d4m10n
Penultimate Amazing
There are at least a few other ways in which gender dysphoria is (relatively) unique.
Firstly, any other mental health diagnosis can be treated without asking healthy people to play along with the self-perception of the patient. Third parties are not expected to pretend to see or hear the hallucinations of the schizophrenic patient, for example, or to affirm that an anorexic patient is corpulent. By contrast, it is considered impolite to utter aloud that Rachel McKinnon or Lia Thomas look oddly masculine in women’s racing kit; we are expected to affirm their identities even though they aren’t even in the room, presumably for the sake of upholding a general social norm in favor of affirmation which will benefit anyone we encounter who might need to be socially affirmed.
Secondly, the evidence base for gender affirming medicine (GAM) is uniquely weak, especially when diagnosing/treating adolescents and young adults. We can go all the way back to the introduction of "Gender Identity Disorder" in the DSM-III (1980) and watch the standard of care evolve from old school psychotherapy to modern GAM without coming across hardly any studies comparing the old treatment modalities to the new ones. Instead, the modern approach spread like an internet meme which was considered too good to fact check, while the old one was demonized as “conversion therapy” because it aimed to help people cope with their feelings and accept themselves without medicalization.
Thirdly—and most controversially—gender dysphoria is one of the only diagnoses which comes with an identity-based support community empowered by influential non-profit institutions (e.g. Stonewall, GLAAD, ACLU) which have a track record of getting results in the legislatures and/or the courts. This means that we cannot count on health experts to work these issues through in a scientific way without falling into the sort of conclusions-first thinking that we expect to see from activists.
