The academic event was invited to psychologists and psychiatrists who seek to broaden the understanding of diversity in the gender space, through an exercise in depathologization and openness to the experience of trans people.
At the beginning of the day, the Dean of the Faculty of Medicine of the Austral University of Chile, Dr. Claudio Flores, delivered a few words of welcome, and said: “This is a highly relevant topic, not only in health, but also social and biopsychosocial that needs to be discussed and that, without a doubt, with the speakers that meet today, the discussion will be highly enriching, I thank the participants ”.
On the other hand, Esteban Gutiérrez, child and adolescent psychiatrist and academic of the Child and Adolescent Psychiatry program of the UACh, highlighted that “this is a highly fashionable topic, of deconstruction, how people face in their diversity and how clinical practices must be transformed for a respectful clinical practice ”.
Presentations
On the occasion, the valuable participation of the team of the Transiting Unit of the Dr. José Horwitz Barak Psychiatric Institute of Santiago was counted, starting with Dr. Antonio Menchaca, psychiatrist and head of the unit, who made a presentation on the work that has been carried out since 2017 in the institution, giving an account of the work team that compose it and how crucial the welcome is for the people who come to that health unit.
On the other hand, Dr. Menchaca explained: “The trans phenomenon, not in the way it is described in modern times, is very old. That people of one sex identify with another sex, before the Spanish. These expressions of different sexuality are conditioned by religious aspects and are tolerated and accepted, both inside and outside the religious situation ”.
Likewise, he pointed out that the objective of the unit is “to accompany mental health problems, whether or not they are trans-related problems. For example, we have had trans psychotic patients, which has nothing to do with it, but they need a culturally sensitive treatment ”.
In addition, he commented that transgender is an umbrella that includes many different people. Something that is self-defined and that there is a lot of diversity in terms of incidence and prevalence. And that, regardless of the pathology or not, there should be no abuse and that psychiatrists, mental health professionals, social workers, among others, must work to prevent psychiatric diagnoses from becoming an insult.
Meanwhile, the Dr. Paulo Paredes, psychiatrist and professional of the unit, spoke about the good treatment of trans people, collecting the experience in the unit, stating that “it is a process that continues over time, studied, reviewed, every week we constantly try to have international and national reviews. U. Diego Portales drew up a guide, which we have also been incorporating into our work ”.
He also referred to the obstacles that many people have in their journey and explained the general and common concepts of sexual identity. The vulnerable contexts to which these people expose, the main one being social inequity. And that, on many occasions, there are microaggressions in therapy, which is why it provided tools to better work therapy with trans people. In addition to this, in the areas of suicide risk assessment and psychotherapeutic support, he spoke about how to offer therapy to traffickers so that they can recognize internalized stigma, to investigate its effects. As well as what elements are important when working with people belonging to sexual and gender diversity and what attitudes LGBTI + people value from their therapists.
In the same way, Josefina Cáceres, psychologist and trans woman dedicated to the specialized care of trans people in the unit, she spoke about “Effects of internalized transphobia and its impact on mental health. What and why”.
To contextualize, the professional began by talking about Harry Benjamin, a German endocrinologist, who was the pioneer in the dysphoria association, which is currently the association of trans health professionals, which is the one that governs the guidelines for health care in trans people. . And he highlighted that “the non-acceptance of the body on a daily basis produces dysphoria, anxiety, which produces mental disorders. Gender dysphoria and pathologization stigma, but dysphoria is not equivalent to trans ”.
In addition, he provided an idea of what minority stress, the factors and its consequences on mental health mean in trans people.
“The model of the Transit Unit is to deliver freedom, self-identification of the person, we give them all the right to transit, through an accompaniment of reflection with identity. We get very little sexual. Because from our point of view, it is a phenomenon of identity and not sexual. We do not question anything about the person, we give him the freedom to realize how he is perceived and how they are being built ”.
To close the day, Jonathan Kaufamm, Clinical psychologist and specialist, gave the talk “Marginal sexualities and pathologizing discourses – Narratives of trans”.
To start, he showed a scene from the movie MY, to give an account of the experience of trans people in permanent struggle with the imaginary that society puts them a priori. In this sense, he clarified that “depathologizing means integrating the other, who is not aligned by their particular condition. The difficulties we face are related to homogenization problems, a consequence of the invisibility of the subjects. Depathologization means critical understanding of the concepts we use ”.
He then showed scenes from the documentary of Daughter of a bitch, to illustrate the marginality regarding sexuality. Here, he stated that “there was a period in which they were considered deviant. Then they progress to psychiatry where gender dysphoria is diagnosed, which allows them to access a gender change, but implies accepting their condition as pathological. It becomes relevant to understand some issues to change and have full respect for the subject. Because self-affirmation is a constant, which implies a high psychic workload and activism and other spheres give continuity to their experience. The psychoanalytic clinic should help in this ”.
The activity closed with a round table with reflections from the participants on the theme.
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