Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
School of Social Work, York University, Toronto, ON, Canada.
Cult Med Psychiatry. 2024 Jun;48(2):247-270. doi: 10.1007/s11013-023-09838-0. Epub 2023 Sep 22.
Emerging evidence suggests that transgender individuals are more likely than cisgender peers to receive a diagnosis with a primary mental disorder. Attributions of madness, though, may serve the social function of dismissing and discrediting transgender individual's self-perceptions. The narratives of individuals who stop or reverse an initial gender transition who also identify as living with mental health conditions can sometimes amplify these socio-political discourses about transgender people. Through a critical mental health lens, this article presents a qualitative analysis of 16 individuals who stopped or reversed a gender transition and who also reported a primary mental health condition. Semi-structured, virtual interviews were conducted with people living in Canada. Applying constructivist grounded theory methodology, and following an iterative, inductive approach to analysis, we used the constant comparative method to analyse these 16 in-depth interviews. Results show rich complexity such that participants narrated madness in nuanced and complex ways while disrupting biased attitudes that madness discredited their thoughts and feelings, including prior gender dysphoria. Instead, participants incorporated madness into expanding self-awareness and narrated their thoughts and feelings as valid and worthy. Future research must consider provider's perspectives, though, in treating mad individuals who detransitioned, since alternate gender-affirming care models may better support the identification and wellness of care-seeking individuals who may be identified (in the past, present, or future) as mad.
新出现的证据表明,跨性别者比顺性别同龄人更有可能被诊断出主要精神障碍。然而,将疯狂归因可能具有将跨性别者的自我认知边缘化和抹黑的社会功能。那些停止或逆转最初性别转变但同时也被诊断出患有心理健康问题的个体的叙述有时会放大这些关于跨性别者的社会政治话语。本文从批判性心理健康视角出发,对 16 名停止或逆转性别转变且报告有主要心理健康问题的个体进行了定性分析。对居住在加拿大的人们进行了半结构化的虚拟访谈。我们采用建构主义扎根理论方法,通过迭代的、归纳的分析方法,使用恒定性比较方法对这 16 个深入访谈进行了分析。结果显示出丰富的复杂性,参与者以微妙而复杂的方式叙述了疯狂,同时打破了偏见,即疯狂使他们的想法和感受失去信誉,包括先前的性别焦虑。相反,参与者将疯狂融入到扩展的自我意识中,并将他们的想法和感受叙述为合理和有价值的。尽管如此,未来的研究必须考虑到治疗从跨性别转变为非跨性别的疯狂个体的提供者的观点,因为替代的性别肯定关怀模式可能更好地支持寻求关怀的个体的认同和健康,这些个体可能在过去、现在或将来被认定为疯狂。