Die Rolle der Kliniker bei Genderdysphorie

In einem wissenschaftlichen Beitrag beleuchtet Stephen B. Levine die Behandlungsansätze und Möglichkeiten der Psychotherapie bei Menschen, die an Genderdysphorie leiden. Und er liefert am Beispiel von jugendlichen Patienten ein Modell für einen Bewertungsprozess, das sich deutlich von dem üblichen „Affirmations-Modell“ unterscheidet.

„Gender identity is only one aspect of an individual’s multifaceted identity” and „it is relevant and ethical to investigate the forces that may have propelled an individual to create and announce a new identity.” ... "Making a diagnosis of gender dysphoria is easy. Thinking about what it is a response to is not."

Zusammenfassung des Artikels

The fact that modern patterns of the treatment of trans individuals are not based on controlled or long-term comprehensive followup studies has allowed many ethical tensions to persist. These have been intensifying as the numbers of adolescent girls declare themselves to be trans, have gender dysphoria, or are 'boys'. This essay aims to assist clinicians in their initial approach to trans patients of any age. Gender identity is only one aspect of an individual’s multifaceted identity. The contributions to the passionate positions in the trans culture debate are discussed along with the controversy over the official, not falsifiable, position that all gender identities are inherently normal. The essay posits that it is relevant and ethical to investigate the forces that may have propelled an individual to create and announce a new identity. Some of these biological, social and psychological forces are enumerated. Using the adolescent patient as an example, a model for a comprehensive evaluation process and its goals are provided. The essay is framed within a developmental perspective.

Der Bewertungsprozess dauert bei Levin ca. 2 Tage, alle Familienmitglieder werden in unterschiedlichen Zusammensetzungen informiert, getestet und interviewt. Interessant sind auch die Konzepte.

Zu vermittelnden Konzepte

Professional values are communicated to the family. Some of these are stated in the initial meeting with the family. They are repeated or introduced when it is apparent that one or more of the family members do not yet grasp them.

1. We aim to reestablish or to maintain the family’s bond to one another (in most instances). Parents and patient are not to reject one another.
2. Parents are not the trans teen’s enemy when they express concerns about their offspring’s future; they have the right and responsibility to do so. The patient may be too young, unwilling, or unable to verbalize his or her concerns about the new identity. The parents may be expressing what the patient actually thinks, but is unable to say.
3. The adolescent is in charge of determining his or her gender identity, now and in the future.
4. It is important to identify and discuss the forces that moved the teen in the direction of a new identity.
5. Humans always have ambivalence about major life changes even when they deny it.

Reflections on the Clinician’s Role with Individuals Who Self-identify as Transgender, 15.09.2021

Interview mit Stephen B. Levine, 16.11.2021