Die Hoffnung auf ein besseres Leben
Wie auch immer Menschen zu ihrer ‚Gender-Reise‘ kommen, spätestens die irreversiblen medizinischen Maßnahmen können nicht ‚ausprobiert‘ werden, es besteht immer das Risiko, sich zu irren. Selbst für Erwachsene ist es oft schwer, herauszufinden, ob sich damit die Unzufriedenheit mit dem eigenen Geschlecht beseitigen lässt.
Dr. Az Hakeem, Facharzt für Psychiatrie und medizinische Psychotherapie und Honorary Associate Clinical Professor at University College London (UCL) Medical School aus London, hat jahrelang therapeutische Gruppen für Erwachsene moderiert. Er nahm jeweils zur Hälfte erwachsene Personen auf, die eine medizinische Transition durchlaufen hatten und diese oder Teile davon bedauerten. Zur anderen Hälfte bestand die Gruppe aus Personen, die vor der medizinischen Transition standen und i. d. R. ‚gendereuphorisch‘ waren.
Diese Gruppen boten eine faszinierende Möglichkeit, genderdysphorischen Menschen mehr Einblick in die langfristigen Erfahrungen der Transition zu geben.
„It wasn't a conversion. So my role wasn't to persuade people to not have a sex change. And it wasn't to help people through a sex change, I was being completely neutral. These are adults, they can do what they want. They don't mind what they do, or what I wanted them to do was think about it. And it was an exploratory space. And the regretters said, 'if only we had this sort of exploratory space before we went on to do to have the sex changes, because no, what no one was asking us, what do you mean?'"
Hakeem machte mit seiner Gruppentherapie folgende Erfahrung:
„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."
Lediglich 2 % der ‚gendereuphorischen‘ Teilnehmenden haben schließlich die Transitions-OPs durchführen lassen, 98 % ließen sich nicht operieren.
Zu den im Allgemeinen sehr niedrig geschätzten Detransitionsraten sagte Az Hakeem, er vermute, dass es einfach an fehlenden Follow-Up-Studien liege. Er habe all seine KlientInnen gefragt, niemand sei nachverfolgt worden. Nach der letzten Operation / Behandlung wurden die Transitionierten frei in die Welt entlassen wie Schmetterlinge.
A Fun Friendly Chat with Dr. Az Hakeem, YT-Interview 22.08.2022
Gender A Wider Lens - Podcast: Psychotherapie vor und nach der Transition mit Az Hakeem, 25.02.2022
Interview mit Ak Hakeem, Transgendertrend, 2021
Auf YouTube anschauen
Podcast1 – A Fun Friendly Chat with Dr. Az Hakeem
Az Hakeem zu Detransition und Reue:
„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."
Im Interview wird auch darüber gesprochen, wie bewusst euphemistisch die Sprache bei Trans-Themen oft benutzt wird:
„It's the way it's portrayed. So rather than calling it chemical castration, you're calling it puberty blockers that pause puberty. Rather than saying you're going to amputate the breasts of girls, you're saying it's top surgery. You know that is sanitized. And rather than saying you’re not even going to explore why they feel that they’re the wrong sex, you're calling it affirmation therapy. Affirmation sounds positive, doesn't it? Affirming sounds great, but affirming means you're not asking them‚ ‚Oh, why do you not like being a boy?‘‚ ‚Why do you not like being a girl?‘, which is the obvious question. Affirmative though is yes, because your body's wrong, well this is what we can do. So affirmative is collusion, whereas exploration is always helpful: you know with any problem think about it and explore it."
