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Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults Paperback – 28 Dec. 2023

4.5 4.5 out of 5 stars 72 ratings

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In recent years, there has been an explosion in the number of children and young people who diagnose themselves as gender dysphoric, or trans. In the UK, and worldwide, there is a growing tendency to refer them on to \x27specialist gender services\x27 almost as soon as they express any confusion or distress about their biological sex or gender identity. Due to the rapidly rising numbers and various pressures on the system, patients are increasingly likely to be offered life\-altering medication and\/or surgical treatments, often with little exploration of their emotional world. As so little is yet known or understood regarding this increase in gender incongruent patients, it seems precipitous to proceed onto physical treatments before any assessment work is undertaken. Many who present as gender dysphoric have complex needs with comorbid problems such as autism, histories of abuse or trauma, social phobias, depression, eating disorders, and other mental health symptoms. Therefore, all aspects of the individual\x27s life deserve thorough assessment and therapeutic work. This book is aimed primarily at clinicians working in the field to provide a model for understanding, assessing, and treating gender dysphoria. The model uses a psychoanalytic framework to help explain disturbed states of mind and how psychic defences can be enlisted unconsciously to avoid overwhelming psychic pain. This offers professionals a way of trying to think with, and offer understanding to, their trans identifying clients. Clinical examples are given to illustrate these processes and promote the understanding of transgender children, adolescents, and young people and their internal worlds, their thinking, and their interpersonal relationships. As well as clinical exploration and understanding, the book includes an overview of the current political, social, and clinical environments which have all impacted on the clinical care of trans identifying individuals. As well as professional and trainee clinicians, this book might also prove useful to parents, other professionals, and possibly the gender dysphoric person too.

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Review

Gender Dysphoria is a thoughtful and timely contribution to the current controversy around gender dysphoria, how it is thought about and how it is treated when help is sought. [...] The book would clearly be of interest to anyone working with this client group, but I also found it a valuable resource in terms of thinking about the adolescent state of mind. [...] Gender Dysphoria is an important book and a valuable contribution to the current debate. The book would grace the shelf of any trainee or practising therapist.



Gender dysphoria is increasingly being seen as a part of the spectrum of human diversity. This has resulted in a profoundly reductionistic and decontextualised clinical approach to gender distress. The authors draw on their extensive clinical experience to illustrate how gender dysphoria cannot be understood without understanding the developmental and relational contexts within which it arises. Their detailed case examples document the unique psychic landscapes of people suffering gender dysphoria, illuminating how the ubiquitous "born in the wrong body" conceptualisation can leave vast areas of historical and current lived experience unaddressed. The authors utilise a psychoanalytic lens to understand the experience of both patient and therapist in therapeutic work with gender dysphoria, in a way that is both accessible and insightful. This will be an invaluable reference for those seeking to go beyond the surface to work at depth with gender dysphoria. This work is remarkable for its bravery in presenting a perspective on gender dysphoria that is increasingly being excluded from social and clinical discourse.



This clear, excellent, clinically based account is very timely. It will help those who want to find their way through the confusing and often contentious writings on the subject of gender identity. It is well founded on experience of helping and working with people who do not feel at home in their bodies, particularly in regard to their sexual identity. They bring to the subject an unusual amount of clinical experience of this specialised psychological area. I strongly recommend it to those in the psychological, medical, and social fields, as well as to anyone who wants an informed account of a confused and confusing subject.



I highly recommend this sensitive and timely book to laypersons and professionals who are interested in learning about the complex, controversial, and contemporary subject of gender dysphoria. The authors, Susan and Marcus Evans, are open, compassionate, non-judgemental, and able to tolerate uncertainty in their understanding of those who experience gender dysphoria, are transitioning, or detransitioning. Their psychoanalytically oriented therapeutic model takes into account the individual's development, family, culture, and political environment. I think the reader will especially appreciate the additional attention paid to the response of adolescents, emotionally unstable personality disordered people, and suicidal individuals to gender dysphoria.



In this timely, necessary book, Susan and Marcus Evans provide key insights into what adequate psychotherapeutic explorations of gender dysphoria should look like [...] This book is a must-read not only for those working with gender dysphoria but also those who wish to expand their thinking on this cutting-edge work when dealing with the unbearableness of catastrophic anxiety.



