Gender-affirming care, critical thinking, humility, and the ethics of psychiatric interpretation: A response to Amos (2024, 2026)

Recent arguments in Australasian Psychiatry have claimed that gender-affirming care (GAC) is incompatible with competent and ethical medical practice because it relies on invalid diagnosis, forecloses inquiry into psychopathology, conflates trans identification with psychosis, and resists appropriate evaluation. This viewpoint responds to arguments advanced by Amos in 2024 and 2026. It argues that these claims rely on pathologising premises, selective interpretation of comorbidity, unsupported causal inference, and an unduly narrow account of evidence. Competent GAC can incorporate assessment of trauma, psychosis, ambivalence, capacity, and co-occurring mental health needs without presuming that trans identity is itself pathological.