Key Findings

• Argues that the 'trans' identity label encompasses a complex range of internal psychic positions beyond consciously stated preferences
• Explores cases where premature embrace of transgender identification may undermine the painful psychic work needed to understand what being transgender means for a given young person
• Highlights the difficulty clinicians face when asking 'why transgender' is perceived as pathologizing in external culture
• Advocates for 'equidistant curiosity' about meaning and function as core to an analytic approach
• Warns against both using psychoanalysis as a conversion tool and against silencing exploratory dialogue

Abstract

The capacity of transgender to incorporate all gender variance and sexual preferences has become a powerful tool of activism and personal identification. Rather than being an index of marginality 'trans' has become a central cultural site. In this paper, I will argue that this identity label encompasses a complex range of internal psychic positions in relation to consciously stated sexual preferences and gender identifications. My aim is to explore what can appear to be in some cases a premature embracement of the empowering potential of the transgender identification through my work with under 18-year-olds who are seeking medical intervention for gender dysphoria. This can undermine the painful psychic work required to establish what transgender means for any given young person. In an external culture where to ask 'why transgender' (as opposed to 'how transgender') is felt to be pathologising, working with these young people can prove difficult for the analyst. The challenge is to tread the fine line between a dialogue based on an equidistant curiosity about meaning and function that is core to an analytic approach, and a posture of implicit skepticism.

Summary

Lemma, a psychoanalyst, offers psychoanalytic reflections on transgender identity based on clinical work with under-18-year-olds seeking medical intervention for gender dysphoria. She argues that the 'trans' identity label masks a complex range of internal psychic positions and that premature embrace of transgender identification can undermine the deep psychological work required to understand what this identity means for each individual. The paper advocates for maintaining a posture of 'equidistant curiosity' while warning against both conversion practices and the silencing of exploratory discourse.

Conclusion

My experiential and theoretical reference points are steeped in conventional gender ideas. The grids of intelligibility that frame subjective experience inevitably limit every author, which is precisely why dialogue with others is vital so that we can ensure that we understand the different meanings of transgender identity and do justice to the heterogeneity of experience within the transgender community. Only this way can we assist more effectively those who seek our help. This will include those individuals for whom SRS is the chosen way forwards as well as those for whom this is unlikely to provide a solution. Psychoanalysis has an invidious history in relation to the prejudiced stance it took with respect to homosexuality and we must be careful not to repeat mistakes of the past when we approach transgender. Psychoanalysis should never be used as a tool of coercion or conversion – however subtle – when it comes to individual choices about how to live one's life. However, dialogue is a multi-way process and requires us all to tolerate many voices with a respect for the differences that this will expose. The policing of discourse runs the risk of atrophying thinking and consolidating prejudice rather than exposing it.