A Helpful Secular Approach to Youthful Gender Troubles (Review of Gender Dysphoria by Evans and Evans)

As good Americans, we are often blissfully and intentionally out of touch with what is going on elsewhere. In the case of rushing minors into chemical measures to imitate the opposite gender, this tendency has created an odd international disjunction.


Unknown or unacknowledged by the medical establishment in the U.S., what was the world’s largest gender identity clinic, suddenly closed. Well, they didn’t exactly close, but they announced that they are stopping what they were doing. The statement is sufficiently vague to save face (and stave off additional legal liability), but Great Britain’s centralized Gender Identity Development Service (GIDS) is no more. It practiced the full on the belief-confirmation model, that is, a model of care that confirmed what a child believes about his gender without challenge. Consequently the practice fast-tracked kids to opposite gender imitative procedures.


The GIDS was the largest child and adolescent specialist gender service in the world. England’s National Health System shut down it down in the spring of this year after a high-profile lawsuit. The court case highlighted the lack of scientific evidence for the safety and efficacy of the chemical and surgical measures routinely used.


Two of the doctors instrumental in the challenges that precipitated this change are Susan Evans and Marcus Evans. Their book, Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults (Oxfordshire, Oxford, England: Phoenix Publishing House Ltd., 2021) lays out their contrary opinion of treating gender dysphoria as a symptom rather than the cause. Some of their story of resistance in Britain are relayed in the earlier portions of the book, but their main goal is to offer a different model.

These doctors are level-headed psychoanalysts so, like all Freudian approaches to a problem, I find theirs to be at times insightful and usefully descriptive in diagnosing, at other times boring, and at other times downright weird. (At one point, they bring up the Oedipal Complex, p198. Yikes! Is that still around?)


By level-headed, I mean they make statements like this:


About the problem in youth…

P134 Many of the young people presenting with gender incongruence have co morbid problems…on the autistic spectrum, or have ADHD, have eating disorders, depression and anxiety, or obsessional thoughts, etc.

P72 -It is common to find that young people with gender dysphoria also have a history of an eating disorder.

P73 -Actually GD can be related to going through puberty. If you are terrified of having a period, and you can stop it by sheer will-power, which you can, for example, by weight loss—it’s called amenorrhoea—you might.


About treatment…

P149 “The idea of transition can be thought of as an attempt to triumph over the limitations of the reality of the body as if the person can kill off an unwanted aspect of the self.”

P39 When doctors always give patients what they want, you have the opioid crisis.

P97 Neuroscientists understand adolescence to be a process that is not usually completed until the age of the mid-twenties.


About afterwards….

P33 “Satisfaction surveys” reported on within first year post-treatment are not worth much.

P150 It is highly likely that, even after transition has occurred, the suicidality will re-emerge.

P27 Services for detransitioners and desisters are virtually non-existent. (Very true).



Not bad, I think, for a secular treatment. In my upcoming book, Across the Kitchen Table, I review how these cycles of harmful psychiatric interventions play out in history. I don’t know if this book and England’s move is a bellwether for the next phase in the usual cycle. But it is heartening to see. After the British NHS announcement, Scotland, Sweden and Finland also suspended such treatment for minors. Europe is reversing course on this. The American government and medical establishment, however, soldiers on.


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