What to Say and What to Omit? Strategies and Self-Narratives for Obtaining a Diagnosis in Gender Transition

In gender transition, psychological and diagnostic assessment is essential for accessing medical treatment and gaining legal recognition. This puts the psychologist in the role of gatekeeper and places the diagnosis at the center of the clinical relationship, despite recent guidelines' depathologizing orientation. This study investigates how trans people approach and prepare for psychological interviews, what they report and what they tend to conceal to optimize the chances of being diagnosed as Gender Dysphoric. Thematic analysis of transcripts of two focus groups involving 13 people brought to light several narrative strategies aimed at assuring the saturation of the clinical criteria needed for the release of the diagnosis, among them the (more or less intentionally) forced adherence to gender binarism in the definition of Self and attempts to hide or affirm aspects of themselves in the clinical encounter. The perception of vexatiousness and imbalance of power in the relationship also emerged as a prominent theme. Between the many implications, the most important relates to the risk that the psychological pathway can be exploited to obtain the diagnosis and, once set up like this, it may lose other functions and meanings. The study can contribute to directing professional practice towards trans people's actual needs to promote health and gender affirmation.