Sunday, 12 January 2020

We need to consider the psychosocial aspect of Gender Transition more

We need to consider the psychosocial aspect of Gender Transition more

Welcome to 2020. Over the last year we’ve seen a spate of news articles from around the world questioning the validity of transition and focusing on de-transition. For those who work with and/or are part of the TGD community—despite attempts to cast doubt on the legitimacy of TGD people’s transition—there is only a statistically low instance of de-transitioning of around 2%. De-transition is legitimate, but an uncommon event.


There is something however, to be said about the complex challenges of transition and the wear it has upon the mental resilience of TGD people. Historically, TGD people have had to jump through unreasonable, problematic and unhealthy hurdles to get to transition. More recently there has been a much needed move towards a more reasonable, less burdensome model of transition. It’s known as the gender affirming model of care.  In essence it argues that TGD people need to be trusted when they talk about their gender diversity. TGD people are the best people to make the decision about how they identify. The gender affirming model of care continues to be challenged in the media. The Australian up until the beginning of the year continued to publish articles misgendering young trans men, and claiming that somehow autism amongst younger trans community members equated to a diminished capacity to make decisions about gender identity. The media in the UK has been swarming to report an alleged case brought against Tavistock Gender identity development service (GIDS). The Applicants claim that health professional, parents and minors lack the capacity to make any decisions about gender identity, even in the case of reversible treatments such as publicity blockers. Similarly, the Royal Children’s Hospital Gender Service in Melbourne continues to bare the brunt of attacks around their model of gender care. 2020 is lining up to be a repeat year in the media, with little chance of change.


Unfortunately what’s been lost in the unrelenting attack on TGD folk is that while gender affirming care is by far the best and most effective model for transition we need to continue to work at improving its overall effectiveness. We know that affirming people in their gender identity and giving them access to legal and medical transition in a timely fashion is the best way to support TGD people. Removing roadblocks, unreasonable impediments and empowering people to transition is essential to positive outcomes. The importance of reasonable and timely access to transition, supporting vulnerable people however doesn’t account for the steep learning curve that so many TGD people experience in affirming their gender.  It is an almost universal truth that regardless of where our gender identity takes us, we all learned cultural norms associated with being raised male or female. These rules, codes, unconscious laws and engendered stereotypes are burned into us from the earliest age. Gender transition shouldn’t necessarily mean we have to learn new gender rules, but it does help to be aware of a lifetime of previous conditioning. 


On a practical level not being aware of how our unreflected gendered behaviour has an effect on how people perceive us can be devastating. It can be one of the biggest hurdles to managing our own mental health and primarily because it is both invisible and rarely spoken about away from the therapist’s couch. So while gender affirming care means TGD people are able to identify as their authentic selves without having to go through unreasonable and even harmful delays, it doesn’t necessarily help them to come to terms with how to navigate an often hostile gendered world. Thus it is important that TGD people consider appropriate counselling, getting involved in a TGD social group, find mentors and allies to help with this.  Not because being transgender or gender diverse is a mental heath problem, but because being TGD makes you susceptible to a much higher mental load than you’ve probably ever been used to before.


There’s often a fine line here. Trans Men, trans women, gender diverse and non-binary folk shouldn’t have to learn to navigate the world dealing with all the unwritten rules of gender. It’s hard enough, frustrating enough and impossible enough for cis people to do this in a healthy way. For TGD folk it becomes dangerously unrealistic. The focus rather should be on education, self-acceptance and self-awareness. These are very important. Whether you feel the need to conform, ignore or overturn gendered behaviour, finding peace with who you are is incredibly important for all of us. Two quotes that put this into perspective. First Jung said, ‘Until you make the unconscious conscious, it will direct your life and you will call it fate.’  And secondly Picasso; ‘learn the rules like a pro, so you can break them like an artist.


Eloise Brook