Trans is not the new gay: How psychoanalytic elitism and the rejection of science are creating a repetition of the past

Psychoanalysis has a troubled history with regard to sexual minorities. Throughout much of the twentieth century, prominent analysts endorsed a highly pathologising and coercive approach to homosexuality, which was essentially a form of conversion therapy. This departure from accepted analytic technique persisted for decades due to psychoanalytic elitism and the rejection of mounting empirical science contradicting the psychoanalytic position. Today, a pressing concern for psychoanalysis is to avoid repeating this history when theorising about and working with transgender people. Psychodynamic explorations of trans identity formation are being framed as new iterations of conversion therapy, wrongly implying coercion and falsely conflating psychodynamics with pathology. Furthermore, the author cautions that unquestioning gender affirmation shares an important conceptual similarity with gay conversion therapy, in that it can collude with a wish to eliminate a shame-filled or hated part of the self. In our haste to avoid repeating the past, psychoanalysis is deploying the very same tactics that insulated its stance on homosexuality from revision and course correction, but now with regard to trans. The author argues that if we are to avoid causing further harm to our patients and our profession, we ignore the science at our own peril.