Rafferty’s clinical notes show that he saw her as a “high-risk” patient, citing the emotional and sexual abuse she had suffered and the precarity of her current situation with no income and not enough food to eat. Rafferty then specified that “current goals” of treatment included “masculinising hormones” and “top surgery” but that the patient was experiencing “internal turmoil between alters about [the] meaning of gender identity that likely requires additional support and exploration”. Yet apparently Rafferty saw nothing serious enough to delay the administration of testosterone injections.
These are shocking allegations. But this isn’t the first tangle “gender-affirming care” has had with dissociative identity disorder. At the 2022 World Professional Association for Transgender Health conference in Montreal, a session was dedicated to helping providers transition patients who claim to have multiple personalities. These “alters” or “headmates”, presenters claimed, each possess their own sense of gender identity and desired gender presentation — identities and presentations that may be in conflict with one another.
One “headmate” may desire a masculine presentation, which may require testosterone and a double mastectomy. Another may prefer a feminine appearance. Dr. Christopher Wolf-Gould lamented that patients must often “choose” between their trans identities and their identities as “plurals”, since clinicians may balk at facilitating hormonal and surgical interventions for such complicated psychiatric cases.
Assuming that one buys into such a contested diagnosis in the first place, these cases raise difficult questions about the possibility of consent and the potential for medical harm and regret. How does a clinician adjudicate conflicts within the self about which irreversible interventions to pursue, when “headmates” disagree?
“If it’s a small system [with a limited number of ‘headmates’], it’s preferable to interview each headmate. But if it’s a huge system with thousands of headmates, interview a council [of ‘headmates’],” Wolf-Gould advised, before conceding that, “obviously, they share a body, so they have to make one decision.”
It shouldn’t take a legal case alleging serious medical harm to see that something has gone badly wrong in this area of medicine. The evidence of harm has been out in the open for years. Unfortunately — and tragically — this won’t be the last of it.
Read the rest at UnHerd!
The rest of her life in jail wouldn't be sufficient to atone for her crimes
I heard about the trans craze at the same time I heard about the DID craze - a few years ago now, though I believe the trans thing came first. Gen Z kids were saying they had DID and calling themselves a system. Check out the compilations of the tik tok videos on youtube, introducing each of their alter, each with a different name, clothing style, gender identity, different sexual identity (ace, demisexual) etc etc. The same cohort also self diagnosing with autism and ADHD.
It came out of nowhere, then it's all over tik tok/ instagram/ youtube. How any therapist could think this is anything but a bizarre online social contagion is beyond me. Kids looking for answers in the wrong places and therapists affirming them into medicalisation. Easy profit.