In some cases of ROGD with serious depressive symptoms, a deep self-loathing & shame lies at the core of the client's suffering. A fantasy of escaping the suffering by modifying the body, much like in ED, can become obsessive. W/ article below, replace ED terms with GD terms:

2/ Replace:
Eating Disorder --> Gender Dysphoria
Weight Loss --> Transition or Passing
Food Restriciton, Bulemia, Anorexia --> Binding, Transition, or Trying to Pass
Thinness --> Maleness (for FtMs)

ED can serve as an identity & false promise of hope if ideal body is achieved

3/ In ED, failure to achieve the ideal body is also seen as one's existential failure as a person. This reminds me of the way clients describe the inability to pass or be perceived as their preferred 'gender identity'.

4/ When a GD person decides transition is not the answer, this may parallel what happens when an ED patient stabilizes and lets go of the desire to control their body: a flood of depression arises, as the core angst is now front and center for them to feel and deal w/ honestly:

5/ "The reality of working with people who are suffering in the throws of depression and an eating disorder is that it is difficult not to feel hopeless for their hopelessness.

6/ "Their hopelessness is extremely painful. It is an inner torture and misery, and it is encompassed by intense feelings of self-hatred and self contempt. For many, their emotional salvation was going to be the eating disorder.

7/ It was going to be thinness, physical beauty, or social acceptability. Many come to feel that they have even failed at the eating disorder and have lost the identity they had in the eating disorder. Hence, the hopelessness goes beyond hopeless,

8/ because not only is there nothing good in their lives, there is nothing good in them. Not only is there no hope for the future, there is nothing hopeful at the moment but breathing in and out the despair they feel. It feels to them like the suffering will last forever.

9/ Therapists who work with eating disorders need to be prepared for the flood of depression that pours out once the eating disorder symptoms and patterns have been stabilized or limited to some degree."

What's the solution? Releasing false guilt of one's fundamental flawed-ness

10/ "The most helpful thing we can do in every session with these clients is to generate hope. Nurturing hope is not always a clear-cut and obvious list of techniques or interventions,

but rather a willingness by both client and therapist to face the hopelessness in a kind and loving context."

https://centerforchange.com/hope-hopeless-depression-eating-disorders/

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