International Theological Institute, Trumau, Austria
In spite of our ambition for scientific ‘neutrality’, psychiatry’s understanding of man and mental health is closely related to the prevailing zeitgeist. A sharp increase in the frequency of gender dysphoria of post-pubertal onset over the last decades among adolescents calls for diagnostic precision, since many of these patients have diagnoses of autism spectrum disorder, depression and anxiety disorders. A cultural influence on dissatisfaction with one’s gender is demonstrated by the popular transgender trend in adolescent culture leading to a social contagion. It is also demonstrated by the physician’s tendency to implement the protocol of chemical suppression of puberty and impersonation of the opposite sex for children with gender dysphoria not based on objective evaluation of the causes of the disturbance, but at the parents request. The harm done to these patients consists first of all in the physical effects of puberty blockers, and subsequent sterility in the case of further administration of opposite sex hormones. That fertility is considered less important to person’s identity than their subjective, possibly temporary, beliefs, and that the concept of sexuality has moved from an emphasis on reproduction to the prevalence of feeling seems to reflect a change not in medical or psychological science, but rather in the philosophical/anthropological paradigm of sexuality. From the perspective of mental health and a long-term subjective satisfaction, the lives of patients who had undergone Sex Change Operations raise many questions. Among them is – whether the classical approach of dynamic psychotherapy should not be reconsidered as a good standard of practice thereby helping the patient to avoid the cultural meme and, most importantly, to avoid harm.