t do that.

She tried to share her findings, but nobody there was interested. It became clear that for one reason or another, these doctors were not offering best medical care to vulnerable patients and were doing them a disservice. This wasn’t a precedent. We all know how surgeons can be.

Cosmetic surgeons operating on healthy women to the point of disfigurement, gastric surgeons taking advantage of misogynistic beauty standards and performing expensive and unnecessary gastric banding operations, there are many examples of medical opportunism that manipulates the vulnerable.

So she left, someone else took her place and made a career out of it and we are where we are now. I think most people know this is another medical scandal in the making. It has the elements of all the previous medical scandals – misogyny, homophobia, eugenics, maverick men.

Whether trans people want to hear this or not, surgery doesn’t solve psychological problems, but it can make them worse. Key to health and happiness is accepting our bodies, not pretending that they are an identity that can be discarded. Sex can’t be changed. If you are struggling with accepting your body, please take care and make sure to supplement information that surgeons and others who are making a profit out of gender reassignment, with information from people who regretted undergoing these procedures. 

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