One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria
- PDF / 639,929 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 30 Downloads / 190 Views
LETTER TO THE EDITOR
One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria Roberto D’Angelo1,2 · Ema Syrulnik2 · Sasha Ayad2 · Lisa Marchiano2 · Dianna Theadora Kenny2 · Patrick Clarke2 Received: 4 November 2019 / Revised: 17 September 2020 / Accepted: 19 September 2020 © The Author(s) 2020
Turban, Beckwith, Reisner, and Keuroghlian (2020) published a study in which they set out to examine the effects of gender identity conversion on the mental health of transgender-identifying individuals. Using the data from the 2015 U.S. Transgender Survey (USTS) (James et al., 2016), they found that survey participants who responded affirmatively to the survey question, “Did any professional (such as a psychologist, counselor, religious advisor) try to make you identify only with your sex assigned at birth (in other words, try to stop you being trans)?” reported poorer mental health than those who responded negatively to the question. From this, Turban et al. concluded that gender identity conversion efforts (GICE) are detrimental to mental health and should be avoided in children, adolescents, and adults. The study’s conclusions were widely publicized by mass media outlets to advocate for legislative bans on GICE, with the study authors endorsing these calls (Bever, 2019; Fitzsimons, 2019; Turban & Keuroghlian, 2019). We agree with Turban et al.’s (2020) position that therapies using coercive tactics to force a change in gender identity have no place in health care. We do, however, take issue with their problematic analysis and their flawed conclusions, which they use to justify the misguided notion that anything other than “affirmative” psychotherapy for gender dysphoria (GD) is harmful and should be banned. Their analysis is compromised by serious methodological flaws, including the use of a biased data sample, reliance on survey questions with poor validity, and the omission of a key control variable, namely subjects’ baseline mental health status. Further, their conclusions are not supported by their own analysis. While they claim to have found evidence that GICE is associated with * Roberto D’Angelo [email protected] 1
Institute of Contemporary Psychoanalysis, Los Angeles, CA 90064, USA
Society for Evidence-Based Gender Medicine, Twin Falls, ID, USA
2
psychological distress, what they actually found was that those recalling GICE were more likely to be suffering from serious mental illness. Further, Turban et al.’s choice to interpret the said association as evidence of harms of GICE disregards the fact that neither the presence nor the direction of causation can be discerned from this study due to its cross-sectional design. In fact, an alternative explanation for the found association— that individuals with poor underlying mental health were less likely to be affirmed by their therapist as transgender—is just as likely, based on the data presented. Arguably, even more problematic than the flawed analysis itself is the simplistic “affirmation” versus “conversion” binary, which
Data Loading...
