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Feminism: Sex and gender discussions

Transitioning or therapy as the treatment for gender dysphoria

181 replies

FairHippopotama · 22/08/2026 13:52

Most trans rights activists will tell you that all who claim to have gender dysphoria are valid in their feelings and the best treatment for gender dysphoria is always transitioning--both socially (e.g. pronouns, clothing) and medically (e.g. hormone therapy, mastectomy). These transitions should be accepted by society.

As far as I can tell, the typical gender-critical view is that while gender dysphoria may be a genuine condition, in all cases therapy or some such is a much preferred treatment to transitioning. Accepting transitioning is seen as requiring society to affirm certain falsehoods and harming women's interests. Am I right about this though? What are your thoughts?

Personally, I think the truth is slightly more moderate: gender dysphoria is a real condition, but should only be treated with transitioning in some cases--transitions which society should accept (but not be forced to do so). It depends on whether the cause is neurological and unchangeable (a sort of brain-body mismatch) or social and able to be treated with therapy (in my opinion).

Apologies if this is worded poorly and doesn't make sense.

OP posts:
6ate9 · 22/08/2026 18:17

@StylesSluttyShorts “No one actually transitions to anything they do they?”

This!! Changing sex is physically impossible. Only therapy should be offered.

maximc · 22/08/2026 18:20

Whatever is up with trans people makes no practical policy difference due to the impossibility of telling the difference between someone who really wishes he was a lady & someone who wants in the changing room to see breasts & bottoms. There is a public perception that hormones & surgery create a middle way, but under European human rights law it is not possible to require these before recognising transgender identity. The policy choices are biological sex vs self identification.

roseyposey · 22/08/2026 18:25

Parents with DC like this need to switch off the internet, throw away devices and enrol them into lots of sports and other activities to keep them busy, healthy and outwardly, not inwardly, focused.

backformoreofthesame · 22/08/2026 18:25

I am not sure therapy is right or needed
a more generally tolerant society however where people are not judged no matter how they present , where girls can be George or Georgiana or whatever without being bullied or teased or despised or classed as weirdo

FairHippopotama · 22/08/2026 18:28

maximc · 22/08/2026 18:20

Whatever is up with trans people makes no practical policy difference due to the impossibility of telling the difference between someone who really wishes he was a lady & someone who wants in the changing room to see breasts & bottoms. There is a public perception that hormones & surgery create a middle way, but under European human rights law it is not possible to require these before recognising transgender identity. The policy choices are biological sex vs self identification.

Good point, but is it right to legislate against genuine trans people on the basis of non-trans predators? Probably not, but then women remain vulnerable.

OP posts:
6ate9 · 22/08/2026 18:29

backformoreofthesame · 22/08/2026 18:25

I am not sure therapy is right or needed
a more generally tolerant society however where people are not judged no matter how they present , where girls can be George or Georgiana or whatever without being bullied or teased or despised or classed as weirdo

Girls can be called George or Georgiana without being bullied. What they can’t do is become a boy.

backformoreofthesame · 22/08/2026 18:37

i think you are missing the point

one of the main drivers for me thinking I must be a boy was the bullying I was subjected to because I didn’t fit the gender norms. Clearly there was something wrong with me. I didn’t want or like what I was supposed to like as a girl according to the other girls in my class. I was a weirdo

and I think that the gender norms have become much more rigid not less so over the last few decades / for which I suspect social media plays a part.

if the only group you fit is the trans boy group that is what you become

Waitingfordoggo · 22/08/2026 18:43

I believe gender dysphoria is a thing that people experience but I don’t believe it is a condition in its own right; rather a symptom of something else (and that ‘something else’ might be neurodivergence, trauma, shame over same sex attraction or paraphilia.) I think this is more or less what Dr Az Hakeem says. The man talks a lot of sense and has been working with trans-identifying people for decades.

Onbuy · 22/08/2026 18:56

It’s a mental health illness and should be treated as such. Therapy.

But there are also a sizeable amount of people I suspect who are doing it for attention or they’re bored, and the treatment for them? Ignore. Shrug. Indifference. And let it fizzle out when they realise they’re not getting the attention they’re hankering for

Onbuy · 22/08/2026 18:58

backformoreofthesame · 22/08/2026 18:25

I am not sure therapy is right or needed
a more generally tolerant society however where people are not judged no matter how they present , where girls can be George or Georgiana or whatever without being bullied or teased or despised or classed as weirdo

Nope…. What you see as more tolerant I see as ridiculous

Are you saying if someone identifies as a hamster, we should all accept this and move on?