This book is as thoughtful as it is necessary. Every responsible clinician and therapist who treats children and adolescents must read it - and read it carefully.

About the Author

Susan Evans is a psychoanalytic psychotherapist trained at the former Lincoln Centre for Psychotherapy. Retired after nearly 40 years in the NHS, she now has a private practice in South East London. She is a member of the British Psychotherapy Foundation, the London Psychoanalytic Psychotherapy Service, and is registered with the British Psychoanalytic Council (BCP). She trained as a State Registered Nurse in 1977, then trained as an RMN and worked within many mental health specialist services including addictions, eating disorders, and in a specialist mother and baby service, which won the Sir Graham Day Award for NHS service development (1999). As a psychotherapist she worked for 12 years at the Tavistock and Portman NHSFT in the Adult Department and also in the Gender Identity Development Service for Children. She was responsible as Course Organiser for the development and delivery as senior clinical lecturer of several training programmes at the Tavistock and a Senior Fellow at University of East London. Marcus Evans is a psychoanalyst and was an adult psychotherapist at the Tavistock & Portman NHS Foundation Trust with 40 years' experience in mental health, originally training as a psychiatric nurse. After qualifying as a psychotherapist at the Tavistock & Portman NHS Trust, he took up a post as head of the nursing discipline. Marcus was Associate Clinical Director of the Adult & Adolescent departments between 2011 and 2015. Marcus has designed, developed, and taught outreach courses for front line staff in various settings for the last 25 years. He was also one of the founding members of the Fitzjohn's Service for the treatment of patients with severe and enduring mental health conditions and/or personality disorder in the adult department. He has written and taught extensively and is author of Making Room for Madness in Mental Health: The Psychoanalytic Understanding of Psychotic Communications, published by Karnac in the Tavistock Clinic series.

Product details

  • Publisher ‏ : ‎ Phoenix Publishing House (28 Dec. 2023)
  • Language ‏ : ‎ English
  • Paperback ‏ : ‎ 272 pages
  • ISBN-10 ‏ : ‎ 1912691787
  • ISBN-13 ‏ : ‎ 978-1912691784
  • Dimensions ‏ : ‎ 22.91 x 15.19 x 2.44 cm
  • Customer reviews:
    4.5 4.5 out of 5 stars 72 ratings

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Customer reviews

4.5 out of 5 stars
72 global ratings

Top reviews from United Kingdom

Reviewed in the United Kingdom on 1 January 2022
I socially and medically transitioned and realised it wasn't working for me. I then came across Marcus Evans in an interview on YouTube, found he had published this book, thought I have got to read it. I'm so glad I did. Best purchase I've ever made. My gender dysphoria has disappeared. It's a true miracle. Thankyou so much to Marcus and Susan.
18 people found this helpful
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Reviewed in the United Kingdom on 7 July 2021
A thoughtful and compassionate book exploring a difficult and politically contentious area. Although it is aimed at professionals, and includes references to psychological theory that I am unfamiliar with, it is also accessible to a non-professional reader. It explains how gender dysphoria often sits within a wider set of mental health problems for an individual, and why it should not be addressed in isolation.
12 people found this helpful
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Reviewed in the United Kingdom on 25 July 2021
Recomended reading for any parent going through the trauma of supporting a child experiencing GD. This type of therapeutic is essential regardless of whether the person transitions or not.
14 people found this helpful
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Reviewed in the United Kingdom on 13 November 2021
An excellent book to gain an understanding of the condition. You do not have to be a psychologist to understand it.
9 people found this helpful
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Reviewed in the United Kingdom on 21 July 2021
Excellent book for clinicians who work with or are interested in gender dysphoria disorders.
Highly recommended
9 people found this helpful
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Reviewed in the United Kingdom on 29 May 2021
I’ve been a psychotherapist for twenty years and so always on the look out for well-written literature that provides useful therapeutic models that could be used to benefit the client. Though with the sensitivity surrounding gender dysphoria I was a bit hesitant purchasing this book.
However, I’m pleased I did. I found this book was written containing informative case examples including step by step breakdowns and case discussions from a psychoanalytical perspective. Along with discussions on the wider topics surrounding gender dysphoria including societal and cultural trends, child development and co-morbidities.
I would recommend this book to therapists (and those interested) that need a balanced and sensible resource to help navigate the topic of gender dysphoria.
21 people found this helpful
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Reviewed in the United Kingdom on 29 July 2022
This publication is written by authors that promote conversion therapy which is known to cause life long harm to children as young as 10. Their false claims of using "talking Therapies" is a cover for conversion "torture" as recognised by the World Health Organisation. This publication promotes harm of children and should be removed from sale as it goes against all good recommended practices within the world of medicine. It claims Gender Dysphoria is a mental condition which it is not. Being Gay or Trans is not a mental illness that needs to be cured through psychology but is a sexual condition as stated in the DSM5
7 people found this helpful
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Reviewed in the United Kingdom on 22 April 2023
The aspiration of this book is good in wantng to describe a sensible approach to assessing and helping children and adolescents with gender dysphoria. It is however repetitive and laborious and could have been edited to make it more readable. I sighed at yet another case history and the dialogue between the young person and the therapist made me think I would have thrown a book at the therapist with their predictable comments.
One person found this helpful
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Top reviews from other countries

