This paper critically examines the current landscape of gender dysphoria treatment, focusing on the influence of institutional pressures, political ideology, and psychological avoidance. It highlights how dissenting voices within clinical settings are often suppressed, drawing on significant reports such as the Cass Review (2024) and Dr. David Bell's findings from 2018. These reports raise concerns about the lack of empirical evidence supporting the affirmation-only treatment model. Institutional dynamics have created an environment where clinicians and parents are discouraged from raising concerns, limiting open inquiry and meaningful engagement with the complexities of gender distress.
A pervasive pattern of avoiding psychological engagement has taken root both at institutional and individual levels. Within clinical frameworks, affirmation has been prioritised over exploration, shaping treatment protocols and limiting clinician discretion. This paper argues that the widespread suppression of psychological inquiry mirrors the defensive mechanisms individuals use to ward off psychic pain. Drawing on the work of Bion, Klein, and Steiner, it explores how both institutions and individuals engage in defensive externalisation - rejecting complexity, silencing uncertainty, and avoiding deeper psychological work.
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London
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