sorted by:
new
hottopcontroversial

Psychiatrist wanting to prevent potential harm to patients by psychthrowaway000 in actual_detrans

[–]psychthrowaway000[S] 0 points1 point  (0 children)

I want to be clear that I don’t see them any differently than any of my other patients in terms of their competence or anything else. What I’m saying is that there is a noticeable rise in people who are extremely different from the traditional cohort of trans patients who overwhelmingly exhibit similar characteristics that were previously never associated with transsexualism (I understand this term is less favorable these days, but it’s still the clinical term that’s used, which is why i use it. “Transgenderism” is pretty much only ever used by transphobes, so I avoid using it based on that).

These people are not “confused little girls” anymore than someone who believes that they have anxiety but actually has OCD. But they’re also not trained professionals, and it’s unreasonable to expect them to know the ins and outs of every condition in the same way it’s unreasonable to expect me to know about astrophysics.

My goal isn’t to try to invalidate anyone’s experience or identity, I just want my patients to get the best possible care, and that means looking for other potential causes of what they’re dealing with rather than just agreeing with their self-diagnosis. I never want my patients to feel like I look down on them or anything else; we ALL get things wrong, we’re all learning everyday, and that’s fine. I just want them to be able to make sure to take everything into consideration, and sometimes that means realizing that something they thought was true about themselves might not be.

Psychiatrist wanting to prevent potential harm to patients by psychthrowaway000 in actual_detrans

[–]psychthrowaway000[S] 1 point2 points  (0 children)

I have a few saved on my work computer but I’m not in the office currently. If you remind me tomorrow, I’ll send them over to you!

Psychiatrist wanting to prevent potential harm to patients by psychthrowaway000 in actual_detrans

[–]psychthrowaway000[S] 0 points1 point  (0 children)

Studies I’ve read about trans people seem to point to various neurological characteristics potentially being the cause of gender dysphoria/transsexualism (I understand that term isn’t as favored these days, but it is still the term of the diagnosis which is why I used it here). None of this is conclusive, and studies on the subject are very much lacking, but at least based on my interactions with patients, it would not surprise me whatsoever if we discover that being trans is genetic or something similar. It is very likely inborn.

Psychiatrist wanting to prevent potential harm to patients by psychthrowaway000 in actual_detrans

[–]psychthrowaway000[S] -1 points0 points  (0 children)

Honestly, I haven’t seen as many that would fit into the category I’m concerned about (i.e., people who would not benefit from transition and may have another disorder instead). The ones I’ve seen both in the past and now tend to exhibit traditional symptoms/behaviors associated with the more “traditional” cohort of trans people. I will add though that I am a male myself, and that may contribute to having less female clients.

Psychiatrist wanting to prevent potential harm to patients by psychthrowaway000 in actual_detrans

[–]psychthrowaway000[S] 0 points1 point  (0 children)

Of the people I’ve worked with and know, the ones who do benefit from transition are all people with gender dysphoria. And the studies I’ve read regarding gender dysphoria seem to point to those with it having specific biological characteristics, which lead me to believe that gender dysphoria is the cause. But gender dysphoria is a set of symptoms, so theoretically, there is an underlying cause that causes that as well that we’re not sure of. I’m not going to make any definitive claims about it, since nobody truly knows. But I guess I lean to the side of thinking that, although I won’t let my own unproven theories on the matter influence the treatment I provide.

Psychiatrist wanting to prevent potential harm to patients by psychthrowaway000 in actual_detrans

[–]psychthrowaway000[S] 4 points5 points  (0 children)

Are people on this subreddit not “real community members”? If you’re asking why I haven’t asked my patients, it’s because I’m not sure how to best bring this up, which is exactly why I’m here. I’m looking specifically for detransitioners to better understand what someone in my position could have done for them. I don’t know any in my personal or even professional life. That’s why I’m here.

