Information on Non-Transition Treatments

[Guest ashleynikole]

Forgive me if I'm repeating something already said here, I have honestly searched high and low (here and on Google) looking for any information regarding any forms of treatment of Gender Dysphoria that DO NOT involve any level of transition (hormones, surgery, etc).

I'm also not interested in any "religious" treatments that involve ministries like Exodus or the likes (nothing against them, I'm sure they are well intentioned people, but I have found plenty of info that they are not successful in actually treating anyone).

I've looked high and low all over the interwebs (all my links in my google searches are purple now) and I really can't find anything that explains alternative treatments for gender dysphoria (alternative to transition). What little research I have found just eludes to anything but transition being even remotely successful.

I totally believe that transition is the right path for me, but I have to exhaust all my resources for anything that might be good for me, help me get past this, without a possible transition. Anyone with anything that can point me in any direction would be greatly appreciated.

I have found a lot of solace here in the stories and experiences of others and genuinely appreciate each of you who have shared a piece of your life in this corner of the world.

God bless

[Charlize]

Ashley, i'm afraid i do not know of any "cures". Many of us find peace with occasional dressing or just the comfort of knowing about our own gender identity. More of us i think try to push all these thoughts away with various amounts of success. I know of many who never had surgery or HRT and live as the opposite gender. That has been possible throughout history. I think the clue rides in the quotes i put around cure. I'm really not sure that i have a disease. Though it may not be normal to feel as i do about gender it is simply the cards i have been dealt. I can now live as myself in honesty and without fear. The lying and fear were a real disorder needing a bigger cure for me.

Hopefully someone will be answer your question with a different program of action, but for now i've actually found some peace with myself in this world.

Hugs,

Charlie

[VickySGV]

Now that some degree of GD is recognized as part of your life, it is not going to leave you. Transition has a lot of possibilities and meanings which makes life a real puzzle. If you mean not changing your public presentation or any medical facts about your body, some people do manage on fantasies alone, some write things under a pen name, others take up hobbies more associated with their preferred gender. In choosing that option you could even come here as you have been, play games under a female identity, and maybe at the extreme go for a single item of clothing. Even here, a gender therapist could be of help, since to them this is within the realm of normal for some GD patients. They can also help you gauge how this is working for you as you go along.

Going less than full time, and CDing on a set basis or an "as needed" is very common, and is the full limit of what a great number of people do. Not all CDers will have full blown Gender Dysphoria, and their goals are different from say, mine, Good people for the most part and for the ones with GD, it is satisfying and controls their lives.

Transition via HRT, GCS and RLT does not cure GD and I will be the first to let that cat out of the bag, and a tiger indeed it is on that subject. GD is still very much part of my life or I would not be here. For me though it is a matter of knowing how it has affected my life. I am older so some of the problems younger people face are ones I do not have to think about, but my GD is alive and still being felt.

No one here will tell you that you have to be "transitioning" to be a legitimate bearer of GD. Control and happiness can happen if you get help from people familiar with GD and it is not one size fits all by any means. No cures, but there can be serenity.

[Guest KimberlyF]

There is a process that I believe can help people dealing with many issues.

If all of the steps can be done alone, that's great. If one needs professional help, that's great too.

First, identify if the problem is big enough to cause major life issues. It doesn't matter if it's drinking or ticks from Tourette's or being online often, or GD. If you can keep a job and relationships are not a problem and you aren't in a depression, then it's prob something you have decent control over. Maybe it will be a bigger issue later, but for now, not a biggy.

One problem is that sometimes we trick ourselves and say things aren't a problem. But while I wouldn't bet the house on it, my gut says the majority of the time we just ask ourselves if we drink too much or if GD is impacting our lives, the majority of the time it's yes. Maybe just the act of asking puts us in a place of taking it to the next level and examining things deeper.

IF it is impacting me, what is it that is doing it? With GD, it can be the shape of our bodies, how we are treated, the clothes people wear, the conversations we are excluded from, and on and on. If one can find out what it is that the real problem, they can know how to deal with it.

