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"we encourage a psychotherapeutic model that provides a process of psychological exploration, in which an individual’s personality structure, beliefs, defence mechanisms, and motivations are assessed and examined in a supportive environment... https://twitter.com/Quillette/status/1357153538921558016
... All of these elements, we believe, are helpful for anyone planning this kind of life-altering decision."
"our goal was never to make it more difficult for gender dysphoric children..to obtain help and treatment. What we wanted was for these families to get the right treatment. There is currently no gold standard, long-term research in the area of childhood medical transition."
"The desire to reduce pain and anxiety by rushing into either social or medical transition needs to be resisted, as there are long-term costs that a child in a fixed state of mind is unable to imagine or understand."
"The denial of the psychological factors influencing the desire to transition can unwittingly lead the patient and health professionals to embrace concrete, affirmative solutions, while ignoring relevant aspects of the individual’s mental-health situation and personal history."
"they can experience daydreams in the vein of “If only I were…” to help manage the emotional struggles of day-to-day life. A trans-identifying child can become more fixated and invested..and it becomes a belief that if only they’d transition, all their problems would resolve."
"Individuals with a fragile ego structure also tend to be prone toward black-and-white thinking, which leads them to concrete rather than symbolic solutions...
...This also makes them susceptible to the somewhat rigid thinking and stereotypes that now characterize the more stridently promoted elements of trans-rights activism and its associated ideological component"
"All human beings are complicated. And our problems are usually multidimensional. This is why therapists need to take an interest in the meaning of a patient’s presentation, as well as explore the dynamics underlying the presenting belief system...
...Unfortunately, for reasons described above, any exploratory stance whatsoever can be experienced as disturbing or even offensive to gender-dysphoric patients. This is because it threatens to undermine their internal defences and belief systems...
...The therapist therefore needs to demonstrate respect and empathy in understanding the role that these defensive structures play in supporting the patient’s ego and managing his or her anxiety."
"Many young people with gender dysphoria appear to be frozen in their current preoccupations..by the time they present for transition..typically have suppressed any of the doubts and anxieties they would naturally entertain, having instead projected them onto those around them"
"in our experience, we have found that children wishing to transition subconsciously often hope that a parental figure will step in and help to identify and understand the part of the self that they are trying to discard...
...Some detranstionors mention, after the fact, that they were disappointed by doctors’ and therapists’ inability to stand up to their insistent demands for transition action."
"a psychologically healthy person needs to come to terms with his or her sexual self, and so it helps if a therapist can support the person as they begin to think about their fears and anxieties, rather than encourage them to seek avoidance mechanisms...
...The task of adolescence is to prepare for adulthood, not to artificially postpone it."
"The therapist has to bear in mind that it is common for people to, at least subconsciously, seek to eradicate unwanted aspects of the self. But it is not really possible to do this, as discarded parts of the self tend to re-emerge, particularly when the ego is under pressure...
...Mental health is based on an ability to integrate various aspects of the self, not pretend them away, while differentiating between psychotic and non-psychotic forms of thought...
...This means being able to recognize the difference between reality-based thought and wishful thinking, and helping patients learn to do likewise."
"In fantasy, the individual can believe, at some metaphorical level, that the suicidal act would actually restore the ideal relationship or position they feel they have lost. Some part of the suicidal patient believes they will survive and be reborn in some way through the..act."
"You can perform surgery on the body, but it is a mistake to try to surgically remove a part of one’s personality. Psychological maturity and mental health are based on an ability to tolerate different aspects of the personality, and intolerance does not help psychic integration"
"Plastic surgeons are quite familiar with patients who seek surgeries in order to erase or manage a psychological difficulty, and the more ethical among them refer these patients to psychiatrists...
...Rapid medical and surgical interventions for those with gender dysphoria will leave such problems unaddressed and perhaps compounded."
"Children need help and support in coming to terms with who they are as part of the maturational process. One often hears it suggested that even toddlers possess some unchanging, soul-like “authentic self” whose actualization eventually requires them to take puberty blockers...
...This conception betrays a misunderstanding of the changing nature of human development, since children’s identities develop as they mature."
"Throughout our careers in mental health care, we have been familiar with similarly challenging clinical presentations. Depressed patients feel worthless and suicidal; anorexics feel too fat, and starve themselves; and obsessional patients perform rituals repetitively...
...Professionals need to show both empathy and understanding of the mental defences..this general principle must apply equally to patients seeking gender transition, not in order to pathologize them, but to help heal their internal worlds...
...Patients with gender dysphoria need services that are insulated from overzealous advocacy groups and political activists. A rigid one-size-fits-all affirmative approach is unhelpful...
...Where children are concerned, we need a new model to ensure more clinically rigorous, balanced, and ethical assessment and treatment protocols...
...At the very least, the ordinary ethical standards of good practice must be restored to this area, as our duty, first and foremost, must always be “do no harm.”
The above thread is the words of @sueevansprotect and @marcusevanspsyc
http://evanspsychotherapy.co.uk/ https://www.crowdjustice.com/case/protect-children/
http://evanspsychotherapy.co.uk/ https://www.crowdjustice.com/case/protect-children/
