Thoughts on Gender Exploratory Therapy

In the past, I have expressed criticism of Gender Exploratory Therapy (GET), but these are meant to be constructive criticism. I believe the model for sex reassignment services needs to be drastically reformed, with what Stella O’Malley describes as a “Least Invasive First” Approach. Under this model, the first line of treatment should be at least one year of GET, before one is allowed to pursue social, legal, or medical transition. At least, this should be the approach for natal females, as there are important sex differences in the presentation of Gender Identity Disorder.

At the present moment, I think GET is mostly a waste of time and money for natal males. The proponents of GET lack a deep understanding of the most common cause of Gender Identity Disorder in natal males, that being autogynephilia (AGP). There is a video that is hilariously titled “ROGD Boys Exist!”, which showcases a textbook case of AGP. The husbands of transwidows were once boys.


On the other hand, GET is probably more effective in treating “Rapid Onset Gender Dysphoria” in natal females. In fact, I would advise most natal females to pursue GET before considering hormonal, surgical, or even social (“real life test”) transition. Even in natal females, I do not think GET is consistently effective. This is a controversial opinion, but I think that Gender Identity Disorder in natal females is best modeled as a multifactorial problem, and that disordered female sexuality is a key, neglected component. There is a false dichotomy that exists in the gender critical movement, that dysphoric females are victims of trauma, while dysphoric males are sexual perverts. Some of us females are also sexual perverts!


…Joking aside, the current approach to the subject of sexuality is to react with disgust. While this might be the natural reaction, this leaves what might be a major underlying causative factor unaddressed. Without indulging a person’s exhibitionism, the approach must be to simply address the facts of the matter. Otherwise, it is not possible to effectively troubleshoot the problem of Gender Identity Disorder.


The group I place my most faith in are detransitioned women, as these are the ones who were once part of the gender ideology cult, and intimately understand the problem at hand. One detransitioner who recently impressed me is Laura Reynolds. As the rate of detransitioners continues to rise, the most intelligent of these detransitioners might develop a reliable toolkit to resolve Gender Identity Disorder in the vast majority of natal females. My optimistic forecast is that this will take place some time within the next few years. 


Here is a contribution to this effort. I can only speak to my experience, which is an unusual and stubborn presentation of Gender Identity Disorder, but not the most stubborn or extreme case.


Gender Identity Disorder breaks down into two components:

  • Gender Dysphoria: An obsessive preoccupation with gender stereotypes, and the social expectations of men and women.
  • Sex Dysphoria: An obsessive disgust towards one’s sexual anatomy, and an obsessive desire to become the opposite sex. 

Both are diseases of the mind, but require different therapeutic approaches.


In natal females, Gender Dysphoria is mostly caused by misogyny, and is reinforced through internet culture. It can be effectively treated with Cognitive Behavioral Therapy (CBT). However, the core component of Gender Identity Disorder is not Gender Dysphoria, but Sex Dysphoria. Gender Identity Disorder cannot be considered resolved without eradicating Sex Dysphoria.


In natal females, Sex Dysphoria is probably a Body Image Disorder that can be classified alongside anorexia and bulimia. While CBT is effective in treating most Body Image Disorders, it falls short when it comes to Sex Dysphoria. CBT can effectively address the problem of “I want to become a biological male,” as this is an irrational thought that is impossible to achieve. But, in my experience, Sex Dysphoria can resist CBT, where the goal shifts from “become male” to “become FTM”. CBT is not effective in addressing the problem of “I want to become an FTM”, as this is not an irrational thought, but a goal that can be realistically achieved. 


Based on my own experience, I propose the following treatment approach: “Negotiation”. The previous description demonstrates that Sex Dysphoria can be “negotiated” down from the desire for male embodiment towards a desire for transsexual (FTM) embodiment. The objective is to further “negotiate” this down, towards a desire for masculine female embodiment. This is achieved by weighing the pros against the cons of hormonal and surgical treatment, abandoning these in favor of non-invasive strategies for masculine embodiment. The most effective of these are cross-dressing and exercise, the second of which is conducive to bodily health.


Realistically speaking, child transition is the scandal of our lifetime, and upcoming lawsuits are bound to impact access to hormonal and surgical treatments. If insurance companies drop coverage for Gender Identity Disorder, testosterone therapy and the required lab tests will become cost prohibitive for many, if not most. Due to safety concerns, the risks will outweigh the benefits in most cases, making the “negotiation” strategy more advantageous. Hopefully, this insight will help develop a therapeutic strategy that is more effective in resolving Gender Identity Disorder for natal females.

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