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Frequently Asked Questions? FAQs

I just turned 50. I have been gender dysphoric all my life. Is it too late for me to consider transitioning?

No, it is not too late to seek treatment. In my practice, clients who are 50+ are very common. In fact because of their maturity, they tend to be very good candidates for transition. I would not let your age be a limiting factor if indeed you are interested in transitioning.

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What do you recommend to an individual who believes they have gender dysphoria?

It all depends on where I am asked that question. If it is via e-mail over the internet I ask them where they live and then try to find someone to refer them to that is qualified to help. If the person is in my office I take the individual seriously and start my standard therapeutic procedure.

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How often are individuals who believe they are gender dysphoric incorrect in what they feel?

In my practice that has rarely happened. In fact I can only recall twice in the last 24 years where someone has come in and said they were gender dysphoric only to realize after several therapy sessions that they were not. Gender dysphoric feelings are very clear and unless the person has some other psychological or characterlogical problems they usually know what they are talking about.

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What are the best support systems for individuals with gender dysphoria?

Other gender dysphoric people. The most common support structures these days is the internet. It is almost always where gender dysphoric people find that they are not alone in their feelings. In my practice I have the advantage of being able to provide in-person therapy and support groups. Groups are very helpful in establishing long standing friendships that can be very helpful for all parties.

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Of those men who fully transition via SRS, what are their success-rate statistics? I enjoy the writings of those who suddenly feel fulfilled, knowing deep in their core that they did the right thing for themselves. And yet, there must be "false positives," those who thought they knew what they were doing, but then found disappointment on the other side and remained generally unhappy about themselves. It would be informative, I think, to hear their thoughts on themselves.

Yes...there are some "false positive" post-op individuals out there in the world. Fortunately they are rare. Actually extremely rare. There have been many outcome studies done over the last 30 years. Here is a paragraph from a paper I wrote that was published in Gender and Psychoanalysis entitled Implications of Being Gender Dysphoric: A Developmental Review.

Treatment: Although there is still some disagreement as to how gender dysphoria begins and who should qualify for hormonal and surgical intervention, there is a remarkable amount of agreement in several important areas. Most psychologists now agree that gender dysphoria qualifies as a subject of clinical attention separate from other disorders. Further, most clinicians agree that the gender identity beliefs these people hold are profound, deep seated, and non-delusional. Even more significantly, outcome studies now clearly indicate that when three conditions are met: a proper differential diagnosis, a significantly long trial period of living in the gender of choice, and a satisfactory surgical result, there is only a small incidence of postoperative regret. Indeed, in a review of the outcome literature Pfafflin (1992) reports that less than 1% of the female-to-male transsexuals who had undergone sex reassignment had any regrets. For male-to-female transsexuals the number was slightly higher at less than 2%. Later studies supporting Pfafflin's report include Bodlund O. et al., (1996); Cohen-Kettenis P.T (1997); Exner, K. et al., (1995); Rakic, Z. et al., (1996), and Smith Y. L. et al., (2001). It should be noted that satisfaction is measured by self report of improvement in the individual's psychosocial well being.

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Nothing on this site should be viewed as providing therapeutic advice. No formation of a client/therapist
relationship with Dr. Vitale is intended or to be implied or inferred. The information provided in this site is for educational
purposes only. I attempt to keep the information current but make no representation or warranties in that regard. You should
not rely upon this information as a substitute for consul with a qualified mental health professional.