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Frequently Asked Questions? FAQs

What are the best support systems for individuals with gender dysphoria?

Other gender dysphoric people. The most common support structures these days is the internet. It is almost always where gender dysphoric people find that they are not alone in their feelings. In my practice I have the advantage of being able to provide in-person therapy and support groups. Groups are very helpful in establishing long standing friendships that can be very helpful for all parties.

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Of those men who fully transition via SRS, what are their success-rate statistics? I enjoy the writings of those who suddenly feel fulfilled, knowing deep in their core that they did the right thing for themselves. And yet, there must be "false positives," those who thought they knew what they were doing, but then found disappointment on the other side and remained generally unhappy about themselves. It would be informative, I think, to hear their thoughts on themselves.

Yes...there are some "false positive" post-op individuals out there in the world. Fortunately they are rare. Actually extremely rare. There have been many outcome studies done over the last 30 years. Here is a paragraph from a paper I wrote that was published in Gender and Psychoanalysis entitled Implications of Being Gender Dysphoric: A Developmental Review.

Treatment: Although there is still some disagreement as to how gender dysphoria begins and who should qualify for hormonal and surgical intervention, there is a remarkable amount of agreement in several important areas. Most psychologists now agree that gender dysphoria qualifies as a subject of clinical attention separate from other disorders. Further, most clinicians agree that the gender identity beliefs these people hold are profound, deep seated, and non-delusional. Even more significantly, outcome studies now clearly indicate that when three conditions are met: a proper differential diagnosis, a significantly long trial period of living in the gender of choice, and a satisfactory surgical result, there is only a small incidence of postoperative regret. Indeed, in a review of the outcome literature Pfafflin (1992) reports that less than 1% of the female-to-male transsexuals who had undergone sex reassignment had any regrets. For male-to-female transsexuals the number was slightly higher at less than 2%. Later studies supporting Pfafflin's report include Bodlund O. et al., (1996); Cohen-Kettenis P.T (1997); Exner, K. et al., (1995); Rakic, Z. et al., (1996), and Smith Y. L. et al., (2001). It should be noted that satisfaction is measured by self report of improvement in the individual's psychosocial well being.

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Can you tell me if there is a link between sexual abuse in a male between the ages of 8 and 10 and gender identity disorder? Could sexual abuse cause this disorder and if so can you direct me to some articles that deal with just that sort of circumstance?

Although we are uncertain as to what may cause gender dysphoria, I can say for certain that there is no reason to believe that sexual abuse at any age is responsible. I have worked with over 600 gender dysphoric individuals over the last 31 years and only a handful reported being abused as a child. In those cases the gender dysphoria the individuals experienced predated the abuse. Furthermore I have never read reports of sexual abuse being a determining factor. Recent evidence shows that the most probable cause is a congenital abnormality.

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I recently met a man who told me that he was a male lesbian. What does that mean? Is this a case of gender identity disorder? Are there any references to male lesbianism in the literature?

When a man uses this phrase, it generally means that he is attracted to women but not in a male way. For him the accent would be more on what other men would refer to as foreplay. Penetration of his partner may not be his main objective when having sex with a woman.

Gender Dysphoria has more to do with gender role preference in life in general than it does with choice of sexual partners or how the individual makes love. GD may be present but such a diagnosis would require much more information than what you have presented me with.

I'm sorry but I don't know of any references to male lesbianism in the professional literature.

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Is it possible that if I had GD from early childhood (6-8 years) could it, in your opinion, with the help of psychological counseling (instigated by anxious parents) have gone into remission and resurfaced at a later date say early or late puberty?

 

I can't say with any certainty if gender issues can go into "remission" in early childhood and re-emerge in puberty, but it is well known that social pressures to conform to expected gender presentation can be very effective at submerging the issue, especially in children. I have worked with a lot of people who report similar circumstances. Every case is different and you will have to work that out for yourself with the help of a therapist before you can go on with transition. Given your psychological bent, I'm sure you already know this.

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DISCLAIMER: 

Nothing on this site should be viewed as providing therapeutic advice. No formation of a client/therapist
relationship with Dr. Vitale is intended or to be implied or inferred. The information provided in this site is for educational
purposes only. I attempt to keep the information current but make no representation or warranties in that regard. You should
not rely upon this information as a substitute for consul with a qualified mental health professional.