Onbuy · 22/08/2026 18:59

backformoreofthesame · 22/08/2026 18:37

i think you are missing the point

one of the main drivers for me thinking I must be a boy was the bullying I was subjected to because I didn’t fit the gender norms. Clearly there was something wrong with me. I didn’t want or like what I was supposed to like as a girl according to the other girls in my class. I was a weirdo

and I think that the gender norms have become much more rigid not less so over the last few decades / for which I suspect social media plays a part.

if the only group you fit is the trans boy group that is what you become

What snapped you out of believing you were a boy @backformoreofthesame ?

DramaAndBullshit · 22/08/2026 19:00

backformoreofthesame · 22/08/2026 18:25

I am not sure therapy is right or needed
a more generally tolerant society however where people are not judged no matter how they present , where girls can be George or Georgiana or whatever without being bullied or teased or despised or classed as weirdo

Except this isn’t what the TRAs want. They insist they can change sex, that they are trapped in the wrong body. No one is stopping anyone living in the way they want, wearing what they want, etc. Society is tolerant enough to do this, that’s not the issue here. It’s that men are trying to invade women’s spaces.

6ate9 · 22/08/2026 19:06

backformoreofthesame · 22/08/2026 18:37

i think you are missing the point

one of the main drivers for me thinking I must be a boy was the bullying I was subjected to because I didn’t fit the gender norms. Clearly there was something wrong with me. I didn’t want or like what I was supposed to like as a girl according to the other girls in my class. I was a weirdo

and I think that the gender norms have become much more rigid not less so over the last few decades / for which I suspect social media plays a part.

if the only group you fit is the trans boy group that is what you become

I’m sorry that you were bullied.

I’m not sure that gender roles are more rigid nowadays. Significantly more men stay at home to look after their children than in past decades. Modern fathers also spend substantially more daily time on childcare and housework than previous generations.

Women have entered the formal labour market and leadership positions at much higher rates, breaking down the rigid historical separation of men as sole breadwinners and women as strictly homemakers.

Cultural attitudes increasingly support personal expression, career choices, and emotional vulnerability outside of traditional masculine or feminine archetypes.

BridgetYourFortyDaysAreUp · 22/08/2026 19:15

is it right to legislate against genuine trans people on the basis of non-trans predators?

@FairHippopotama
Let's have a foolproof, legal definition of "genuine trans people" first, then we can talk about how to legislate based on an inner feeling of gender, expressed mainly by an exterior display of stereotypes.

Even those who believe in gender identity do not agree on what, why, or how it manifests.

This is why we legislate based on sex, which is defined, measurable, and immutable. How people express themselves or feel about themselves is called personality. We can not legislate for personality.

We can, however, explore personality through therapy. I know of no way of changing someone's personality through surgery,* but I suppose you could argue that personality can be altered through the administration of drugs.

I believe in, and have firsthand knowledge of body dysmorphia, which, I believe, is what "gender dysphoria" is in many cases. A lot of people don't believe their bodies fit their sense of self, or who they are, when they see themselves in the mirror. We normally treat this with therapy, or, latterly, just as an example, weight-loss drugs. If we could help people be more at peace with their bodies, and, crucially, remove rampant misogyny from society, I think this would go a long way towards reducing the number of young people, especially girls, who think that they should become the opposite sex.

Which will never be possible.

ed. *except probably brain surgery

Backtoschooloncemore · 22/08/2026 19:25

is it right to legislate against genuine trans people on the basis of non-trans predators?

What is this legislation against genuine trans people that you speak of?

6ate9 · 22/08/2026 20:00

@FairHippopotama Good point, but is it right to legislate against genuine trans people on the basis of non-trans predators?

What are ‘genuine trans people?’

BinturongsSmellOfPopcorn · 22/08/2026 20:27

FairHippopotama · 22/08/2026 17:59

Well, some of the underlying reasons why women seek sex separation are related to sex itself, but I think a lot of them are related to things that trans women, at least trans women identified and treated early enough, wouldn't share. For example, male brains might be more violent, but testosterone and gender roles definitely play a role too, most likely a larger role. Once you remove those, I'd imagine there's a lot of overlap in the likelihood to commit violence between males and females.

Utterly incoherent. Some reasons are sex but some might not be, maybe, in some circumstances, you imagine. And totally unworkable. This suggests that single-sex services should be open to people of the opposite sex - but only if they've had early enough hormone and surgical treatment and sufficient socialisation.

What's the cutoff? How on earth do you legislate for this? And presumably you'd need different criteria for every different situation. You've already said a flat no to prisons and schools and an unqualified yes to unspecified others, so there must be a sliding scale of some sort. Vague handwaving doesn't cut it for legislation - you need to spell out in detail how it applies to specific circumstances.

You mentioned privacy and comfort but immediately dropped them again and switched to only violence as the criterion. If a rule is based on multiple reasons then all of them need to be addressed.