For some people, all they currently want, all they need, is the acknowledgement of what they feel inside. So some people have found comfort in just talking to a therapist, or coming out to their spouse. At that time. Things might change later, but if they can find happiness for a while or maybe forever, why go FT or start HRT, or have SRS?

Some people have severe body issues. Going FT or HRT will not fix that.

And there are endless combinations. Sometimes fixing one causes another issue to bubble to the surface or become worse.

The goal should be to find the right path for the individual.

[Guest Brenda Hailey]

Interesting topic, and like you I havent found anything to suggest there is any way "out" of being transgender, the closest cure I think just comes from these now traditional methods of FT HRT SRS,but I still dont think those things are an absolute cure either.

We are truly stuck this way "for better or for worse", that is the only real choice we have in all of this. Which one we choose is what we live.

Its the choices and their uncertainty that make this so difficult,we have others experience to pull from, but we will never really know for sure unless we do what we think we need,ourselves.

More of us i think try to push all these thoughts away with various amounts of success. I know of many who never had surgery or HRT and live as the opposite gender. That has been possible throughout history. I think the clue rides in the quotes i put around cure. I'm really not sure that i have a disease.

I have been thinking a lot about that subject lately Charlie,,,,,,,what did transgender people do before the advent of modern medicine? I think living in those times to be much much worse than what we live in now. I cant imagine how someone with severe body dysphoria was able to cope,or if they even did at all. which of course puts into question for me at least, if they could live without HRT and surgery then why is it so common to do now? I understand we have evolved technologically but I wonder what could be learned from those in the past who had severe forms of this and still survived against all odds.

I suppose I can look at those who are surviving now without HRT and Surgery, but they still know those options are there if needed whereas those in the past did not.

Somebody had to be the first one to feel strongly enough about surgery to just do it anyway....the uncertainty for that person must have been astronomical,but they still did it.

There are no clear answers to any of this really or it wouldnt have taken me 40 very confused years just to get this far.

Brenda Hailey

[Guest Sarah Faith]

Interesting topic, and like you I havent found anything to suggest there is any way "out" of being transgender, the closest cure I think just comes from these now traditional methods of FT HRT SRS,but I still dont think those things are an absolute cure either.

We are truly stuck this way "for better or for worse", that is the only real choice we have in all of this. Which one we choose is what we live.

If you are saying transition isn't a one size fits all cure that would be correct as it isn't for everyone.

If you are meaning though that Gender issues never really go away completely even with transition, I would have to disagree on that point based on my own experiences. While I haven't had SRS yet, I can say that HRT and transition have gone a long way towards getting me past gender issues. In my case I've always known who I was, it's something I've suffered from since my earliest memories and basically acted like a wrecking ball through my entire life because I just could not cope with inhabiting a body that wasn't mine. However since transitioning and going full time and all of that, I can honestly say I rarely think about the fact that I am trans anymore except when I'm involved in the trans community like LP, or the few moments I experience some horror in the bathroom as I notice what's down there.

Like I have said before at least for me, being trans is not the core of my identity it's just a condition that I am dealing with. I do absolutely believe that if someone seeks the appropriate treatment for them (whatever that may be), and follows through with all levels of it ranging from the mental to the physical one can reach a point of closure with gender issues.

[Guest Brenda Hailey]

Interesting topic, and like you I havent found anything to suggest there is any way "out" of being transgender, the closest cure I think just comes from these now traditional methods of FT HRT SRS,but I still dont think those things are an absolute cure either.

We are truly stuck this way "for better or for worse", that is the only real choice we have in all of this. Which one we choose is what we live.

If you are saying transition isn't a one size fits all cure that would be correct as it isn't for everyone.

If you are meaning though that Gender issues never really go away completely even with transition, I would have to disagree on that point based on my own experiences. While I haven't had SRS yet, I can say that HRT and transition have gone a long way towards getting me past gender issues. In my case I've always known who I was, it's something I've suffered from since my earliest memories and basically acted like a wrecking ball through my entire life because I just could not cope with inhabiting a body that wasn't mine. However since transitioning and going full time and all of that, I can honestly say I rarely think about the fact that I am trans anymore except when I'm involved in the trans community like LP, or the few moments I experience some horror in the bathroom as I notice what's down there.

