This is what the Portman Clinic had to say about Gender Transition in 2002

[BarrackerBarmer]

...pre Gender Recognition Act, following the court case which precipitated the GRA.

8 Portman Clinicians wrote this letter to the Telegraph:

"Sir - The recent judgment in the European Court of Human Rights (report, July 12), in which a post-operative transsexual person was granted permission to marry in his adopted gender role, is a victory of fantasy over reality.

The experience of many psychiatrists, psychoanalysts and psychotherapists working with transsexual patients is that they are individuals who, for complex reasons, need to escape from an intolerable psychological reality into a more comfortable fantasy. By attempting to live as a member of the opposite sex, they try to avoid internal conflict, which may otherwise prove to be too distressing.

It is a measure of the urgency and desperation of their situation that they frequently seek surgery to make their fantasy real. By carrying out a "sex change" operation on their bodies, they hope to eliminate the conflict in their minds. Unfortunately, what many patients find is that they are left with a mutilated body, but the internal conflicts remain.

Through years of psychoanalytic psychotherapy, some patients begin to understand the origins of their painful conflicting feelings and can find new ways of dealing with them, other than by trying to alter their bodies. The recent legal victory risks reinforcing a false belief that it is possible to actually change a person's gender. It might also strengthen the view that the only solution to psychic pain is a legal or surgical one."

(Bolding mine)

This is an article by Az Hakeem from 2010
Deconstructing Gender in Trans-Gender Identities

His view is that gender is irrelevant and unnecessary

My opinion is that gender is a wholly societal construct of decreasing relevance to a society, which may actually manage without the added virtual dimension it adds to biological sex differences which already exist as a differentiator.

And that talking to patients and getting them to think about what gender really means results in fewer of them wanting physical procedures.

I have stressed that psychological outcomes are the only ones which I deem to be of importance to the therapeutic work with these patients, rather than bodily ones which would merely be a mirroring of the patients’ bodily focus at time of presentation. I have however also noticed that once gender is deconstructed within the microsociety of my group, that hardly any of the trans-gender patients go on to pursue physical reassignment procedures. It could be understood that if there were no gender, there would be no need to change it.

Dr Az Hakeem was at the Portman from 2000-2012 and he doesn’t seem to be very old now, so he must’ve been one of the young ones coming through, Bespin.

www.drazhakeem.com/about

Oh hullo, it's Mandy Rice Davies again.

asking you near impossible questions?

Like what?

I would also counsel against spending a great deal of time with psychiatrists once you've met a few.

Dated 2015:

www.drazhakeem.com/specialist-psychotherapy-for-gender-dysphoria/

Dr Az Hakeem also recognises the existence of autogynaephilia and detransitioners.

...there are also people with gender identity conditions who choose not to pursue physical gender reassignment... Such patients may include those with autogynaephilia, those with non-binary gender identification, and those with intermittent fluctuation between gender dysphoria and transvestism. Other patients may have previously had physical gender reassignment procedures and have since changed their mind and once again find themselves with a gender identity incongruent with their physical body.

ILikeyourHairyHands ive worked with loads of them and some of them are lovely, just some can be errrmmm.

www.england.nhs.uk/wp-content/uploads/2017/04/gender-development-service-children-adolescents.pdf

Just putting this down in here because my googling re: current NHS policy (for adults) accidentally pulled it up and I wanted to share it and ask if it’s been posted before, does anyone know where?

This might be the most up to date adult stuff? Again, putting it here to see if anyone knows?

www.england.nhs.uk/wp-content/uploads/2013/10/int-gend-proto.pdf

Bespin, many are are errrrmmm.

I agree that many psychiatrists and therapists are awful and some/many very questionable but if you get down to the nitty gritty with the actual people who suffer you can hear the truth of it. It is self-evident and not something created by dodgy doctors.

Of course talking about and getting to the root of psychological pain takes time, trust and some kind of stability for the process not to be abusive and violating. It is not the same as treating situational or reactive depression after bereavement etc.

Which is why some doctors supported some kind of transition if it proved the only way for a person to feel stable enough to function. It was intended as a means to an end, not an end in itself.

But money saving policies like 'care on the community' and reductions in structures like supported housing leave people out in the cold to deal with their problems themsleves unguided and unsupported, and so must rely more on what strategies they can find.

