Introduction to “Can we think psychoanalytically about transgenderism?”

All controversial discussions require a willingness to confront differences and as such, developing them is never an easy task. But in the case of the present controversy, “thinking analytically about transgenderism”, the task is especially difficult. It would seem that when it comes to the topic of transgenderism—in general, not specifically within psychoanalysis—political lobbies and influences often become quickly involved, the different sides tend to feel misunderstood, persecuted or disparaged by the other, and tensions run high. Nevertheless, we at the IJP, think it is important to open this topic to reflection and debate and to feel free to do so.

Here we will present two views, one by David Bell. He is past President of the British Psychoanalytic Society and a Consultant Psychiatrist at the Tavistock and Portman NHS Foundation Trust where he leads the Fitzjohns Unit for the more complex/severe disorders. He has published and lectured on the development of psychoanalytic concepts, psychosis, and the work of Freud, Klein and Bion. He has always been deeply involved in interdisciplinary studies – the relation between psychoanalysis and literature, philosophy and socio-political theory. David Bell is one of the UK’s leading psychiatric experts in the area of asylum and immigration. Over the last three years he has been intensely engaged in thinking about gender dysphoria in children.

In his paper entitled “First do no harm”, David raises questions regarding what may be seen to be the contemporary trend of viewing the lack of congruity between one’s sense of gender identity and one’s birth sex as mainly a physical issue, a problem with the body, which can be changed through medical procedures. In turn, this trend downplays the role of social-cultural factors and psychical ones in shaping gender identity, and the possibility of one’s gender identity being reshaped through psychical rather than bodily change comes to be regarded by some as disrespectful and even unet