Like I have said before at least for me, being trans is not the core of my identity it's just a condition that I am dealing with. I do absolutely believe that if someone seeks the appropriate treatment for them (whatever that may be), and follows through with all levels of it ranging from the mental to the physical one can reach a point of closure with gender issues.

I was basically saying what would "you" "anyone" have done if HRT or surgery was not available to you? You still have to choose the wrecking ball or ???

If for some reason the hormone treatments had to permanently stop would you still be you or would the wrecking ball come back?

Is the core of ones identity HRT because without it they would not be past their gender issues?

Is surgery the core of someones identity because without it they would "still" be dysphoric regardless of the other steps?

Are any of these things really an absolute cure in changing how you feel inside if they are not maintained and still strived after?

I dont mean to sound like a contrarian party pooper but these are questions I am asking myself because I just dont know any better.

Knowing who you were as a child could certainly make it easier for you to not define the core of your being,by being transgender, however some of us have not known what this actually is until way late in life and are very welcoming to finally knowing what it is that we have been blindly suffering from for so many years, I dont necessarily mind labeling myself transgender at this point because it had eluded me for so very long and I finally "got it". Trust me its way better than the labels I was giving myself all those years of self loathing.

I am totally happy for anyone who has found their happiness in whatever way they found it. I am not saying anyone is wrong for what they choose, I just dont know where mine is yet and how far I have go to get it, or if it is even possible.

I can say though at this point in my life knowing what I now know I have been happier and filled with more hope and joy than at any other time in my life,for how much longer and to what degree I could have more, I have no idea yet...I do still feel dysphoric,and it has been lessened a great deal by just accepting my transgender label for what it is and just being ME,but I think there is still more to discover and the door has finally opened, but either way I know from a lifetime of experience so far "this isnt" just going away. That may change in the future, but what I know right now is all I know, and is all I can speak to,at least until I have experienced more.

I want to transition more than anything else right now but I still have a few more unanswered questions I feel it prudent to work through them before taking the plunge. Cold feet and ignorance are steadily losing ground,and hopefully following everyones advice about going slow and making sure, is going to pay off.

I thank you for your input Sarah and mean no disrespect to you at all.

I am glad you have found your peace and a bathroom is the last vestige of your horror I dream of feeling that confident about myself and being that far along.

Brenda Hailey

[Guest Sarah Faith]

I understand what you are saying Brenda, and it is good that you are asking questions and taking it carefully. It is always good to try to figure out just what is exactly the right treatment since most of them are pretty hard to undo.

In regards to what would I have done with out the ability to transition, HRT, laser, or any of that. The same thing I was doing before, continue to gain weight and withdraw further and further from reality. I was on a road to one of two places, death or a mental institution. I had lived as my self online for years, but reality was like a slap in the face to me and the stark contrast of the two drove me crazy anytime I went out the door or had to look at my body. So no there really wasn't any alternative to me, I had contemplated having my self committed on more than one occasion just to completely disconnect from reality so it was a matter of time.

it truly varies though on the individual, some find other ways of coping or their dysphoria just isn't on the same level and they do not need to take such extreme measures. I think the most important aspect of transition is knowing ones self, and what is the right course for you. Which you seem to be doing which is good.

Thank you, confidence comes with time and effort so it takes awhile but it is a good place to get to. Especially for me since I started from a point of extreme social anxiety.

[Guest LizMarie]

I spoke with a childhood friend some months ago for the first time in decades. She was very understanding of me. When she was very small, her father drove to the town dump, pulled out a shotgun, and killed himself. Now, years later, she tells me that her mother eventually told her that her father had gender issues that drove his depression, hence her sympathy towards me.

When you can't address your issues they may overwhelm you.

I don't think there is a single "fix" for gender dysphoria. I know one person here in the city where I live who presents male in public no matter what, even at TG meetings. He has a wife who he says has been understanding and supportive. At home he presents female occasionally. He writes fiction about strong feminine heroines. His family knows he's a more "touchy feely" guy emotionally than most men. For him this has been enough.

