Articles

Gender Re-assignment Surgery: Psychological Issues

At a recent talk at the American Psychological Association meetings in San Francisco, August 17-20, 2007, Marci Bowers, M.D., a surgeon who performs gender re-assignment surgery in Colorado and who herself is transgender, gave a highly informative discussion of psychological issues with which she has personally dealt, as well as the ones with which she has frequently dealt in patients of hers. The essence of Dr. Bowers' talk was that while surgery and hormonal therapy are increasingly common treatment for gender dysphoria, there continues to be significant prejudice and discrimination against transgender individuals.

Upon deciding to have surgery, through the course of surgery, and post-surgically, many men and woman deal with highly conflictual divorces, custody battles, job loss, and rejection by family members. Dr. Bowers emphasized the powerful feelings of rejection that many patients suffer after gender re-assignment surgery.

Having treated a number of transgender people myself, I am often taken by the acute psychological pain as well as the negative consequences that so many transgender people suffer. One myth that Dr. Bowers discussed, with which I certainly concur, is the misperception that transitioning individuals are really gay men or lesbians in denial, or that they are mentally ill. Dr. Bowers stated, “because dysphoria (sadness) is currently listed as a psychological disorder, transgender people who are suffering with this are assumed to be mentally ill. This does not allow them to be treated equally no matter how visually compelling the change is.”

Within the context of our knowledge that attachment and intimacy are so important for all human beings, many psychological issues stem from the barriers that transgender people have around intimacy. Nonetheless, many transgender people both because of misconceptions on the part of the public as well as psychological issues with which they are struggling, often have problems with developing primary attachments that are fulfilling and satisfying.

Psychologists can play an important role with the transgender population, helping these people overcome psychological and emotional issues that can burden these persons on a daily basis. Psychologists have a moral and ethical obligation to help to raise awareness among the psychological community about the social and emotional issues that transgender people often times face. Persons interested in a personal account of a transgender person may want to read a recently released book by a colleague, who writes under the pen name of Natalee Greenfield, Ph.D., entitled, The Two Worlds of Tina.

September 2007