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transRecently, this page came to my attention. It's a German language page which contains a translation of a letter proporting to be from a number of practitioners at the NHS's Portman Clinic, which is a major centre for psychotherapy in London. The page includes the original English text at the bottom, which is fairly short and I shall include it here:
This letter was apparently sent in 2002, in the context of a legal decision which led to the 2004 Gender Recognition Act. Although it is 6 years old, a quick check suggests some of the signatories are still working there.
I find this letter particularly concerning because the Portman Clinic offers GID services to adolescent trans people. While I do not know if any of the signatories are involved with that part of the clinic's operation, I think it's worrying that representatives of a clinic dealing with gender dysphoric young people apparently held (still hold?) such a view of trans people. It may go some way towards explaining why the UK lags behind countries such as the Netherlands and the US in not prescribing hormone blockers to gender dysphoric adolescent people until they have reached the age of 16, where they can be transferred to an adult gender clinic.
It seems to me that this is pretty much advocating reparative therapy, and comes as something of a contrast to the mainstream adult GIC at Charing Cross hospital, which seems to be showing an increasing willingness to engage and liaise with the trans community directly, and whose doctors have been on the record as guest speakers at various trans support group meetings as stating that they do not regard transsexualism as a mental illness.
I in no way wish to engage in scaremongering, but I do feel that we are failing our trans youth in the UK when attitudes such as this seem to be present at one of the few places where they can supposedly go for help. While I won't pretend that trans healthcare for over 16s in the UK is just peachy (PCTs refusing to fund hair removal generally, and some PCTs refusing to fund pretty much anything in particular, and the requirement for social transition before hormones, which I feel is not universally appropriate and may encourage unmonitored self-medication), London's major GIC is at least staffed by people who don't regard us as delusional, don't refer to our surgeries as "mutilation", and are willing to engage with the community directly.
While this letter is historical, and may not represent the views of those at the Portman working directly with trans youth, at the very least I think this sort of letter is very unhelpful, and risks undermining confidence in a centre which trans youth should be able to have confidence in.
| Re: The psychiatry of transsexuality Date: 15 July 2002 Sir - The recent judgment in the European Court of Human Rights (report, July 12), in which a post-operative transsexual person was granted permission to marry in his adopted gender role, is a victory of fantasy over reality. The experience of many psychiatrists, psychoanalysts and psychotherapists working with transsexual patients is that they are individuals who, for complex reasons, need to escape from an intolerable psychological reality into a more comfortable fantasy. By attempting to live as a member of the opposite sex, they try to avoid internal conflict, which may otherwise prove to be too distressing. It is a measure of the urgency and desperation of their situation that they frequently seek surgery to make their fantasy real. By carrying out a "sex change" operation on their bodies, they hope to eliminate the conflict in their minds. Unfortunately, what many patients find is that they are left with a mutilated body, but the internal conflicts remain. Through years of psychoanalytic psychotherapy, some patients begin to understand the origins of their painful conflicting feelings and can find new ways of dealing with them, other than by trying to alter their bodies. The recent legal victory risks reinforcing a false belief that it is possible to actually change a person's gender. It might also strengthen the view that the only solution to psychic pain is a legal or surgical one. From: Sira Dermen, Dr Damian Gamble, Dr Az Hakeem and five others Portman Clinic,London NW3 |
This letter was apparently sent in 2002, in the context of a legal decision which led to the 2004 Gender Recognition Act. Although it is 6 years old, a quick check suggests some of the signatories are still working there.
I find this letter particularly concerning because the Portman Clinic offers GID services to adolescent trans people. While I do not know if any of the signatories are involved with that part of the clinic's operation, I think it's worrying that representatives of a clinic dealing with gender dysphoric young people apparently held (still hold?) such a view of trans people. It may go some way towards explaining why the UK lags behind countries such as the Netherlands and the US in not prescribing hormone blockers to gender dysphoric adolescent people until they have reached the age of 16, where they can be transferred to an adult gender clinic.
It seems to me that this is pretty much advocating reparative therapy, and comes as something of a contrast to the mainstream adult GIC at Charing Cross hospital, which seems to be showing an increasing willingness to engage and liaise with the trans community directly, and whose doctors have been on the record as guest speakers at various trans support group meetings as stating that they do not regard transsexualism as a mental illness.
I in no way wish to engage in scaremongering, but I do feel that we are failing our trans youth in the UK when attitudes such as this seem to be present at one of the few places where they can supposedly go for help. While I won't pretend that trans healthcare for over 16s in the UK is just peachy (PCTs refusing to fund hair removal generally, and some PCTs refusing to fund pretty much anything in particular, and the requirement for social transition before hormones, which I feel is not universally appropriate and may encourage unmonitored self-medication), London's major GIC is at least staffed by people who don't regard us as delusional, don't refer to our surgeries as "mutilation", and are willing to engage with the community directly.
While this letter is historical, and may not represent the views of those at the Portman working directly with trans youth, at the very least I think this sort of letter is very unhelpful, and risks undermining confidence in a centre which trans youth should be able to have confidence in.