What will work for you, Ashley? None of us know. None of us can know. Only you know. Maybe cross dressing and a regular "girl's night out" with a cross dressing group will be enough for you. I don't know.

The goal of any gender dysphoria treatment is not to transition but to find techniques and practices that allow you to be at peace with yourself, to not be depressed because of your gender dysphoria, to not seek to harm yourself because of your gender dysphoria.

Transitioning is frequently mentioned because it's a very visible change in someone's life. But it's not always necessary. Statistics I've seen suggest that about 1 in 500 to 1 in 600 people are trans. But in the US only about 1 in 2500 to 1 in 3000 actually seek SRS. So that's only 1 in 5 or 1 in 6 trans folk actually seeks SRS (almost always as part of a transition). Maybe the number who transition, including those who do not seek SRS is twice that. Even three times that would still only be about half of all gender dysphoric people and I think that's too high.

So the majority of trans folk find a way to live with themselves that does not involve transitioning. Let that sink in. The majority of trans folk do not transition. But the question of how they cope is probably as individual as the number of individuals.

Finally, I would caution you to not mistake obsessions to distract yourself from actual practices that relieve your gender dysphoria. I had such obsessions - long distance running and hiking in the late 70s and early 80s, computer game programming in the mid 1980s to late 1980s, coaching youth soccer from about 1989 to 1996, internet gaming from 1997 to about 2010. I used these things not to cope so much as to hide from myself. I was viewed as anti-social and generally unhappy. Today I'm seen as a much happier, outgoing, and positive person by those around me. In fact the running joke is that as "him" I almost never smiled or talked to others, and now, as myself, I almost always am smiling and chatting.

As I said, none of us can tell you what will work for you to relieve your gender dysphoria. Transition is discussed so widely because it is the one common path taken by so many of us who suffer from more extreme forms of gender dysphoria but even transition is a highly individual thing, varying from person to person in what that means.

I'm sorry I can't be more specific.

[Guest AshleighP]

I always find so much great information in these posts. Thank you all for sharing your wisdom and experience. These are some issues and questions I have had myself. Reading all these caring responses helps more than you all can imagine. While I have no advice to offer Ashley, I can offer support and the fact that you can know you are not alone. There are many people here who care and are more than willing to share advice and information.

I think the posts that state everyone is different are absolutely spot on. What works for one person will not work for another. Only by truly getting to know ourselves can we discern the extent we need to go to be comfortable and content.

[Guest ashleynikole]

Thank you so much for all your replies.

Just to clarify, I know there is no one cure all for this and I know it varies greatly by person. My general research experience has shown me that I can categorize the response to GD into 4 basic roads (these are broad roads).

1. Do nothing, continue life as usual.

2. Reparative Therapy (illegal in 2 states and very dangerous with no known success).

3. Repression Therapy (ie. learn to live with your dysphoria while working to relieve the symptoms that come with it).

4. Transition (live some or all of your life in the opposite gender, be it CD, FT, HRT, SRS).

I was mainly looking for statistical evidence regarding 2 and 3. Mainly I was asking for this because 1) I can't find it, and 2) surely someone somewhere has done even some type of study to see if any of it is successful in relieving GD short term and/or long term. I was just curious if anyone had a link or two to scientific information about the non-transitional therapies.

I'm a science nerd, so it's just my nature to look at everything. Thanks so much...and congrats to Sarah for having a team in the Super Bowl (Go Broncos...hehe).

[VickySGV]

I was mainly looking for statistical evidence regarding 2 and 3. Mainly I was asking for this because 1) I can't find it, and 2) surely someone somewhere has done even some type of study to see if any of it is successful in relieving GD short term and/or long term. I was just curious if anyone had a link or two to scientific information about the non-transitional therapies.

I'm a science nerd, so it's just my nature to look at everything. Thanks so much...and congrats to Sarah for having a team in the Super Bowl (Go Broncos...hehe).

