I'd expand on both the parenthetical quote Eliza shares ("only pain perceived as curable is intolerable") and the Redditor's comment quoted at the bottom, (summed nicely in the final lines: "What should a therapist tell a transwoman with gender dysphoria due to inability to become pregnant? Any answer to that question can be applied to o…
I'd expand on both the parenthetical quote Eliza shares ("only pain perceived as curable is intolerable") and the Redditor's comment quoted at the bottom, (summed nicely in the final lines: "What should a therapist tell a transwoman with gender dysphoria due to inability to become pregnant? Any answer to that question can be applied to other manifestations of gender dysphoria.)
It's largely outside the discussion of the paper, but not only does this "you're a broken version of your true self" sentiment damage self-esteem - it also stresses that you're an "other," and that'll you'll be forever outside society, or are not capable of being understood. And as the incongruence never abates, there's nothing the patient can do to feel "part" of humanity or society. They're forever a work-in-progress, estranged not only from some ideal version of self, but also that this work-in-progress is also a permanent outsider or adversary, even, of the public writ-large.
It seems that may have something to do with the increasingly violent and extreme messaging from the trans community (e.g., "trans genocide," the memes combining assault rifles and trans flags, etc.).
The whole cocktail of "affirmation" is a failure. The best way to support trans and potentially trans individuals is by *providing them care for the illnesses they have* and to *question their self-conceptions* as the Reddit author does when suggesting CBT be used in the place of affirmation.
Is the goal not to reduce suffering and help these folks feel comfortable in their own skin? Affirmation appears to be making this suffering worse. The road to hell is paved with good intentions, and all that.
"Only pain perceived as curable is intolerable." I'm sorry but that's just not true. One of the things that makes a difference to a person's ability to tolerate emotional pain is whether or not they feel hope for the alleviation of that pain in the future. When a patient gives up hope that they will ever feel different from how they do now, that is a major risk indicator of suicide, ie because losing hope that their pain will ever go away makes the pain feel intolerable. Which is why helping your patient to have realistic hope is a suicide prevention strategy in counselling work with suicidal patients. In the case of a menopausal woman or man who identifies as a woman and is grieving about not being able to get pregnant that realistic hope would look like "you won't ever be able to get pregnant, but you won't always feel this intense intolerable grief about this, because feelings change, and as you work through your grief your feelings about this will change, and you will learn to live with this and it will be okay."
But yes, the goal should be to help these folks feel comfortable in their own skin. And that would be the way to reduce their suffering. The goal is (or ought to be) to reduce their suffering by helping them to accept themselves as they are, and accept reality, and feel more comfortable in their skin. Just like working with a client with an eating disorder.
I'd expand on both the parenthetical quote Eliza shares ("only pain perceived as curable is intolerable") and the Redditor's comment quoted at the bottom, (summed nicely in the final lines: "What should a therapist tell a transwoman with gender dysphoria due to inability to become pregnant? Any answer to that question can be applied to other manifestations of gender dysphoria.)
It's largely outside the discussion of the paper, but not only does this "you're a broken version of your true self" sentiment damage self-esteem - it also stresses that you're an "other," and that'll you'll be forever outside society, or are not capable of being understood. And as the incongruence never abates, there's nothing the patient can do to feel "part" of humanity or society. They're forever a work-in-progress, estranged not only from some ideal version of self, but also that this work-in-progress is also a permanent outsider or adversary, even, of the public writ-large.
It seems that may have something to do with the increasingly violent and extreme messaging from the trans community (e.g., "trans genocide," the memes combining assault rifles and trans flags, etc.).
The whole cocktail of "affirmation" is a failure. The best way to support trans and potentially trans individuals is by *providing them care for the illnesses they have* and to *question their self-conceptions* as the Reddit author does when suggesting CBT be used in the place of affirmation.
Is the goal not to reduce suffering and help these folks feel comfortable in their own skin? Affirmation appears to be making this suffering worse. The road to hell is paved with good intentions, and all that.
"Only pain perceived as curable is intolerable." I'm sorry but that's just not true. One of the things that makes a difference to a person's ability to tolerate emotional pain is whether or not they feel hope for the alleviation of that pain in the future. When a patient gives up hope that they will ever feel different from how they do now, that is a major risk indicator of suicide, ie because losing hope that their pain will ever go away makes the pain feel intolerable. Which is why helping your patient to have realistic hope is a suicide prevention strategy in counselling work with suicidal patients. In the case of a menopausal woman or man who identifies as a woman and is grieving about not being able to get pregnant that realistic hope would look like "you won't ever be able to get pregnant, but you won't always feel this intense intolerable grief about this, because feelings change, and as you work through your grief your feelings about this will change, and you will learn to live with this and it will be okay."
But yes, the goal should be to help these folks feel comfortable in their own skin. And that would be the way to reduce their suffering. The goal is (or ought to be) to reduce their suffering by helping them to accept themselves as they are, and accept reality, and feel more comfortable in their skin. Just like working with a client with an eating disorder.