Psychiatrists in AU and NZ Shift Stance on Gender Dysphoria, Recommend Therapy [View all]

[janterry]

A new position statement from the Royal Australian and New Zealand College of Psychiatrists (RANZCP) stresses the importance of a mental health evaluation for people with gender dysphoria — in particular for children and adolescents — before any firm decisions are made on whether to prescribe hormonal treatments to transition, or perform surgeries, often referred to as "gender-affirming care."

"There is a paucity of quality evidence on the outcomes of those presenting with gender dysphoria. In particular, there is a need for better evidence in relation to outcomes for children and young people," the guidance states.

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Asked to explain the new RANZCP position, Philip Morris, MBBS, FRANZCP, said: "The College acknowledged the complexity of the issues and the legitimacy of different approaches." Exploration of a patient's reasons for identifying as transgender is essential, he told Medscape Medical News, especially when it comes to young people. "There may be other reasons for doing it and we need to look for those, identify them and treat them. This needs to be done before initiating hormones and changing the whole physical nature of the child," he said.

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Concerns have arisen that some transgender identification is due to social contagion, and there is a growing number of "detransitioners" — people who identified as transgender, transitioned to the opposite gender, but then regretted their decision, changed their minds, and "detransitioned" back to their birth sex. If they have had hormone therapy, and in some cases surgery, they are left with irreversible changes to their bodies.

As a result, Scandinavian countries, most notably Finland, once eager advocates of the gender-affirmative approach, have pulled back and issued new treatment guidelines in 2020 stating that psychotherapy, rather than gender reassignment, should be the first line of treatment for gender-dysphoric youth.

https://www.medscape.com/viewarticle/960390