An article in The Guardian (05/23/2007) features someone who feels that she was “improperly” authorized for sex reassignment surgery after only 45 minutes of consultation 20 years ago, and now regrets the decision. The psychiatrist who diagnosed her with gender identity disorder and approved the surgery was censured by the professional body last week for this and many other rushed diagnoses/surgeries.
The problem with “gender identity disorder” specialists like this psychiatrist is that trans people generally don’t want anybody who would actually evaluate their mental state rigorously. They know what they want for the most part, and prefer “specialists” that would issue a letter of approval as quickly as possible. As a result, less rigorous “specialists” become popular within the trans community and drive out competitors who are more thorough. I’ve come across more than a few GID “specialists” who seem unprofessional and incompetent, because professionalism and competency are not what trans people look for in a GID counselor/psychiatrist. The only attributes required to succeed as a GID “specialist” are the ownership of medical (or sometimes psychotherapist) license and the ability to sign on a form letter (being disinterested in patient’s well-being is actually a plus).
I believe that the current standards of care that requires doctors to act as “gatekeepers” to ensure that the patient is a true transsexual is fundamentally flawed, as it perverts the clinical relationship between the physician and the client. In fact, I would argue that it is in violation of basic therapeutic ethics because the role of the “gatekeeper” conflicts with the primary responsibilities of a physician or a therapist. When anything they say in a counseling session could be used to block a procedure they want badly, trans people have no incentive to speak honestly about any anxieties or confusions they might be feeling, for example.
I think everyone would be better off if we moved on to a medical regime in which doctors only concern themselves with ensuring that the client is properly informed of risks and benefits of the sex reassignment surgery, and that s/he is not making a life-determining decision in a haste.
(Via Feminist Philosophers)