kaw0606
5.0 out of 5 stars Therapists need to read this book
Reviewed in the United States on 12 February 2024
In a climate where informed consent, ethics, and doing no harm are labeled transphobic, therapists are feeling intense pressure to stay silent about the push for gender affirming care. Gender affirming care is a medical protocol. No such framework in mental health exists. This book demonstrates a truly client-centered approach that affirms the dignity and worth of individuals while also helping to face the underlying issues and regrets associated with so-called gender therapy. Co-morbidities are being masked by gender diagnoses and left untreated. If I had the money to spare, I'd buy 1,000 copies and hand them out at the social work conference. We all need to be better informed and courageous.
GB
5.0 out of 5 stars A critically important book - on par with trans-forward Finland
Reviewed in Canada on 21 July 2021
Wow - this book is chock full of important information on how to care for and compassionately treat young people with gender dysphoria, on par with what is happening in trans-forward Finland, which as of Summer 2020 is prioritizing ethical psychotherapy throughout the country for all kids under age 18. We need all options on the table to prevent people from becoming lifelong medical patients or enduring irreversible drugs or surgeries that they may later regret. The authors here are not saying that no one would benefit from medical transition, but that we need to be balanced and impartial to try to determine who will benefit most, given all the known (and unknown) side effects.
Amazon C.
5.0 out of 5 stars What you need to know and don't know - The other side of "lived experience"
Reviewed in Canada on 15 May 2022
If you truly care about understanding mental distress in individuals, you need to read this book. Invaluable to clinicians, parents, policymakers and most importantly patients who need to know they are not alone in their distress and its origins. This book reveals the deep distress and legitimacy of the many causes of Gender Dysphoria/Gender Incongruence and opens up the narrative of good care and not "just because" care.
joanne
5.0 out of 5 stars Excellent and important book
Reviewed in the United States on 25 July 2021
There is a lot unknown about how to treat gender dysphoria, although it is known most with childhood onset grow out of it. The older adolescent onset young people are an entirely new cohort.

Given the physical dangers of the lifetime hormones and surgeries, and lack of moderate or high quality studies of accompanying mental health outcomes, it is very good to understand how at least some people find explorative psychotherapy alone helps them resolve their gender distress.

This book is desperately needed to help people with this painful condition. I hope many therapists read it and add this knowledge to their tools.
David M Martin
5.0 out of 5 stars For those interested in safe, sane, ethical, and compassionate perspectives
Reviewed in the United States on 7 September 2022
As a Portland-based psychotherapist I can only say how much I enjoyed and appreciate this book. I think it is a must read for all psychotherapists. It does not have all the answers. However, gender dysphoria in this day and age is a very complicated and dynamic diagnosis and experience. A desire to transition can have many symbolic psychological meanings within a client’s psyche. There cannot be a one-size-fits-all approach to gender dysphoria. Treatment models must remain as free as possible from political and ideological bias so that genuine therapists can work deeply with their individual client. It is imperative to understand the complex role of gender identity in client’s more global functioning. This book helps restore gender dysphoria to the realm of normal, treatable, human conditions and offers new and updated perspectives on this ever-expanding clinical presentation. It returns this presentation back to the client-centered counseling room where human behavior patterns are met with curiosity and compassion as well as being able to help clients challenge black-and-white thinking about quick solutions and deleterious behaviors. This book is an island of clinical sanity in a storm of deleterious ideology.