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  • Marcus Evans

Assessment and treatment of a gender dysphoric person with a traumatic history


This article presents a composite case based on a group of female-male transitions with a history of trauma due to early separation or family illness. These early traumas can interfere with the integration process of mind and body. Symptoms of gender dysphoria often arise or increase in response to subsequent separations later in life, as individuals move from childhood to adulthood. References to gender clinics increase at puberty, or at the point of separation from the family, as individuals face the prospect of leaving home for university. Afflicted by anxieties linked to the onset of puberty or separation anxiety, these individuals sometimes seek a medical transition to regain control of their bodies. Exploring underlying psychoanalytic issues can help clinicians assess various conscious and unconscious influences, and help patients make more informed decisions about whether to pursue a medical transition. A focus on defense mechanisms and thought patterns can help clinicians find ways to work with people who may be highly defensive and concrete in their thinking, and feel threatened by the way their minds work.


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