Factors Motivating Psychotherapists\u27 Referral of Gender Dysphoric Youth For Medical Referral

This study explored the lived experience and perspectives of licensed psychotherapists who refer gender dysphoric youth for medical treatment of their gender dysphoria. A sample size of seven was comprised of volunteer participants recruited from an online support group for self-identified licensed psychotherapists who engage in affirmation therapy and make medical referrals of youth with gender dysphoria. A qualitative, phenomenological approach was used, with in-depth interviews administered by the researcher. Open-ended questions within the interview elicited detailed descriptions of participants’ experiences and illuminated the decision-making process utilized by participants when making these referrals. The interviews, conducted remotely, were recorded and participants’ responses transcribed and analyzed by NVivo 14, software designed for qualitative research. Twenty-seven themes emerged from this analysis, revealing that participants overwhelmingly based their evaluations of youth for medical referral not on having been formally trained or educated on gender dysphoria and its treatment nor on a specific theoretical foundation, biblical approach, or psychotherapeutic orientation. Instead, the majority of participants endorsed basing their evaluations of youth clients on personal experience as a gender dysphoric/transgender-identified individual or ally, and on personal belief systems rooted in gender ideology rather than research. These results raise questions around whether, as mental health professionals within the fields of psychology, counseling, and social work, it is appropriate to continue to evaluate and treat childhood gender dysphoria in ways uncharacteristic of the traditional evidence and research-based approach utilized with other mental health disorders