It is the same for almost all severe MH problems. We talk about 1 in 4 people suffering from a MH problems, but whilst the intention is to destigmatise mental illness, I think the actual effect is that more people just say 'Oh we have all felt a bit depressed/anxious/OCD haven't we' and this minimises and trivialises the complexity and extent to which some people suffer.

So many say 'live and let live' but I think they really mean is I don't really want to think about it or be troubled by it.

fractalplimsoll i very much agree with this in relation to a lot of mental health problems. I find that psychiatrist have for too long been sent up as the pinicale of mental health provision and while that can provide valuable insight into conditions and when prescribing the correct treatment pathway be very effective, there actual input into people is often limited due to size of caseload, and it is left to other mental health professionals to do the longer term work, with hopefully minimal interference from them (the number of times i have sat in a meeting and the psychiatrist as decided to change everything or not change anything when it clearly is needed grrrrrrrr).

Mental health services are slowly changing to be a truely MDT approach and for too long gender services were ruled over by a few psychiatrists who saw them as there personal domains that no one could touch, hence the different approchs throughout the country which are only now being standardized.

Oi Bespin - you forgot to punctuate badly to show more vulnerability.

As you were.

It is the same for almost all severe MH problems. We talk about 1 in 4 people suffering from a MH problems, but whilst the intention is to destigmatise mental illness, I think the actual effect is that more people just say 'Oh we have all felt a bit depressed/anxious/OCD haven't we' and this minimises and trivialises the complexity and extent to which some people suffer.

This is very true. Awareness campaigns often lead to resources being captured by the middle class worried well. I'm not entirely sure they are the best way to go at all.

(Are NBs and pomo-addled blue-hairs the "worried well" of the trans movement? Perhaps the catastrophically dysphoric might better view them as Trojan horses capturing resources than as actual allies?)

TellsEveryoneRealFacts i am on my laptop, so am able to not use bloody auto correct. if you find that a lack of punctuation shows vulnerability then you have a funny understanding of what that means.

I always thought you could just dismiss me due to it as not knowing what i am talking about. you can not have it both ways, im either really clever and faking it or not.

as i keep saying i am not here to play games as no one wins at the end of that. i am hear to tell my truth and present another side of this debate.

so as you were. (i like that i might use it as a catch phrase lol )

as i keep saying i am not here to play games as no one wins at the end of that. i am hear to tell my truth and present another side of this debate.

Why does your truth mean everyone else has to lie to you though?

Why does your truth mean that women and girls are put in harm's way?

Why does a small number of people's truth mean a number of people need to lose their jobs for pointing out that their truth isn't based in reality?

Why are you not on other forums asking them not to target women and not to harass their employers to sack them for holding views that are concurrent with basic human biology?

Are NBs and pomo-addled blue-hairs the "worried well" of the trans movement? Perhaps the catastrophically dysphoric might better view them as Trojan horses capturing resources than as actual allies?)

I've always seen them that way.

It is a relief to find that there are professionals who are gender critical whilst not denying physical intervention to the truly dysphoric.

I also expect he would be considered to be a paternalistic gatekeeper by activists.

To go back to the OP - I am not surprised and that makes a lot of sense.

How is having sex-change surgery in order to try and pacify a mental disquiet any different from people who have hundreds of surgeries in an effort to look like Barbie dolls or people who believe there is something wrong with a limb and want it cut off?

We don't encourage any of those people - in fact quite the opposite - and yet anyone who think it's wrong for teenagers to cut off their breasts in a futile attempt to change sex is called a bigot? What the fuck?

TellsEveryoneRealFacts my truth does not mean any of those things you are entitled to hold the things you find to be true to you and to express them, we will let society sort out the balance of them and there value. why do the richest 1% of the world get most of its resources, why are we not all on there fighting for that. we could fight forever and our time and our emotional resources are limited. so we all picked here. i stayed on here because sometimes gone unchecked this forum can simply echo itself. Both sides of this debate, and yes i do beleive there is a debate to be had wish to dismiss the others views without engaging in them (say like telling someone they are not using full stops to look vulnerable).

have a lovely day anyway, work time now.

Gosh, it would be terrible if a conversation among women was allowed to go unchecked, without a single male opinion to balance things out...

AngryAttackKittens yes it would so i am glad that we can all have this debate together :)

Transplaining! As welcome as its more common counterpart.