Gender-affirming care through the lens of abnormal illness behaviour and abnormal treatment behaviour
Clarke, Patrick, and J Amos, Andrew (2025) Gender-affirming care through the lens of abnormal illness behaviour and abnormal treatment behaviour. Australasian Psychiatry, 33 (2). pp. 282-288.
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Abstract
Objective: To describe the increasing number and changing demographics of patients presenting with gender dysphoria and provide an account of patient- and clinician-related factors which may have contributed to these changes. The concept of abnormal illness behaviours introduced by Pilowsky, and its extension to the concept of abnormal treatment behaviours by Singh, provides a framework for understanding healthy and pathological interactions between gender dysphoria patients and their doctors. Conclusions: Abnormal illness behaviours driven by the reinforcing contingencies of gender-affirming care may explain, in part, the increasing number and changing demographics of gender dysphoria, as well as the increasing incidence of desistance and detransition. The under-diagnosis and under-treatment of mental health disorders by clinicians treating these patients are examples of abnormal treatment behaviours. Uncritical affirmation of patient reported gender identity appears likely to conceal unconscious motivations of some patients and clinicians, increasing the risks of harm to both.
| Item ID: | 88168 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1440-1665 |
| Keywords: | abnormal illness behaviour, abnormal treatment behaviour, child and adolescent psychiatry, psychoanalysis, psychotherapy |
| Copyright Information: | © The Royal Australian and New Zealand College of Psychiatrists 2024. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the Sage and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
| Date Deposited: | 30 Mar 2026 07:28 |
| FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320221 Psychiatry (incl. psychotherapy) @ 100% |
| SEO Codes: | 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100% |
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