Podcast2 – Understanding Gender Dysphoria and Identity: The Connection to Autism | Dr. Az Hakeem
Dr. Az Hakeem, Facharzt für Psychiatrie, forensischer Psychotherapeut und Gruppenanalytiker, spricht mit Abdullah Boulad über Psychiatrie, Genderdysphorie, Identität, Trauma, Psychotherapie, Autismus, Burnout und die Bedeutung kritischen Denkens in der psychischen Gesundheitsversorgung
Understanding Gender Dysphoria and Identity: The Connection to Autism | Dr. Az Hakeem, YT, 02.07.2026
00:00 – Vorstellung von Dr. Az Hakeem
01:52 – Von Kunst und Literatur zur Psychiatrie
03:30 – Einblick in die Welt der forensischen Psychotherapie
06:24 – Kindheit, Identität und Anderssein
08:13 – Die Geschichte hinter der Gothic-Ästhetik
18:08 – Biologisches Geschlecht, Gender und Genderidentität verstehen
24:13 – Reue nach der Transition: Die Perspektive eines Psychiaters
27:04 – Autismus und GD: Die Verbindung
29:36 – Die Debatte um die Tavistock-Klinik und die Versorgung von Menschen mit Genderidentität
34:05 – Gruppentherapie bei GD: Ein alternativer Ansatz
42:04 – Gendermedizin und die Debatte um Kinder
44:24 – Unterstützung für Menschen, die ihre Genderidentität hinterfragen, Umgang mit nonkonformen Kindern
46:39 – Trauma, sexuelle Entwicklung und menschliches Verhalten
53:18 – Die Rolle der Neugier in der Behandlung psychischer Erkrankungen
56:42 – Warum jede Geschichte gehört werden sollte
1:00:45 – Erziehung ohne Etiketten und Vorurteile
1:06:14 – Burnout, Angstzustände und Depressionen bei Leistungsträgern
1:08:47 – Warum „anspruchsloses Fernsehen“ die psychische Genesung fördern kann
1:10:06 – Dr. Az Hakeems tägliche Gewohnheiten für mehr Ausgeglichenheit
1:12:30 – Abschließende Gedanken zu psychischer Gesundheit und menschlichem Verhalten
Einige Ausschnitte zum Thema „Genderdysphorie" aus diesem Podcast:
Genderdysphorie und Autismus
„What I found was that the transsexual males, so the ones who were certain that they wanted to be women, were all autistic, all of them. … What I found was that all 100% of what of the males who would formally be called transsexual are on the spectrum. Totally 100% 100% 100%. I was the first person to say that's true and it differs from the female to male transsexuals."
„So what I found was the degree of autism predicted whether or not they'd regret it later. So if they were really quite autistic, and they really believe that by having a wig and long hair and a dress and lipstick that people believe that they're a woman because they got a female name and pronouns, then they might be happy because people just humouring them saying, 'Oh yes, she, her, what Janet.' and they might accept that. But it was the ones who weren't that autistic that they started off with gender dysphoria, then they go to transgender euphoria and then because they didn't have enough protection, waterproofing from enough autism. They then had this sense of what if they don't really believe that I'm a woman. And they were the ones who regretted it."
„So not everybody autistic becomes transsexual, but if you're autistic, and you don't know you're autistic, but you feel different pelvic different to your peers, and then you come across the concept of being trapped in the wrong body. It might appeal to you. That's when they and being autistic, they hone in on it. They become blinkered and they run with it."
Ist Gruppentherapie sinnvoller für Menschen mit ASS?
„So what I found is if you're doing therapy with an analytic therapy thoughtful challenging therapy with someone who's autistically trans a transsexual it's very difficult because you get into a 'yes no', 'right wrong', 'male female' like a pantomime so that's why I did group analysis."
Das Verständnis von männlich und weiblich erweitern
„So you know I encourage being people to be subversive. You can wear what you want. You can wear make, that doesn't mean you're the wrong sex. You know my point is nobody is wrong. You can do what you want. And I wanted them to increase their repertoire of what it was to be male or female."
