The Three Ways of Managing Gender Dysphoria

I'm 74 years old, have four children, four stepchildren and eight grandchildren, soon to be nine. Yet I was transgender for 15 years, between the ages of 12 and 26. It was a painful and unforgettable experience during which I was obsessed with not letting my trans-identity show through effeminate behaviour or a spontaneous reaction that would betray my homosexual tendencies. I mention it here because, at my age, you have to ask yourself what you want to do before you die. Well, I want to pass on my story to tell young people suffering from gender dysphoria that there are at least three ways of dealing with the pain of gender dysphoria:

1) Resigning oneself to living with dysphoria.

2) Changing one's body to match their mind via hormone therapy and surgery.

3) Reconciling your psychological identity with the biological identity of your sex with help from a qualified therapist. Today, this third path has become a new taboo called ‘conversion therapy’. It's a mistake to make it a new taboo, even if a famous documentary on the subject has mixed conversion therapy with exorcism, guilt-tripping speeches, group prayers and behaviourist therapies from another age, as well as some legitimate and honest speeches, with a certain amount of bad faith.

In 1976, after eight years of supportive psychotherapy, which helped me not to despair and not to commit suicide, I was able to meet a deeply sympathetic phenomenological sexologist psychiatrist who offered me, among other things, an experience of cognitive behavioural therapy (CBT). This delicate episode enabled me to overcome my fear, my deep-seated complex and my abysmal shame about my gender identity and my homosexual attraction. The experience was like being born again. I chose the third way.

Today, it's been almost 50 years since that happened and I've been able to have a love life with women, get married, have children and grandchildren as well as a free and fulfilling social and professional life. The term ‘gender dysphoria’ was completely unknown to me in 1960-70, when I suffered from it and felt monstrous and ashamed. But since the 2000s, the term has become commonplace in the media and I think that all mental health professionals are aware of it and that some of them try to help the teenagers affected by suggesting that they modify their bodies using puberty blockers, hormone therapy and sex surgery. There is now a heated debate throughout the western world surrounding this “gender affirming” care, accompanied by new taboos and condemnations, as if this would help the young people and their parents.

My experience seems to prove that there is a third way, which I call ‘reconciliation therapy’ between gender identity and sexual identity (not to be confused with ‘conversion therapy’). Yes, psychological identity is a flexible thing and there are therapies that allow you to change not only your behaviour, but also your self-image in the eyes of yourself and others. However, this approach is not well known, even though it offers an alternative to the early prescription of puberty blockers and cross-reactive hormones.

Adolescence is a very delicate period when you have to avoid making irreversible changes. However, in my personal case, if I'd had the opportunity to embark on the path of changing my body to become a trans-woman, I would have rushed into it, UNLESS I'd had access to a third way testimonial like this one. In that case, I would have thought about it and would have liked therapeutic support to consider the three paths, without excessive guilt, without hiding and without fear of the repercussions for my family, friends and society. I could have counted on supportive therapy until I was 18 to avoid depression and suicidal thoughts, and then made a definitive and informed choice between the three ways of managing gender dysphoria.