Navigating Gender Dysphoria: Challenges and Therapeutic Dilemmas

With 35 years of clinical experience, Dr. Lisa Duval sees what others won't say: gender dysphoria is fundamentally a phobia of adulthood. In this piercing analysis, she explains how treating puberty fear with blockers is like telling someone afraid of bridges to "avoid every bridge in your life"—the opposite of proper therapy. Dr. Duval reveals how multiple young women in her practice leaned in and whispered: "I don't think I'm even gay or queer. I'm just so afraid of penises." She exposes the shift from evidence-based to "rights-based medicine," the borderline personality patterns underlying trans identification, and how therapists' "malevolent benevolence" harms with the best intentions. From Taylor Swift lyrics revealing truths about growing up to the exhausting psychological burden of "faking the voice" that trans people hide, this conversation strips away the ideology to reveal what clinicians have forgotten: "We know how to help people through distress. Why aren't we doing it?"