Transgender Issues and Depression
Over the last 19 years as a psychiatrist I have made referrals to specialist centres for young people who present with depression with suicidal thinking and transgender identity.
In the last five years there has been an increase in the number of these types of cases referred by doctors to the Tavistock and Portman Clinic in London , where young people have to wait for over one year before they are seen.
In this year we try to work with young people in line with their goals, which most often involves affirmation of their transgender identity and acceptance of the life they want to lead.
Young people often present as fragile, confused and struggling to assert themselves. Often they may have Autistic Spectrum Disorder or ADHD depression and be socially isolated and out of school.
Children in these situations spend alot of time on social media and gaming.
What is the scientific evidence for the practice in the specialist transgender clinics especially in cases where adolescents present as transgender after very short history, without signs earlier in childhood?
The safeguarding issue of submitting children to over diagnosis and over treatment in a specialist gender dysphoria clinic has been considered.
The needs of the child irrespective of gender politics and social media influences are paramount.
When a child says they are suicidal and transgender we must take it very seriously and get talking and listening to their observations of their life.
There is a difference between saying you are suicidal, threatening by suicide and actually being suicidal in the context of Depression.
There is a difference between thinking you are transgender and being transgender.
If we explore these issues openly with a young person we can better understand their individual journey. The experience of depression often coexists in the life of young people who have a transgender identity with need for acceptance.
I am interested in how we best support these young people while they are on a waiting list and how we best work with the specialist clinics and respectfully challenge the evidence for their treatments in light of the safeguarding issues.
Gender Identity and Dysphoria Service, GiDS, Tavistock and Portman Clinic, London