And no, I'm not suggesting DR 'simply remembered' being under 18 months old, but there isn't room here for an entire undergraduate module on developmental psychology. Gina Rippon's The gendered brain covers a fair bit of it if you're interested.

Shortshriftandlethal · 22/08/2026 20:46

FairHippopotama · 22/08/2026 16:08

@SunCloudRain Do you mean mental health condition (e.g. depression) or mental disorder (e.g. autism)?

You raise a good point about transitioning not completely alleviating distress (at least not completely), but I would say it is able to reduce dysphoria in some cases where therapy is unable to help. Your own cases sheds light on exactly why the first resort can't be transitioning though! I'm glad to hear it turned out well in the end.

@Homemerge How is it only a mental health condition? For those who have gender dysphoria (or what appears to be gender dysphoria) in connection to their sexuality, sexual interests, or neurodiversity, I understand your meaning, although I'm still not certain 'mental health' applies. However, our brains do have a sex that they conceive of us as being (a sort of gender identity I guess) and dysphoria can result from any discrepancy between this conception and genuine sex. The David Reimer case demonstrates this perfectly. Reimer was brought up a girl and told he was female despite being male. The resultant dysphoria caused him to (de)transition by the time he was 15 years old, having had discomfort 'always' and being suicidal when he was 13. Here the brain knew it was male, but was being told the body was female. Parallels are clear with transgender experiences--the brain thinking it is one thing, but the body being another.

@WallaceinAnderland Eddie Izzard is a difficult case. He has said he felt transgender since the age of 4, but then again, he has identified as genderfluid and was OK with being referred to as a man (at least at some times) in 2019. This lack of permanent and unchangeable dysphoria suggests to me that any dysphoria he think he does have is born out of something entirely. In other words, his feelings could be treated with therapy.

By people who claim they have no sex at all, are you referring to agender or non-binary people? Again, I think they fall into the therapy category. It's not a coincidence that the number of people identifying as agender or non-binary has risen massively with awareness and 'trendiness' of the trans movement along with rates of neurodiversity. 'A lifestyle choice' still feels like a misnomer there though; as much as it might be for something like depression. They do genuinely hold feelings about their gender, but there's actually no neurological disorder. Your examples of badly treated young women and older men do seem like lifestyle choices though, where a conscious decision for some sort of ulterior motive.

@BinturongsSmellOfPopcorn It means I think that other people should treat these transgender people like they would anyone else of that gender, referring to them as they prefer and allowing them into spaces for that gender. But I wouldn't support any government attempts to force people to use certain names or pronouns, nor would I support the government forcing private businesses to operate mixed-sex facilities in this way. I still think school facilities and prisons should be separate.

Distinguishing the cause of dysphoria is complex but I think age is a key factor. In the David Reimer case I mention above, Reimer said he had always felt some level of dysphoria. This matches cases of gender dysphoria seen before roughly 2010. The typical patient referred to gender services was in their infancy, usually male too. By comparison, non-neurological causes manifest in dysphoria that starts later in life, around puberty or even in adolescence. So too do the ways of transitioning change: someone with this neurological mismatch will often want to go the whole way with every possible method of transition, but today we seen more and more people saying they are non-binary or genderfluid or not taking surgical options.

Dysphoria may not be solved by transition, but it can be reduced by it. A reduction in dysphoria doesn't require it to be fully eliminated. I'm aware mental health worsens etc., but I think this would be seen regardless of the treatment or whether there is treatment at all (at least for those whose gender dysphoria can't be treated with therapy). The Finnish and Swedish studies compare rates among trans people with controls, but not just the rates of trans people before and after transitioning. When this has been done in the past, e.g. with Smith et al. (2005), transitioning seems effective.

Neurological gender dysphoria is different from weight-related eating disorders and body dysmorphia because the problems there are of self-image and anxiety. They have no connection to what is genuinely true about the patient and can't be alleviated with acceptance or validation. Gender dysphoria, however, is based explicitly on the fact that the patient really is one sex or the other, and not the one their brain thinks of them as. There's evidence to suggest that transitioning does help in these cases too.

@Shortshriftandlethal Gender dysphoria itself is not a recent phenomenon like queer theory. It may appear recent because the trans rights movement has gained a lot of ground in the last decade, and there has been a huge increase in the number of those diagnosed with it, but gender dysphoria has been investigated alongside transitioning for decades, at the very least since the 1960s.

The genders themselves and their roles are socially defined, but a person's gender isn't. A feminine gay man is still a man even if he's soft-spoken and wears dresses; a masculine lesbian is still a woman even if she's brash and wears suits. I would argue a person's gender is what their brain conceives of their sex as being. Nevertheless, I agree with you that 'gender ideology' does mistake gender non-conformity with being transgender, and that this argument has led to the increase in people whose gender dysphoria (if it can be described as that) can be solved with therapy.

