Gender Dysphoria Being Questioned: Overreaction, Overdiagnosis, and Overmedicalization?

Gender dysphoria is a medical term listed in American Psychiatric Association’s textbook to describe the distress resulting from the incongruence between the gender assigned at birth and the gender with which one identifies.

It is “characterized by a strong and persistent cross-gender identification associated with anxiety, depression, irritability and, often a wish to live as a gender different from the one associated with the sex assigned at birth. Subjects with gender dysphoria often believe themselves to be victims of a biological accident and are cruelly imprisoned in a body incompatible with their subjective gender identity. The most extreme form of gender dysphoria is called transsexualism.”

In just a few years, this phenomenon has evolved exponentially from extremely rare to commonplace. “It is a tidal wave”, says Dr. Serge Hefez in Paris, one of the first psychiatrists specialized in consultations for those experiencing this distress, usually surfacing at adolescence, or sometimes earlier, during childhood. The number of gender clinics has increased in the United States, from two in 2007 to well over 50 today. Between 2016 and 2017, the number of females seeking gender surgery quadrupled in the United States. Currently 2% of American high school students, predominately teenage girls, claim to be transgender. In 2001, only 12 individuals under age 25 in Sweden had received a diagnosis of gender dysphoria, whereas by 2018, the number of cases rose to 1,859.

Associations estimate the number of transgender individuals at 15,000 in France

In her book “Irreversible Damage ” which investigates the craze of transgender children and adolescents in the US, an American journalist, Abigail Shrier, deems that “social contagion” is at play when clusters of adolescents decide to start “transitioning”. In an interview she declared: “Online ‘influencers’ are largely responsible for spreading feelings of inadequacy about one’s own body and encouraging the idea that any perceived failure of perfect femininity means that a girl is probably transgender.”

Nonetheless, child psychiatrist Agnès Condat, who has already evaluated than 200 young patients, contends that the causes of gender dysphoria are multi-factorial. Many hypotheses have been postulated based on psychosocial issues in the family (poor father-son or mother-daughter relationships), biological abnormalities due to hormonal exposure, or environmental causes, etc., although the data is still insufficient to justify any of these theories.

As the first country in the world to recognize gender dysphoria, and allow formal civil registration of “sex changes”, Sweden is now re-considering certain policies due to the growing numbers of transgender individuals. Sweden was also the first country to endorse gender transition treatments in its’ public clinics, starting at age 16. This includes prescribing puberty-blockers for the youngest, injecting testosterone or estrogen, performing chest surgery, changing one’s voice with the help of speech therapists, transplanting or removing hair, etc. From age 18 onward, genital operations have been permitted, to create a penis from the clitoris, or to form a vagina by inverting the skin of the penis or the intestine. The country’s first hospital to pioneer hormonal treatment for gender dysphoria has now invoked the precautionary principle, which effectively puts an end to routine hormonal treatment for all youth under 18, except for clinical trials.

In June 2020, Finland changed its’ policy to recommend that psychosocial support should be the primary course of treatment offered for gender dysphoria. In the same year, the UK began to require court-orders for puberty-blockers for youth aged 16-18 and suspended them altogether for younger children. This decision followed the landmark case of Keira Bell against the London clinic that performed her double mastectomy and prescribed “sex change” hormones. The court’s upheld Ms. Bell’s claim that regrettably, she’d been rushed through gender reassignment without proper safeguards.

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