The whole medical profession shares blame for allowing gender affirmation to progress beyond the experimental phase. However, psychiatry bears greater responsibility for failing to correct the false claim that transgender identities are healthy variants of normal.
Originally published by Andrew Amos on X
Gender affirming doctors cause a serious form of mental illness called shared psychosis. They stop children with developmental problems learning to separate reality from fantasy. Gender identity obscures this unethical behaviour.Fantasy: Trans women are women! Reality: Trans women are men who want to be women, which is impossible.
Like the rest of modern medicine, psychiatry is being transformed from a clinical discipline focused on optimising health to a commercial activity focused on maximising revenue. Once commercial medicine realised that responsibility for patient safety was doctors’ biggest financial risk, it started limiting their exposure by offloading the risk to patients using informed consent protocols.
Gender affirming medicine would not exist without this movement to limit doctors’ duty to guard patient safety. The oath to protect patients from harm is the foundation of traditional medicine. By contrast, affirming doctors claim that it is more important to promote patients’ right to choose gender identity than to protect their physical and mental health.
The whole medical profession shares blame for allowing gender affirmation to progress beyond the experimental phase. However, psychiatry bears greater responsibility for failing to correct the false claim that transgender identities are healthy variants of normal.
Any competent doctor with a basic understanding of human psychology knows it is impossible that healthy child development includes the desire for castration, hormonal sterilisation, and amputation of the breasts. I have written other essays which examine why gender affirming care is incompatible with competent and ethical medical practice.
This essay describes a specific harm caused by gender affirming doctors: the creation and maintenance of the shared delusion that trans women are women and trans men are men. While this belief is a self-evident absurdity to everyone but trans rights activists, it has been indoctrinated into vulnerable gender confused patients to leverage their distress for political purposes.
Gender affirming care causes shared psychosis
Every sane human being understands it is impossible to change sex. Even so, people continue to pursue this impossible dream, which makes them unhappy. For most, left to themselves, the desire eventually fades and they return to normal life.
A few of the rest continue to want to change sex in some symbolic way, but develop healthy accommodations with reality such as gender non-conformity, or mild mental illness such as cross-dressing.
Competent, compassionate treatment of these patients acknowledges their desires, analyses the distress and dysfunction caused by conflict with the real world, and uses psychoanalytic psychotherapy to help them productively re-engage with reality.
Until recently the number of people unable to tolerate the reality that sex can not be changed was vanishingly small, and they preferred to remain hidden. They either completed suicide or retreated into fantasy, often leading to extreme measures like self-castration.
Psychiatrists who treated these patients had no doubt they were affected by severe mental illness. They only started considering physical treatment alternatives like hormones and surgery after psychotherapy failed to help.
Even while they were experimenting with physical treatments these doctors remained convinced that their patients were psychiatrically unwell, and that the physical treatments would not cure their mental illness. They justified physical treatments as harm minimisation strategies. They did not claim that their patients were changing sex.
Unfortunately, a later generation of gender doctors were persuaded by the anti-psychiatry movement that accurately diagnosing the mental illness associated with trans identity is social coercion. They concluded that it was more important to support the political campaign for trans rights than it was to improve trans patients’ physical and mental health.
To pursue this political goal, gender doctors created a pseudoscientific cover that allows trans patients to avoid conscious awareness of the immutability of sex. Gender identity is the central fallacy of gender medicine. It is a scientifically meaningless label designed to obscure the fact that the desire to change sex is a mental illness.
Gender doctors and activists use the illusion of gender identity to promote the delusion that trans women are women and trans men are men. Biological sex has a real and specific meaning, while gender identity is undefined. This means that most people instantly recognise that “trans women are biological women” is false, while “trans women are women” confuses them because it is not meaningfully related to their experience. Most people rightly decide that unless it directly affects them they can safely ignore gender medicine (and gender politics).
Gender doctors and activists who convince gender confused children and adolescents that trans women are women and trans men are men create a form of psychiatric illness called shared psychosis.
Shared psychosis involves a dominant person or group imposing false beliefs on a submissive person or group. It shares features with the abusive relationship style now recognised as coercive control. At the start of a shared psychosis submissive partners are aware that other people don’t share their dominant partner’s delusional beliefs, but they lose this awareness as their own psychosis develops.
Over time, the dominant partner limits the submissive partner’s opportunities to reality test by limiting their contact with other people. At some point, the submissive partner is so convinced of their partner’s delusions that those beliefs become almost impossible to challenge. This leads to further isolation and dependence.
Following the same pattern, under the cover of gender identity, gender affirming doctors impose their false theories about gender onto kids and families using the authority of medicine. Both kids and families become dependent on the ideology and the trans community. Eventually trans ideology becomes psychologically impossible to challenge.
However, broader society continues to believe that biological sex exists, and has little interest in gender. A good example is the widespread insistence that men not be allowed to compete in women’s sport. Trans patients and their families have been trained to believe that these mainstream views violate their human rights, which maintains their isolation and dependence on the trans community that champions their false beliefs.
Ending the indoctrination of gender affirming care
Shared psychosis is not well understood. Shared delusions can be more difficult to treat than the delusions that occur in other psychiatric illnesses like schizophrenia, with little response to medication.
What is certain is that patients with shared psychoses are extremely unlikely to recover while engaged with others who share their false beliefs, and the best treatment is to help them develop relationships with people who don’t share those beliefs.
Gender affirming clinics and the networks that support them make it almost impossible for trans patients to escape the fallacies used to justify their treatment. There are whole communities dedicated to maintaining the harmful delusion that trans women are women.
No doubt many of the people who chant these delusions at protests don’t actually believe that trans women are the same as biological women, but it is equally certain that they don’t care because they are promoting a political position, not pursuing patient health.
Psychosis is caused by faulty reality testing. The only cure is to restore the ability to separate reality from fantasy. For trans kids indoctrinated by gender doctors, the main test is whether they continue to believe that trans women are women, or whether they understand that trans women are men who want to be women, and that sex change is impossible.
The necessary steps to end the indoctrination of gender confused kids into a delusional belief system are:
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Hospital and health systems must eliminate the gender affirming clinics which encourage gender delusions
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The medical profession must call out and reject the use of trans children to promote the political goals of trans rights activists
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The medical profession must enforce its traditional role as the protector of patient safety based on evidence, declare that gender affirming care is an experimental treatment with unpromising results, and discipline unethical medical behaviour
Gender affirming care and the integrity of medicine
At the time of writing it does not appear that the medical profession will voluntarily acknowledge its responsibility for the harms done to trans kids treated with gender affirming care and reverse course.
As the public has become aware of the absurd claims of the trans rights movement, politicians and the legal profession have started stepping in to correct the failures of gender medicine. Across Europe and the U.S. bureaucrats and judges have recognised the absurdity of the claim that trans women are women and trans men are men, and are limiting the harms being done.
Even as doctors have refused to accept the evidence that gender affirmation is more likely to harm kids than help them, courts and legislatures are overruling them to insist that they protect vulnerable children by returning to traditional medical principles.
However, while court decisions and legislation can limit the harms being done, only the medical profession can end them. A profession that does not have the integrity to honestly evaluate and reject a treatment paradigm based on delusion can not be trusted with patient care.
