I was reading a thread elsewhere about BPD and several posters said that the medical establishment wouldn't give a diagnosis of BPD before at least 18 and usually waiting until early 20s. Because they recognised that until then personality is not fully formed. So no diagnosis, no matter how closely the child meets the criteria. Because they don't want to misdiagnose.
extended article by Hacsi Horváth
'The Theatre of the Body: A detransitioned epidemiologist examines suicidality, affirmation, and transgender identity'
(extract)
"I am an adjunct Lecturer in the Department of Epidemiology and Biostatistics at the University of California, San Francisco (UCSF). I’m an expert in clinical epidemiology, particularly in systematic review methods, epidemiologic bias and evidence quality assessment. As a researcher at UCSF, I managed the Cochrane HIV/AIDS Group for over a decade and on several occasions served as a consultant to the World Health Organization (WHO) in their HIV guideline development processes.
For about 13 years, I also masqueraded “as a woman,” taking medical measures which suggest, shall we say, that I was completely committed to that lifestyle. Most men would have recoiled from this, but in my estrogen-drug-soaked stupor it seemed like a good idea. In 2013 I stopped taking estrogen for health reasons and very rapidly came back to my senses. I ceased all effort to convey the impression that I was a woman and carried on with life." (continues)
"I don’t believe GD [gender dysphoria] reflects any kind of problem or glitch in the human body. Here’s what I suggest, in broad strokes, is going on with adolescents and adults:
Heterosexual males (the vast majority of men with GD) have autogynephilia.
Homosexual males with GD enjoy “femininity” and mistakenly believe this means they are “trans” or even women.
Females with GD have internalized misogyny and/or internalized homophobia.
In my opinion—which is based upon extensive research, as well as my own 13-year-long experience in pretending to be a woman–GD is only superficially concerned with one’s sex. It’s more a disturbance of identity, of mistaking the signifier for the signified. Patients have whatever mental illnesses they may have, or that develop while in the ruminations and hypomanic states that typically precede “coming out as trans.” I propose that GD is a moody, brooding syndrome that accompanies these mental illnesses. People with GD have cultivated an idealized vision of themselves as the opposite sex. At a critical point of rumination, after the patient has sufficiently disparaged his or her actual life and idealized life as the opposite sex, he or she realizes that body parts of the opposite sex may be obtained through the services of doctors (Raymond 1979, Billings 1982). Actually transforming into the opposite sex starts to seem feasible. The self-conception “splits” in two, and idealization becomes identity. Having negated any value in their actual male or female presence in the world, and now feeling themselves to actually be the self-generated persona, patients perseveratively ask themselves, “what’s stopping me?” “Feasibility” seems to trigger the split. Here begins the acute phase of GD.
Patients become obsessed with “transition.” To the same extent that they can be energized by the belief that they are making “progress,” as their bodies morph via the hormone drugs and shop clerks address them by their preferred honorifics (i.e. Miss or Ma’am for the males, Sir for the females), they can also feel destroyed by any little delay or perceived setback—including being “misgendered” or identified by others as their actual sex. Nothing else matters but “transition.” The apparent certainty of these patients, as well as their zeal to continue, is seen by “affirmative care” doctors as evidence of “being trans.”
Gender is a hierarchal framework that stratifies and categorizes “masculine” and “feminine” attributes and behaviors. In the context of transgenderism, it is also a convenient rhetorical device to elide the problem of sexed bodies and to label oneself as endorsing one or the other sets of sex role stereotypes. Earlier articulations of GD as “gender identity disorder” made more sense, but it seems that most people understood it to mean “having an opposite-sex gender identity.” I would suggest that it may more accurately be understood as simply an identity disorder, a disordered or disturbed identity, with a fixation on gender.
I agree with the late French psychoanalyst Colette Chiland when she said: “Transsexuals stage everything in the theatre of the body, and nothing in that of the psyche” (Chiland 2003). It is true that persons in the driven, obsessed stages of gender dysphoria can seemingly think of nothing except transition. No-one dreams of asking them to slow down, to seek psychotherapy, perhaps even find a way through this work to prevent transition, which can be costly on so many levels. It would be like standing in the way of a bolting, bucking horse. The fact that people with gender dysphoria are like this is a sign that something is wrong, yet they are not impeded at all.
But doctors are doctors and patients are patients. These surgeries and lifelong hormonal drug regimens didn’t used to be given out like crackerjack prizes. Virtually no research has been done in psychotherapeutic methods to alleviate the symptoms of gender dysphoria, prevent it, or get rid of it altogether. The entire literature comprises a couple of dozen case reports and small case series, some promising, nearly all from before 1990, and all using archaic methods. Based primarily on the pronouncement of Harry Benjamin, the “godfather” of transsexualism, that psychotherapy with these patients was a waste of time, the medical profession increasingly found ways to justify surgical and hormonal transition as the standard of care (Billings 1982). I will get back to this near the end of the article." (continues)
4thwavenow.com/2018/12/19/the-theatre-of-the-body-a-detransitioned-epidemiologist-examines-suicidality-affirmation-and-transgender-identity/