Transgender Trend - fascinating article from Dr Az Hakeem (psychotherapist specialising in gender)

[Gasp0deTheW0nderD0g]

www.transgendertrend.com/interview-az-hakeem/

Transgender Trend have recently put up an article contributed by Dr Az Maxwell Hakeem, who is a forensic psychiatrist and psychotherapist by training. He has specialised in gender disorders for decades. He trained at the Tavistock, which as I understand it is internationally renowned for taking a holistic and psychoanalytic approach to mental illness and distress, one of the things that makes the current shambolic state of their paediatric GIDS clinic so surprising and disappointing.

This is one of his first points. If true, it confirms what I have feared for a long time. People with gender issues fall between several medical specialities and nobody is taking overall responsibility for trying to help them tackle their psychological issues before considering irreversible medical treatments/surgery.

When I entered psychiatry, I was dismayed to see the lack of thoughtfulness and curiosity in relation to trans patients. My experience of the surgeons was that they were master craftsmen and any questions were outsourced to the Psychiatrist. But the Psychiatrist merely seemed to be ruling out any evidence of any major psychoses as the root of the person’s decision, and “allowing” the surgeons get on with the requested procedure. There appeared to be a mutual evasion of responsibility and a lack of any analytical curiosity as to how this person found themselves in this situation.

Below is the paragraph I saw on Twitter that led me to read the whole article. So sad, but it also makes me very angry that these people have been very badly let down by the medical and psychology profession.

I inherited a group of post-operative patients who were mainly depressed and a group of pre-operative patients who are mainly gender euphoric with exciting fantasies of what their life will become. One of the best decisions I made with the service was to integrate these two groups into a heterogeneous group, mixing pre-op and post-op patients. The post-op patients were able to challenge the pre-op idealists with a more reality-based understanding of the limitations of what they were about to pursue and the regrets that they faced.

I was also struck by this observation earlier in the piece.

The fact that I was offering psychotherapy to post-operative regretters – people who had already undergone gender reassignment and had changed their mind – was seen by some as “pointless” because “the irreversible damage had already been done”. I pointed out that the work with regretters was often similar to grief and bereavement work, where someone has been lost. This is mourned, and reparation and rebuilding is the focus.

Yes gasp

I read it. Very thoughtful

Politicians should read this

I agree. There seems to be an utter lack of common sense amongst the people making policy in this area. This is a very accessible article and it's not long. Would be a good start.

Really great work he's done. Would be interested in hearing more from him.

Thanks for the link - that is a fascinating read!

(Excerpts)

I typically found that after anything from 6-12 months in the group the initial Gender Dysphoria had been completely resolved. The Gender Dysphoria was a solution that their mind had come up with to make sense of the confusion, which they happened to find in a gender framework. Once they had come to the conclusion that gender was the framework they had stuck with it.
.....

The public are often told that relative regret is extremely low. But this of course is a complete fiction. There are no follow-up studies, no one knows what the regret rate actually is and this low rate results from the lack of any information being collected. The patients I saw did not officially exist in any gender identity clinics’ books.

And he did say he had some concerns about children

And that surgeons doing the operation s were not curious about how a person came to be wanting these operations

He has a website linked on the piece

Psychiatry has a history of treating the person in front of them, out of the context of their life.
I do not think this approach always works in the best interests of the patient. It doesn't work for people who are trapped in abusive relationships, for example.

So interesting and also important that I as a woman with GC views look clearly at the high satisfaction rates with surgery where people are adults and have had reality-based preparation like the groups Dr Hakeem ran.

It's pretty standard in a specialist area I sometimes work in which involves a fairly extreme form of cancer surgery that patients facing this are able to meet someone living with the surgery. Reality, sunlight and the expert patient in collaboration with the health team.

As women though, don’t we already know that joined-up holistic NHS treatment is a complete fallacy? Each separate department just wants to do the minimum cheapest thing they can to discharge you.

Thank you, will come back to this.

My mother told me recently that ten Tavi was always extremely respected in the past.

I wonder if this idea of bringing post and pre op people together is organically happening on social media via the detransitioners?

What an interesting interview.

I wonder if this idea of bringing post and pre op people together is organically happening on social media via the detransitioners?

That would be very useful. iirc, Watson comments that detransitioners are ostracised on social media and people are warned off about engaging with them. It's difficult to gauge how widespread this is or people's compliance with this directive.

@SweetBabyCheeses99

As women though, don’t we already know that joined-up holistic NHS treatment is a complete fallacy? Each separate department just wants to do the minimum cheapest thing they can to discharge you.

Sadly, I think there's a lot of truth in that. In Bad Science by Ben Goldacre, he says one of the reasons people go to homeopaths, even though there's no evidence whatsoever their treatments work, is because by paying to see a complementary therapist you get a good long consultation in a nice room on a comfy chair and during that consultation the therapist listens attentively and kindly while you talk at length about what's wrong with you and probably all sorts of other things too. Just being taken seriously goes a long way to sort out many minor ailments.

(He also mentions the placebo effect and the fact that by the time a patient is desperate enough to think about paying for private treatment the condition is often reaching the point where the immune system is on the point of curing it.)

Overworked NHS GPs just can't do this, and I don't imagine it's any better in many other parts of the NHS, including mental health services.

Really interesting article. The lack of curiosity amongst professionals seems astonishing. I wonder though how keen people anticipating a marvellous experience through medical transition would be to meet post op transitioners if they knew they had some regrets. I imagine this might partly be behind the rejection of detransitioners - people don’t want to face reality and have invested so much in the idea that transition will solve all their problems and deliver happiness that they can’t risk having their bubble burst xx