Trans People's Attitudes and Beliefs Regarding the Diagnosis of "Gender Dysphoria": Research in the Italian Context

In many countries, the psychological pathway is an important practice in gender transition, especially where a diagnosis is needed in order to access medical treatments and legal recognition. This filter function is a source of debate for both professionals and trans people, particularly because of its potential for equating gender variances with mental illness. Despite recent changes in health communities' attitudes toward diagnosis for gender transition, this issue must be handled carefully, as it can also affect the dynamics of the clinical interaction. This study explores beliefs and attitudes toward diagnosis by addressing the subjective perspectives of 25 people in transition. Through a nonstructured interview, we sought to shed light on how a diagnosis of gender dysphoria is perceived and used, what position trans people take in relation to mental health practitioners, and the possible implications. Interpretative repertoires analysis showed that the diagnosis was experienced as a "constraint," described in terms of convergence toward or divergence from the individual's own identity. Positioning analysis found that the mental health practitioner was seen as either contributing to the denial of participants' identity and hindering their progress along the path to transition, or as supporting this process. The practitioner is also seen as an evaluator rather than an expert, because trans people know themselves best. The findings indicate that the diagnostic process may obscure or interfere with the most important function of the psychological pathway, namely, the creation of an affirmative space and shared objectives.