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gender expression deprivation anxiety

Anne Vitale has written a book called “The Gendered Self: Further Commentary on the Transsexual Phenomenon”.

In the introduction she writes the following:

“There are three stages to a transsexual’s life. In the first stage, the person is either openly or secretly experiencing generalized feelings of anxiety due largely because they are deprived of a sociological outlet for their inner sense of being male or female. Here in the book, I refer to this anxiousness as gender expression deprivation anxiety. This period may start as early as age 3 or 4 and lasts until it must be addressed in a meaningful manner. The second stage is triggered when the gender expression deprivation anxiety rises to a point where the individual can no longer function productively in his or her daily life and decides to enter treatment. The third stage begins when the individual completes a course of psychological and medical treatment and begins living partly or fully in a new gender role.....”

She discusses gender variance and pays tribute to the work of Harry Benjamin as well...

“The Transsexual Phenomenon was published in 1966. Prior to its publication, very little had been entered into the medical literature about the subject. The few works that were published tended to be about cross dressing (transvestism) in men and gave the impression that the “disorder” was one of perverse sexuality. Benjamin, on the other hand, was one of the first to think in terms of “sex” being the physical manifestation of the body while “gender” and gender expression as being a totally different aspect of what it means to be human. Furthermore, he writes that he believed that gender was indelibly imprinted on the brain either in utero or shortly after birth. Instead of seeing his patients as being delusional and suffering from a sexual perversion, he saw his patients as suffering from a form of intersexuality; having the body of one sex but the gender of the other. It is this paradigm shift in thinking that makes his work so important.

Benjamin wrote his book based on actual case studies of just under 500 mostly male-to-female patients over a ten year period (1954-1964). He noted that since psychotherapy was useless, transsexuals should instead be treated by hormonal and surgical sex change. Benjamin went on to predict that eventually neuroscience would find that gender identity and expression was hardwired in the brain and not simply a socially constructed aspect of our persona. As we will see in this commentary, that has come to pass."

What I find most interesting in her introductory comments is the use of the term gender expression deprivation anxiety which I feel very accurately describes what I have suffered from most of my life. She mentions it again in her objectives for writing the book as well as the process of transition being a possible but not mandatory outcome:

“It is my hope here to share my experience in working with more than 500 gender variant clients over the last 26 years—covering everything from intake to long-term
outcomes. Far from being a medical treatise, this book is about otherwise normal people with a special existential problem that has and will continue to color their entire lives. It has been a privilege to have worked with these outstanding individuals. Despite their almost overwhelming handicap, the vast majority of people I have worked with have shown themselves to be highly intelligent, motivated and courageous. My practice has also taught me a great deal about the willingness of many of the people around my clients to give up long-held preconceived notions of who they thought gender-variant individuals were and open up to the new and more accurate life-affirming reality.

Unfortunately, that is not always the case. Far too often I have seen the very notion of gender role transition bring out hatred and spite in once-close families, resulting in abandonment by spouses, divorce and loss of one’s children, as well as loss of long-term friendships, driving the gender dysphoric individual deeper and deeper into despair and far too often to suicide.

A second objective is to pass on to other therapists my philosophy and style of working with gender-variant clients. My approach is simple: I take every individual seriously, no matter how male or female they appear on presentation, how old or young they are, or what social circumstance they are in. I tell each client during our very first session that I have no agenda other than to help them find a way to make their life work. Reaching that goal can vary from finding a minor way to satisfy their need for cross-gender role expression to, if necessary, complete gender role transition. I tell them that I will share everything I know about gender role transition but that ultimately each individual must be ready to accept full responsibility for decisions made along the way.

Finally, this book is about the people who, for no reason of their own making, find themselves intellectually and emotionally separated from living fulfilled lives by the sex of their physical body. It is the story of what it means for thousands of men, women and children who suffer gender expression deprivation anxiety but find a way to go on to live full and successful lives”

Thank you Anne for your brilliant work.


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