The fight over gender therapy

And just like that, after four years of hard work, LeBowitz, de Vries and the rest of their group were called traitors by colleagues and the community they wanted to take care of. “We understood the enormity of the need for these standards from the beginning,” Levovitz told me. “I am not convinced that we have acknowledged the enormity of the controversy. It is the result of the fact that our world, the world of gender care, has exploded. “

In the 1950s And in the 60’s, a small cadre of doctors in Europe and the United States began to talk about how to evaluate adults who want to transfer medically. Harry Benjamin, the endocrinologist for whom WPATH was named, adopted the idea that those he was willing to treat (mostly trans women) were “born in the wrong body.” Fearing lawsuits from dissatisfied patients, doctors excluded patients because of emotional instability. And, arbitrarily, they included only those whom they believed would pass the gender they identified, as Beans Velocci, a historian at the University of Pennsylvania, wrote in an article in TSQ: Transgender Studies Quarterly last year. Some doctors promised trans adults that they would survive as heterosexuals after conversion.

The small group of physicians who wrote the first standard of care were all Sisgender. Since the creation of WPATH in 1979, transgender advocates have been increasingly gaining influence in the organization, but many transgender people have pushed for later versions of the norm in patriarchal and derogatory terms. For some genital surgeries, the criteria require adults to have one year to survive the gender they have identified and provide referrals from two mental-health professionals. Adopting a model of “shared decision making” between adult patients and surgeons, SOC8 is the first version to meet these requirements.

In the Netherlands in the 1980’s, there was a leap forward in medical change for young people. Peggy Cohen-Katenis, a Dutch clinical psychologist who specializes in pediatrics, is beginning to receive referrals from adolescents who are experiencing gender dysphoria (then known as Gender Identity Disorder). But therapy was not the initial answer, Cohen-Katnis, who is retired, told me on the phone this spring. “We could sit and talk forever, but they really needed treatment.” Since their bodies have evolved the way they don’t want to, “they’ve only gotten worse because of it.” He decided to help some of his patients start hormone therapy at the age of 16 instead of waiting for 18 years, at which time he was practicing in the Netherlands and elsewhere. He monitors them weekly, then monthly. “To my surprise, the first couple was doing much better than when they first arrived,” he said. “It encouraged me to continue.”

Cohen-Katnis helped establish a treatment protocol that proved revolutionary. Patient Zero, known as FG, was hired by Henriette A. in 1987. Delemare-van de Wall, was referred to a pediatric endocrinologist who, along with Cohen-Katnis, found a gender clinic in Amsterdam. At the age of 13, the FG woman was suffering from depression as she went through puberty, and Delemare-van de Wall pressed her on antidepressant drugs, Cohen-Katnis later observed. The drug will stop the development of secondary sex characteristics, if she decides to take testosterone, her body will avoid the experience of feeling betrayed, buying time and making it easier for her to go through later puberty. Transgender adults, with whom Cohen-Katnis also treated, sometimes said that they could change before life, when they could achieve their imaginary male or female ideals. “Of course, I wanted it,” FG said of adolescent suppressors, in an interview with The Dutch Approach, a historical book by Alex Baker about the 2020 Amsterdam clinic. “I later realized that I was the first guinea pig. But I didn’t pay attention. “

Over the next decade, Cohen-Katnis and Delamare-van de Wall designed an assessment for young people who seemed to be candidates for treatment. In questionnaires and sessions with the family, Cohen-Katnis explores the causes of a young man’s gender dysphoria, considering whether it can be better resolved through therapy or medication or both. The policy was to delay treatment for people with problems such as attention deficit and eating disorders or those who lack a stable, supportive family, in order to eliminate the causes that could interfere with treatment. “We did a lot of other things before they started, which created a lot of frustration for them,” Cohen-Katnis said. “Perhaps we were very selective in the early stages.” In retrospect, he says, he thinks young people could benefit if they were left out.

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