Das Verhalten von Kindern nicht in Schubladen packen
„You know, I think I had like 26 dolls as a child. Like doesn't mean I was a girl. I think anything the child does or is fine. If he would like to wear a fairy costume, or she would like to be a tank driver, it's fine. That doesn't mean they're wrong, they're the wrong sex. So I encourage my patients to be more subversive, just be a bit more creative and just expand the repertoire – and the rules don't exist. That's a social construct. Anything you do is fine. So, it's so from a parenting thing is to allow everything without inviting them to think that there's a problem. So I've got friends who say that that their children who may be you know a bit tomboy or a bit camp or whatever are invited by the teachers. These 8 or 10-year-old children are invited to consider whether they should be trans because the teachers, have been brainwashed. The teacher saying to a child 'do you think you should be a boy because you like football' and this, that and the other. And then they are planting these ideas into the children's head, you know, that's what I'm saying, it's like one child by proxy transoms by proxy, you're creating problems. If you just leave the children alone, they're fine."
Affirmative Therapie ist Komplizenschaft
„You know, there's this thing called affirmative therapy. It's not therapy. It's collusion. So, if a child says, 'Oh, I think I'm a penguin.' They go, 'Oh, yes, you are a penguin.' And they collude with the false notion. So, it's a misnomer. It sounds good. Affirmation sounds good and positive. It actually just means collusion. And because it's called therapy, people think it's a good thing."
Az Hakeems Beobachtungen
„What I found in my population was the males a 100 % of them of the males I saw who would be called transsexual were on the autistic Spectrum and the and the females they seem to have a higher instance of trauma often sexual trauma or they had a degree of um homophobia so lesbophobia either internalized or externalized from the cultures and societies that they were in so it was a way of escaping from that with a fantasy solution."
Interview mit Az Hakeem zum Thema Genderdysphorie, Lousiana Public Broadcast, YT, 15.05.2023
Az Hakeem’s Gruppentherapieangebot für Erwachsene
Az Hakeem hat 12 Jahre lang an der Tavistock-Klinik in London Gruppentherapien für Erwachsene mit Genderproblemen durchgeführt. Es kamen sowohl Transitionswillige, Detransitionierte, Reumütige als auch Transvestiten und autogynophile Erwachsene.
Viele TeilnehmerInnen waren mehrere Jahre in dieser Therapiegruppe. Nach einem Jahr ging es ihnen meist besser. Az Hakeem berichtet:„The analysis was by the patients so in group analysis, it's analysis of the group by the group including individual in the conductor … and that was fine coming from them and the postoperative regret or the detransition say ‚look you sounded just like I sounded 10 years ago, when I was convinced I need to have a sex change, but now I look back and I can see that and I know it was not the right thing‘, so you know they were able to do it that way and it was wonderful."
„What I found is that less than 2 % of my patients went on for any physical hormonal surgical things less than 2 %, because once they'd realized that this solution they had wasn't really a solution, but it was a proxy solution for something else underlying which they were escaping from and once they dealed with that then everything was okay."
How I became a gender-critical psychotherapist, YT, Az Hakeem, 11.02.2025
Für unsere transidentifizierten jungen Erwachsenen wäre diese Therapieform eine gute Alternative zu trans-affirmativen Angeboten von Behandlern und im Internet. Ein solches Angebot zu finden, ist sehr schwierig, eine Art Suche nach der „Nadel im Heuhaufen". Im Moment gibt es nur englischsprachige Angebote.
Weitere Links
Psychotherapy for gender identity disorders, Az Hakeem, 02.01.2018
Az Hakeem zur Schließung der Tavistock-Klinik in London:
The Future For Gender Identity Healthcare – A Conversation with Dr Az Hakeem, YT, 09.10.2022
Dr. Az Hakeem erläutert die erfolgreiche Gruppentherapie mit erwachsenen Detransitionierten und Transitionswilligen, die er bis 2012 in der Tavistock-Klinik geleitet hat.
Dr Az Hakeem on Detrans: When transition is not the solution, battle of ideas, YT, Oktober 2025 (Min. 4:00 – 14:00)











