Proposal Submitted: Continuing Education for Therapists on Detransitioners, Desisters, and Transition Regret

I submitted this proposal to a major institution that provides continuing education courses for therapists.

Therapists are required to periodically complete continuing education (also known as CEU’s - continuing education units). Requirements vary by state; in Oregon, it’s 40 units every 2 years. There’s a desperate need for a course that looks like this.

Learning objectives

Key objectives

1. Define the terms detransition, desist, and transition regret

2. Gain familiarity with these new and rapidly growing populations

   • Demographics

   • Common sociocultural profiles & social influences, including online communities

   • Narrative themes

3. Hear personal accounts from:

   • People in all stages of detransition

   • Desisters

   • People who regret or question transition

   • Transgender allies

   • Families

   • Therapists and other medical professionals with experience treating this population

4. Learn from these individuals:

   • Why they wanted to transition and detransition

   • What they found helpful and harmful in their treatment from therapists and other medical professionals

   • What they would like us to know so that we can best support their peers in the future

5. Understand common psychiatric comorbities before, during, and after various stages of transition and/or detransition

6. Understand the impacts of puberty blockers, cross-sex hormones, and sex reassignment surgeries on the endocrine and nervous systems, and therefore, on cognition and emotion; as well as other long term psychological and physiological effects of medical interventions, and their clinically relevant impacts on this population

7. Understand the developmental psychology of transition/detransition desires and decision making

8. Address ethical issues with regard to psychiatric evaluation and treatment

9. Understand the relationship between transition/detransition/regret and trauma

10. Develop a trauma-informed approach for the mental health treatment of this population

Course participants will also gain this foundational background:

• Overview the rapidly changing sociocultural narratives about gender over the past few decades

• Understand the medical and psychiatric standards of care for the treatment of gender dysphoria and how they have evolved over the same time period, including DSM definitions and WPATH standards of care

• Identify social, cultural, medical, and technological contributors to the recent exponential increase in people seeking medical intervention for gender dysphoria

• Understand concepts such as “gatekeeping” vs. “safeguarding,” and political and linguistic barriers to therapeutic objectivity

• Clarify common misconceptions that fuel urgency to transition, as well as important safety issues, including the relationship between transition and suicide

• Understand the medical and psychiatric risks, side effects, long term consequences, and unknowns of gender medicine

Outline:

This course will comprise a series of interviews between myself and:

• Medical professionals with appropriate qualifications

• Mental health professionals with relevant experience and expertise

• Detransitioners

• Desisters

• Transgender individuals who regret or question their transition

• Transgender individuals who do not regret transition but support those who do

• Families of transgender and detransitioned individuals

• Researchers in the fields of medicine and sexology

• Representatives of nonprofits that serve gender and sexual minorities, and other relevant advocates

Descriptive narrative:

The past decade has seen an exponential rise in people claiming gender minority identities and seeking medical interventions including novel cross-sex hormones and surgeries. Many therapists’ lack of adequate training and experience, when combined with the heated political nature of gender issues and pressure from sources outside of our field, have contributed to rapidly growing rates of transition regret and reversal. Individuals who regret and/or reverse their transitions frequently report feeling deeply traumatized and psychologically disturbed by their experiences, but have little trust in mental health professionals, often due to our own failures. This results, not only in these individuals hesitating to seek the treatment they desperately need, but also in therapists lacking opportunities to personally witness and interact with their stories. Many clinicians therefore remain dangerously bereft of expertise in this field, underestimate rates of transition regret, are unsuited to help this population, and lack valuable perspectives that may help them serve patients who are currently considering transitioning or detransitioning. This training aims to address these problems and catch therapists up to speed on this new, rapidly growing population and their clinical needs.

Problem or gap addressed

Clinicians’ lack of adequate experience and training with this new and rapidly growing population.

Evidence problem/gap exists

High rates of transition regret coupled by numerous expressions in online communities that these individuals have had negative experiences with therapists and have lost trust in our ability to support them.

Educational needs addressed

See above.

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