Steven Graybar

Abstract Reviews of treatment outcome studies of medically transitioned young people have raised concerns about the methodological problems of these studies and the treatments they support. These concerns include small sample size, lack of control groups, sample selection bias, lack of long-term follow-up data, and heavy attrition rates at follow up. Despite these limitations, major mental health associations including the American Psychological and American Psychiatric Associations continue to support medical transitioning of gender dysphoric youth. This article raises questions for psychologists (and mental health professionals in general) about the theory, research, and practice behind this diagnosis and such life-changing interventions. For these reasons, it’s important to press for higher quality research, specifically mental health research and re-imagine Gender Affirming Care of trans-identified youth as an actual psychotherapeutic endeavor. This proposed approach involves an empirically supported and broadly-based process of informed consent, and maintains an affirming, client-centered stance that envisions multiple treatment options and pathways to gender dysphoria.