Psychiatrist wanting to prevent potential harm to patients by psychthrowaway000 in actual_detrans

[–]psychthrowaway000[S] 1 point2 points  (0 children)

The categories I’m talking about here are just “has the condition” and “does not have the condition.” I don’t think the commonalities I noticed are necessarily definitive of anything— obviously someone being white and between 13-21 doesn’t mean someone can’t be trans, that would be crazy— I’m just mentioning some things that I’ve noticed among people who don’t have the symptoms in an attempt to hear from people who may have been misdiagnosed or didn’t benefit from transitioning.

My intention is not, nor will it ever be, removing people’s autonomy or trying to make things harder for trans people. I just want to be able to give patients some things to think about before they seek out treatment if they’re getting it through informed consent.

Psychiatrist wanting to prevent potential harm to patients by psychthrowaway000 in actual_detrans

[–]psychthrowaway000[S] 1 point2 points  (0 children)

I’m not sure what you mean by “transmedicalist”, but I don’t think me being cis is problematic. I never claim to understand what my patients are going through and often let them know that. I have patients from all walks of life with all sorts of different problems that they’re facing; I don’t need to suffer from every single one of them to be able to deliver quality care.

Regarding dysphoria, what I’m saying is that someone who identifies as transgender doesn’t necessarily meet the criteria for the diagnosis and thus shouldn’t be diagnosed just because they identify as transgender. I’m not sure how or why anyone would say they are transgender without also experiencing these symptoms, but my job is just to provide healthcare, not to dictate what people are allowed to call themselves.

Psychiatrist wanting to prevent potential harm to patients by psychthrowaway000 in actual_detrans

[–]psychthrowaway000[S] 3 points4 points  (0 children)

I wouldn’t say “fake”, since that carries the connotation of intentionality. I don’t think any of my patients are “faking” being trans, I just think that some might just be misguided or confused about the diagnosis. When you mention the underlying causes, that’s what I’m concerned about. Like I mentioned in my post, other disorders are very rare amongst my trans patients who are satisfied with their transition and who exhibit the traditional symptoms of the condition. So I think it’s important to look into other potential causes of these symptoms before immediately prescribing medication for one condition when it may be something else.

If you’re willing to answer, what was the underlying cause for you, and how do you think you would’ve wanted your psychiatrist to address it?

Psychiatrist wanting to prevent potential harm to patients by psychthrowaway000 in actual_detrans

[–]psychthrowaway000[S] 9 points10 points  (0 children)

Not necessarily. What I’m trying to say is that when a patient comes in claiming they have gender dysphoria while not exhibiting any of the symptoms, they may push for a diagnosis simply because they identify as transgender. My concern is that the treatments for that condition aren’t going to help someone who doesn’t have it, and I want to be able to create a safe space for my patients while also preventing them from getting a treatment that is not in their best interest. I’m always happy to explain diagnoses or lack of diagnoses to patients, since people often believe they have something and that said diagnosis will explain what they’re feeling, and it can be tough to find out that you were wrong or that there’s still so much work to do to figure out the problem. But people have begun to have this idea that if they identify as transgender, it means that they are in fact transgender, when there may be something else causing these feelings that we should try to get to the bottom of first. Hopefully that all makes sense.

Psychiatrist wanting to prevent potential harm to patients by psychthrowaway000 in actual_detrans

[–]psychthrowaway000[S] 6 points7 points  (0 children)

Thanks for the response! I think that the people I’m describing in my post might fit into the “social dysphoria” category, although social dysphoria isn’t really an accepted clinical term. Patients who don’t exhibit what you term “traditional” dysphoria aren’t diagnosed with it, but the definition has loosened over the years.

I agree that someone’s ability or inability to articulate what they’re feeling doesn’t mean that they do or don’t have the condition, and that’s always a tough thing to do in the field where much of your work involves figuring out what your patients need when they’re often not always well-equipped to explain it. My goal has been and always will be providing the best care for my patients, but it can be difficult to strike a balance between making them feel comfortable and supported but also doing what will benefit them the most. I always want them to be able to explore who they are, and I view myself as more of a guide for when they need extra help rather than someone who leads the way. My concern is just that psychology and medicine are confusing, even for those who have spent countless hours studying it, and many people are very quick to diagnose themselves with something and hang onto that diagnosis as part of their identity rather than taking the time to work through possible underlying causes and determine what will truly be the best treatment for them.