The WPATH SOC 7 which you can get to from this link in the forums cite Reparitive Therapy conclusion of being non effective and per WPATH is unethical to use as a therapy type. There are two citations of studies in the SOC7 which I have found online, but were to me a bit ponderous to retain the links. http://www.lauras-playground.com/forums/index.php?showtopic=37767

[Guest ashleynikole]

The WPATH SOC 7 which you can get to from this link in the forums cite Reparitive Therapy conclusion of being non effective and per WPATH is unethical to use as a therapy type. There are two citations of studies in the SOC7 which I have found online, but were to me a bit ponderous to retain the links. http://www.lauras-playground.com/forums/index.php?showtopic=37767

Thanks Vicky.

[Guest LizMarie]

Reparative therapy has been found to have extremely low success rates coupled with increased suicidality. This is why the APA and the AMA both declare reparative therapy "unethical" and why some states are banning the practice.

[Guest carolynn2fem]

This is a interesting discussion and like usual I have more to learn that to teach. What I first learned in coming here is ONLY go as far as need to. so far I haven't had to change anything appearance wise

[Guest Leah1026]

I've looked high and low all over the internet (all my links in my google searches are purple now) and I really can't find anything that explains alternative treatments for gender dysphoria (alternative to transition). What little research I have found just eludes to anything but transition being even remotely successful.

The only proven treatment is transition.

That said, some people who can't transition for whatever reason, lead a double life. They present as the sex they were assigned at birth when they're out in the world, but live as themselves at home. Obviously this won't work for a lot of people, but for some it does.

Other than that I have no suggestions.

[Guest LizMarie]

Leah is correct, transition is the one proven treatment. Everything else is ad hoc and highly variable because they amount to coping strategies in a society that is obsessed with the gender binary.

As one noted psychiatrist said, when you have suicide rates that are essentially epidemic in levels and then you develop a treatment that reduces those suicide rates by over 90%, how can you say the treatment is not successful?

[Guest thevaliantx]

No expert here. I can't agree more that GID never leaves you. In fact, once you become aware of it and what it is, one of you will win

[Guest KimberlyF]

The only proven treatment is transition.

Not according to the WPATH people. SOC7:

"An important task of mental health professionals is to educate clients regarding the diversity of gender identities and expressions and the various options available to alleviate gender dysphoria. Mental health professionals then may facilitate a process (or refer elsewhere) in which clients explore these various options, with the goals of finding a comfortable gender role and expression and becoming prepared to make a fully informed decision about available medical interventions, if needed. "

The SOC mentions a few things that can be helpful-much depends on the severity of ones Dysphoria.

[Carolyn Marie]

I agree with Kimberly (did I just say that? ). There are degrees of GD, and degrees of treatment, even degrees of transition. One size does not fit all, nor should it. For a great many, transition is the only solution. But not for all. Someone close to me is proof of that.

Carolyn Marie

[Drea]

Thank you so much for all your replies.

Just to clarify, I know there is no one cure all for this and I know it varies greatly by person. My general research experience has shown me that I can categorize the response to GD into 4 basic roads (these are broad roads).

1. Do nothing, continue life as usual.

2. Reparative Therapy (illegal in 2 states and very dangerous with no known success).

3. Repression Therapy (ie. learn to live with your dysphoria while working to relieve the symptoms that come with it).

4. Transition (live some or all of your life in the opposite gender, be it CD, FT, HRT, SRS).

I was mainly looking for statistical evidence regarding 2 and 3. Mainly I was asking for this because 1) I can't find it, and 2) surely someone somewhere has done even some type of study to see if any of it is successful in relieving GD short term and/or long term. I was just curious if anyone had a link or two to scientific information about the non-transitional therapies.

I am amazed at how the nonsense about "transition is the only treatment" persists. This is something so far from what most therapists say and even the WPATH standards.

But if you are looking to support a desire to transition based upon there being no other viable alternatives, sure it becomes understandable to think in the terms it is the only alternative.

As has already been stated there are many different levels of intensity of gender dysphonia.