Edited

It has only recently be referred to as 'gender dysphoria' though. People have always felt and experienced what we might now call 'dysphoric' feelings - but now they have been couched in the language and symbolism of trans ideology.

Eddie Izzard has been cross dressing since the age of 4; but has now utilised the language of trans activism to rebrand the experience.

Gender is not a synonym for Sex.

SwirlyGates · 22/08/2026 20:52

I would say therapy - and/or drugs that act on the brain, though I don't think there are any at present.

Gender dysphoria is psychological - there is nothing wrong with their bodies, to an outside observer, and you shouldn't treat an issue in the mind by altering the body. That just brings all sorts of health problems, as well as problems of never actually passing as the opposite sex, and the problems to society of a group of people who demand to be treated as something they are not.

There are also plenty of people who think they are trans due to social contagion, and don't really have gender dysphoria. I guess some of these are the ones who eventually detransition.

SwirlyGates · 22/08/2026 20:59

backformoreofthesame · 22/08/2026 18:25

I am not sure therapy is right or needed
a more generally tolerant society however where people are not judged no matter how they present , where girls can be George or Georgiana or whatever without being bullied or teased or despised or classed as weirdo

All fine until the TiMs want to use the female loos. Or use the women's changing rooms. Or enter in female sports. Or take women-only political party posts. Or go into women's refuges. Or demand acceptance by women-only apps. Or want to take part in women-only social groups. Or require other people to call them "women" and "she". You repeat the above with TiFs and male/men/he.

Have I missed anything?

Onbuy · 22/08/2026 21:30

@backformoreofthesame can you come back and tell us what snapped you out of thinking you were a boy?

Pingponghavoc · 22/08/2026 21:44

If someone is in distress about their sex, and it can be cured by cosmetic surgery and drug side effects, are they really distressed by their sex? Their sex hasn't changed.

Similarly if they can be cured by being referred to by the opposite sex pronouns, are they really distressed by their sex?

If their sex distress is cured by being in the opposite sex spaces, are they really distressed about their sex?

Whatever it is, its not about their sex, because there isnt anything on earth that can change a persons sex, yet they claim to find cures. None of which are cures, they are too superficial, nothing has changed.

Yetanotherone12 · 22/08/2026 21:52

WallaceinAnderland · 22/08/2026 14:13

Where do people like Eddie Izzard fit in then? Or those people that claim they have no sex at all and everyone must pretend they can't tell by looking if they are male or female? I'm not even convinced it's a medical condition or a mental health condition for those people. It's just a lifestyle choice isn't it?

What I do honestly believe is that some young women are so badly treated because of the affects of porn that they want to hide their sex and avoid exposure to harm and some older men have a fetish where they are turned on by dressing up as women. Where do those people fit in?

When Eddie first became known his dress style, make up etc was obviously questioned by many an interviewer.

at no point did he say he was a cross dresser, felt like a woman, or a transvestite, to use the terminology of that era.

he maintained he was a man, he enjoyed wearing clothes, make up, nail varnish etc, and they weren’t “womens clothes” they were just clothes, and it didn’t matter who wore them. I actually used to like him and thought less stereotyping of the genders was a good thing.

the transgender “I am a woman on Mondays and every third Wednesday” thing is recent for him.

Yetanotherone12 · 22/08/2026 21:57

FairHippopotama · 22/08/2026 17:59

Well, some of the underlying reasons why women seek sex separation are related to sex itself, but I think a lot of them are related to things that trans women, at least trans women identified and treated early enough, wouldn't share. For example, male brains might be more violent, but testosterone and gender roles definitely play a role too, most likely a larger role. Once you remove those, I'd imagine there's a lot of overlap in the likelihood to commit violence between males and females.

I believe this studies have been done. Male to female transgender individuals commit offences at the same rates as individuals of their birth sex.

so no, transitioning makes no difference to the violence statistics, and transgender men don’t reduce their offending to female levels.

IwantToRetire · 22/08/2026 22:02

Just a slight correct, clarification to my earlier post. The figure of 10,000 is for those with a GRC. I dont know if there is a public figure for detransitioners.

This is the only group that has legal protection along with those who can show they are "on the pathway" to transitioning, getting a GRC.

Everyone else, whatever fancy title they give themselves are not covered by the law, and have no more rights than a group that forms around dressing like Dolly Parton or ...

The Supreme Court made that clear and in fact recognised that their ruling about sex being biological meant that those with a GRC had lost some of their legal rights.

Whether someone who is suffering from physical distress because parts of their body feel alien to them would have a better life through surgery or were prescribed drugs that reduce the feeling of distress we will never know unless or until someone offers this as an alternative and then monitors the results.