[quote gardenbird48]**@SisterWendyBuckett* @Smallblanket* @BlackWaveComing - thank you so much for your input - I am asking the further questions because I'm trying to work out what would usually be sensible with any case that involves medical treatment but worryingly from your responses so far it would seem that I am way off the mark and that effectively children can self-diagnose into major surgery and life changing hormone treatment (which I realise has been gone over before) but it is the apparent self diagnosis element of it that is just hitting home for me - if it this the case then that is just unreal!!
No one is allowed to self-diagnose for any other condition that has medical implications ie. surgery - no one..[/quote]
Well...it's not that the kids give themselves the diagnosis. They immerse themselves in the narrative either consciously or unconsciously (which includes learning how to answer the questions a psychiatrist may ask in a way that leads to diagnosis in order to access the desired treatment and continue to live out the fantasy narrative). Once that's happened, the diagnosis happens very quickly, and treatment can follow, especially if the parents are very enthusiastic - although our most recent psychiatrist says she views parental happiness re transitioning as a red flag.
But....there are a lot of issues around diagnosis in psychiatry. It's not confined to this one issue. A diagnosis isn't scientific, in the way we might understand or expect it to be. It's the box that any given story best fits into at a given point in time. A diagnosis of GD doesn't tell us anything meaningful, really. It's just shorthand for a particular cluster of asserted experiences, which may or may not be accurate.
Re review/pausing/ceasing treatment, if started:
I think the best analogy is one around medical intervention in childbirth. There's a concept in birth studies - the cascade effect - where one intervention during birth makes another and then another more likely. It's how you might be more likely to go from an epidural to forceps to a major tear needing stitching than if you don't start with the epidural. (No birthing judgement attaches to this analogy, btw, a safe birth is a good birth).
It's pretty much the same with GD.
Social transitioning makes blockers more likely. Blockers make cross sex hormones more likely. The more the natural body is altered, the more likely it is that someone will seek out a double mastectomy or other surgeries.
The time to halt the risk of a cascade effect in adolescents is before social transition. Detransitioners are very poorly treated, and given we have no idea who will detransition, better to delay transition until well into adulthood.