I also find the list constructed in the quote above has two inaccuracies. First is the prejudicial characterization of all actions that aren't reparative or transition as repression. What does learning how to express yourself, to express gender non-conformity and the things therapist can help one deal with the dysphoria as repression? The second is characterization of any one action that might be part of transition as being transition. Like I seen more than a few express thought like "If I were going to do anything I am gonna do them all". The reality is that going thru a full social transition involving legal changes is very different thing than either taking hormones and continuing to live as a guy or just living part time by live legally male.

If one is thinking in such black and white terms and, heck, if one just wants an excuse to transition, stop messing around and just do it rather than developing some complex self convincing rationale.

The fact is the majority of trans people don't transition. Of those who actually get formally diagnosed only about 7% go onto surgery. And various percentages do different things. Some find sufficient relief with therapy. Some find that coming out, being able to express themselves at home is sufficient. Others may find hormones is enough. Some may have relief with part time expression. Some may find relief in different combinations. Others go as far as legal changes and full time public presentation but not want surgery. There are even those who have surgery but don't change public presentation.

The long and short is there is no one path, no one fits all solution and this is recognized in the standards of care, yet the community so often persists with this transition or not transition dialog.

[Guest ashleynikole]

I think the "transition is the only option" was simplified down based on studies done where those studied identified as transgender/transsexual to some degree with a formal diagnosis of Gender Dysphoria and after some form of transition, reported 71%-97% (depending on the report) successful treatment for the GD either being completely gone or not even noticeable.

Perhaps I did have some prejudicial characterization in stating that transition means to live at some degree in the opposite sex. That was my bad as I should have said that transition encompasses living your life in some other role other than the gender (and societal roles) you were born with.

After all, the dictionary defines transition as...

the process or a period of changing from one state or condition to another.

So if you move from birth sex to non-conforming or to opposite binary of birth sex (no matter what you do or how you do it), then you are transitioning. Ergo, repression would be categorized as not transitioning and staying with your birth sex, identifying with your birth sex and learning to live in a birth sex role.

In my mind, all the things listed here (with the exception of relief with therapy)...

The fact is the majority of trans people don't transition. Of those who actually get formally diagnosed only about 7% go onto surgery. And various percentages do different things. Some find sufficient relief with therapy. Some find that coming out, being able to express themselves at home is sufficient. Others may find hormones is enough. Some may have relief with part time expression. Some may find relief in different combinations. Others go as far as legal changes and full time public presentation but not want surgery. There are even those who have surgery but don't change public presentation.

...are forms of transition be they public or private. That's just my understanding of the dictionary definition of transition and thus why I lumped everything in to transition being the only viable option (at least for me) and I think why there is that persistence of "transition is the only option".

Hope that clears up why I only have 4 broad categories. Sorry for any confusion.

PS. If you have any studies that show some of the various ways that people "work out" their gender dysphoria with measures of success, I'd love to see them. That's the kind of information I'm looking for.

[Guest Leah1026]

The only proven treatment is transition.

Not according to the WPATH people. SOC7:

"An important task of mental health professionals is to educate clients regarding the diversity of gender identities and expressions and the various options available to alleviate gender dysphoria.

Believe what you want to believe, but let me point a couple things out.

1. Version 7 is different from previous iterations of the SOC becuase it doesn't cover just transsexual people, but all transgender people.

2. Maybe some of those alternatives work for other transgender people, but transsexual people usually need to transition to get real relief and resolution of their issues. Anything short of transition will NOT resolve the issue for transsexual people. If you think that's possible you're either transgender OR in denial.

[Guest KimberlyF]

The only proven treatment is transition.

Not according to the WPATH people. SOC7:

"An important task of mental health professionals is to educate clients regarding the diversity of gender identities and expressions and the various options available to alleviate gender dysphoria.

Believe what you want to believe, but let me point a couple things out.

1. Version 7 is different from previous iterations of the SOC becuase it doesn't cover just transsexual people, but all transgender people.

2. Maybe some of those alternatives work for other transgender people, but transsexual people usually need to transition to get real relief and resolution of their issues. Anything short of transition will NOT resolve the issue for transsexual people. If you think that's possible you're either transgender OR in denial.

Were you going to point out some new information?

