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A History of
Transgender Medicine
In the United States
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The psychological treatment of transgender, transsexual, and gender nonbinary people has changed significantly over the past few decades. Since Harry Benjamin first suggested that you couldn't change a trans person's mind to fit their body, and you had to change their body to fit their mind, a new theory of both medical and mental health began. Initially, researchers and scientists used psychological tools with the detailed precision of microscopes, and scalpels, attempting to determine the causes of "transsexualism," probing and analyzing to determine who was a "true transsexual" and therefore worthy of treatment. Given that trans people often require the assistance of the medical profession, and most physicians do not feel adequately able to access for mental health issues, psychologists, social workers, and other mental health specialists are brought in to assess and approve medical and surgical interventions. As the trans liberation movement began to develop, this gatekeeping was increasingly challenged, creating tension between the mental health profession and the burgeoning trans communities. An evolving process, assisted by the emergence of many trans identified therapists contributing to the profession, has opened up the beginning of a new therapeutic process which supports assessments that value self-determination, diverse identities, and minimizes gatekeeping.
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