‘Inocencia’: case study of a transgender woman without gender dysphoria preparing for gender reassignment surgery

"Abstract: In certain jurisdictions psychotherapists serve as the gatekeepers to sexual reassignment surgery. Therapists are traditionally charged with assessing the existence of long-term gender dysphoria in their transgender patients as the criterion for access to surgery. This case presentation explores the long-term, narrative and dialogic Gestalt therapy treatment of a transwoman, ‘Inocencia’, who has been living as a female for more than a dozen years. She chooses sexual reassignment without experiencing dislike of her male anatomy, and privileges instead emergent lived experience as the basis of her decision. The validity of the artificially binary diagnostic concept of gender dysphoria is called into question. Key words: transgender, gender dysphoria, case study, gender reassignment surgery, confluence, internal support. Note: Some identifying information in this case study, including the name, has been altered to protect the patient’s confidentiality."