Understanding therapy approaches to gender distress

Understanding Gender Dysphoria: Traditional Therapy vs. Gender Affirming Care

Gender dysphoria is a condition where an individual experiences significant discomfort or distress due to a mismatch between their gender identity and their biological sex. As society's understanding of gender has evolved, so too have the approaches to treating gender dysphoria. This blog post explores the differences between traditional therapy for gender dysphoria and gender affirming care.

While gender affirming care has grown in popularity the benefits of gender affirming care have been contested. While people speak of the benefits of gender affirming care it is not clear whether these benefits are temporary or if they exist at all when larger groups of people are studied. Understanding the difference between approaches can help people decide what approach they would like to choose to support their overall well being.

Traditional Therapy for Gender Dysphoria

Traditional therapy for gender dysphoria often focuses on exploring the individual's feelings and experiences related to their gender identity. This approach is more consistent with how body image issues are treated for other conditions like body dysmorphia and eating disorders. Here are some key characteristics:

• Exploratory Approach: Traditional therapy typically involves talking through feelings, experiences, and any underlying issues related to gender identity. The therapist may help the individual understand their feelings and navigate societal norms.

• Focus on Acceptance: The goal is often to help the individual come to terms with their gender identity, which may include acceptance of their assigned gender at birth. Emotional resolution comes from understanding thoughts and emotions and how uncomfortable thoughts and emotions are resolved. This is done using skills and techniques that have a long history of supporting people in feeling better about themselves.

• Emphasis on Mental Health: Traditional therapy may also address co-occurring mental health issues such as anxiety or depression, which can be prevalent among individuals with gender dysphoria.

• Limited Medical Intervention: In many cases, traditional therapy does not include medical or surgical interventions. It may focus solely on psychological support. At IncreMental Health Tips we support a least invasive approach towards resolving gender distress. We are willing to collaborate with other health providers in order to provide comprehensive care.

  
  

Gender Affirming Care

Gender affirming care represents a more contemporary approach to treating gender dysphoria. It emphasizes the importance of aligning one's physical appearance and social identity with their gender identity. Key aspects include:

• Transition Support: Gender affirming care provides comprehensive support that includes mental health services, medical care, and social support tailored to the individual's needs.

• Medical Interventions: This approach often includes access to hormone therapy and surgical options that help individuals "transition" physically to their affirmed gender.

• Affirmation of Identity: Gender affirming care focuses on validating and affirming the individual’s gender identity, promoting alignment to reduce feelings of dysphoria.

• Interdisciplinary Team: Gender affirming care typically involves a team of healthcare professionals, including therapists, endocrinologists, and surgeons, to provide coordinated care.

  
  

Key Differences

While both traditional therapy and gender affirming care aim to support individuals experiencing gender dysphoria, their methodologies and goals differ significantly:

• Objective: Traditional therapy often seeks to help individuals understand and accept their biological sex (regardless of decisions related to transition), while gender affirming care actively supports individuals in transitioning to their affirmed gender.

• Methods: Traditional therapy focuses primarily on talk therapy and psychological support, whereas gender affirming care incorporates medical treatments and social support.

• Validation: Gender affirming care prioritizes affirmation of one's gender identity, while traditional therapy validate the individual's experience without affirming identity. Traditional therapy assumes that our identities are complex and always developing.

Ethical Concerns about Gender Affirming Care

I have attended training in gender affirming care, some of which does not align with ethical principles of other therapy approaches.

• Unhealthy focus on thoughts and emotions: Gender affirming approaches encourage people to assume their thoughts and feelings about their body are unchangeable. This is in conflict with all other forms of therapy which suggest that emotional and thought change are not only possible, but regularly achieved. While traditional therapy is difficult work and can be lengthy, this does not mean that it is ineffective for clients who engage in the process.

  
  

  Key point: There is more social honesty needed about the fact that people can willingly choose transition even if the believe there are other options that could lead to different results. Traditional therapy requires that the therapist and client agree on goals and have common ground on areas of treatment. Some people are not interested in this type of work and seek a different approach for resolution. Respecting individual autonomy is an essential ethical principle regardless of clinical approach.

• Acceptance of self-diagnosis without evaluation: School teachers have been encouraged to assist in transition of a child at the child's request. It would be unthinkable for a teacher to prescribe anti-depressants for a child who says they are depressed, but teachers are often the initiating gender affirming treatment provider who initiates children on a pathway that can involve irreversible procedures.

Key Point: From our experience those who experience gender distress often have complex reasons which cause them to reject their biological sex. These reasons can often be treated effectively from a traditional therapy standpoint.

• Damaging family relationships: Gender affirming approaches tell parents how to interact with the person transitioning. In traditional family therapy on other issues the focus is on opening communication and building understanding. Traditional therapy doesn't require agreement and encourages acceptance of different viewpoints. Gender affirming approaches say parents must agree. This shutting down of conversation prevents family members from developing an understanding that makes it easier to accept disagreements about how to approach body distress.

Key Point: Building understanding using a neutral approach helps to enhance relationships even if disagreement remains.

Conclusion

The treatment of gender dysphoria has evolved significantly, with a return to traditional therapy emerging as a more supportive and comprehensive approach. Understanding the differences between traditional therapy and gender affirming care is crucial for individuals seeking support and for healthcare providers aiming to offer the best possible care. As society continues to advance in its understanding of gender identity, it is essential to prioritize approaches that treat underlying conditions and can prevent people from succeeding in their journey toward self-acceptance and fulfillment.

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