Summary

Lemma, a psychoanalyst, reflects on her work with teenagers seeking puberty blockers (drugs that pause puberty) or hormones. She argues that 'trans' has become a powerful identity and cultural category, but that some young people may take it up too early. That can shut down the painful inner work needed to understand why they feel as they do. She describes how hard it is to ask 'why transgender?' when that question is widely seen as treating it as an illness. She urges therapists to stay equally curious about all possible paths, including medical transition. She firmly rejects using therapy to change anyone's identity, and warns that policing debate harms thinking. The essay is based on a few anonymous cases from her own practice. It sheds light on dilemmas therapists face, but gives no evidence of how often these patterns happen or what follows.

Key findings

• Lemmaは、「トランス」というラベルは、人々が述べる性的指向や性自認との関係において、複雑な範囲の内面的な体験を含んでいると主張しています。
• 医学的治療を求める18歳未満の人々との仕事から、早い段階でトランスの自認を取り入れることが、その若者にとってそれが何を意味するのかを理解する痛みを伴う作業の妨げになったように見える症例を述べています。
• 「どのようにしてトランスジェンダーなのか」ではなく「なぜトランスジェンダーなのか」と尋ねることは、それを病気として扱うと受け取られることが多く、セラピストにとって探ることが難しくなると指摘しています。
• 彼女は「等距離の好奇心」を勧めています。これは、トランスの自認がその人にとって何を意味し、何をしているのかについて等しく好奇心を持つことで、ひそかな疑いとは異なると述べています。
• 彼女の症例資料には、5年間の徹底的なセラピーの後にトランジションしないことを決めた17歳の少女が含まれているとされています。
• セラピーは人々に圧力をかけたり変えたりするために使われてはならず、自分の分野が過去に同性愛者に害を与えたことを認めており、性別適合手術は一部の患者にとって正しい道だと述べています。
• 自分自身の見方も「従来の性別観に深く浸っている」ことを認め、異なる見解の間の対話を求めています。

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.

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.