Is it your statement of belief that GD is unique to TSs? Do you believe that every case of GD is the same with identical triggers and identical concerns? If not, why would the treatment path be identical?

[Guest LizMarie]

The AMA is now overwhelmingly on board with fundamental brain differences being the root cause of transsexuality. And the APA (both of them) both state that the most effective therapy statistically for transsexuals is transition.

One of the most important of these is brain differences concerns the BST in the hypothalamus. "In the hypothalamus, the bed nucleus of the stria terminalis (BST) is thought to be important for gender identity. One study showed that male-to-female transsexuals had decreased BST staining identical to that for genetic XX female subjects (8). In contrast, genetic XY male subjects had significantly increased BST staining. BST staining was not influenced by sexual orientation or sex hormone levels."

These differences can be seen below:

In addition, further brain structure differences are being identified as well that impact transsexuals.

This NIH document references the study (by van Kesteren PJ, Gooren LJ, Megens JA. An epidemio-logical and demographic study of transsexuals in The Netherlands. Arch Sex Behav. 1996;25:589–600) that sex reassignment as overwhelmingly statistically successful in addressing the needs of the transsexual community. Given the size of the TS community the size of the study is significant. If the rates of transsexuality are as high as 1 in 600 as has been suggested by various studies, and if 1 in 2500 actually undergo SRS which have been suggested by direct analysis of number of surgeries in the US per year, then the size of the study in question was almost 25% of the SRS population of the Netherlands and 3% of the overall Netherlands TS population. If the rates of transsexuality are lower, then the size of the study is even more significant because it represents an even larger cross section of the TS population!

Here is the NIH position:

Treatment options for patients with gender identity at variance with physical appearance can be evaluated in the order of extent of invasiveness. The least invasive intervention would be counseling such patients to accept the circumstance. As already noted, however, no available data support the success of such therapy. The next least invasive approach might be a targeted treatment of the underlying problem. The medical community, however, has little knowledge about the brain region associated with gender identity, and even less is known about techniques for manipulating it.

Although current transgender treatment is relatively invasive and does not address the problem completely, it is the most successful intervention available. Studies report very high transgender patient satisfaction with sexual reassignment. Thus far, the largest evaluation has been a survey of Dutch transgender patients (10). Among the 1,285 patients surveyed, 1,280 were satisfied.

As noted, "no available data support the success" of counseling patients to simply accept their circumstances. The second discussed option, manipulating the brain to become more accepting of the body, is not currently possible because the "medical community, however, has little knowledge about the brain region associated with gender identity, and even less is known about techniques for manipulating it".

This leaves transitioning as the primary therapy for dealing with GID. As has been noted in the past here at Laura's, there are people who do manage to live out their lives without transitioning to live in a new gender role. Good for them. But they are also the statistical minority among patients suffering from significant GID. For that category of patients, the number one therapy of choice today is transitioning (aside from suicide and I think we all agree that suicide is a bad option, yes?).

Therapists will assist a patient in trying to meet their personal goals but a transsexual suffering from significant GID ought to be prepared to discover that non-transitioning treatments are very likely to fail to bring them to a level of comfort with themselves that allows them to live a full and fruitful life. Certainly there will be those cases that do succeed at this, but as the NIH document notes, the medical community's primary treatment therapy today is transition, including HRT, and optionally including surgeries to further assist the body to conform to the expectations of the mind.

Therefore, in answer to the original poster's (Ashley's) question - you are unlikely to find any large scale answer to your question of non-transitioning treatments that work. In almost every case where that does occur, the patient has developed their own unique regimen for coping with their GID that is specific to that patient. The single treatment option that does work and which is medically and statistically supported at this time by the medical and psychiatric and psychological communities is transition.

Ashley, if you choose to not transition, it's pretty much you and your therapist in uncharted waters. It's possible you will succeed. Good luck if you choose that path. I will not dissuade you from taking whatever path you choose but I will stand by the statements in this post that transition is the proven most effective treatment for transsexuals suffering from severe GID.

P.S. This is the reason that there is so-called "cheerleading" for transition in the community - because it works. And because it is overwhelmingly statistically successful. Those are facts.