Dr. Az Hakeem: Trans Is the New Goth

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For a person suffering from gender dysphoria, the prospect of medical transition can offer the tantalizing promise of a pathway to inner peace. The anticipation and excitement about starting cross-sex hormones or undergoing a mastectomy or genital surgery often become a focal point for the distressed mind, with individuals pinning their hopes on these medical procedures to resolve all their pain and suffering.

Proponents of sex-trait modification treatments, known euphemistically as “gender-affirming care,” argue that any attempt to reconcile a transgender person with their birth sex, thereby averting the need for hormonal and surgical interventions, amounts to conversion therapy and is therefore unethical.

But the rising rate of detransition and the sharply increasing number of young people telling their stories of regret paint a very different picture. The existence of detransitioners proves that, at least for some, gender identity is not innate and fixed but instead subject to change as a young person grows and matures. 

Many detransitioners say they wish someone had sat them down and thoroughly explained the possibility of regret. They lament not being warned of the serious complications that could arise from the surgeries they chose to undergo, and many feel they were unprepared for the reality of life post-transition. 

But more than two decades ago, a British consultant psychiatrist working at the Portman adult gender clinic in London came up with an innovative approach to minimizing transition regret.