Quote (thesnipa @ Jul 29 2020 07:54am)
i have a general question:
1. do therapists then deserve a modicum of legal responsibility if pill cocktails lead to suicides in patients not previously suicidal?
2. how do we give therapists agency to prescribe hormones to children to block puberty if their entire field is basically guesswork?
i personally think therapists need major oversight in pill cocktails prescribed to treat mild to medium depression when it leads to self harm. and i personally think most of gender science is simply about harm reduction for a group that is highly suicidal statistically. essentially guesswork to try and reduce a glaring problem. and id be fine with this is super pro trans advocates didnt act like gender therapists were working off solid science.
in essence why do we give therapists a lack of responsibility and also legal credence? i personally dont see much more validity in all of psychology than astrology. oh wow u called out that a person who's father left them and who's husband cheated on them has trust issues, spot on!
I think having some skepticism of therapy and psychiatry makes sense, but I also feel that it's likely that you feel the strength of your position because of personal intersections between either yourself or people you know with the mental health field that probably weren't positive. I should note that while I'm still in the middle of earning my degree to become a licensed therapist, the program requirements involve us serving as therapists for many people as part of our training, skills development, and supervision. So my response here is both informed by, and biased, as a result of this.
Therapists aren't legally allowed to be involved in the prescription or management of medication. That's reserved for psychiatrists who have a much more extensive educational background with a medical degree, and their internship/externship involves helping people navigating much more acute displays of mental health. Someone in my position would never prescribe medication, encourage a client to stop/lessen a medication, or anything else. All therapists would do is help someone figure out what the best path forward for them to take would be, whether that be starting medication, stopping, switching, etc. All of that though would be a conversation with their psychiatrist and we'd just support them along that journey. That said, neither the psychiatrist nor a therapist are held liable should a client die by suicide, even if the medication that the person was taking had an increased risk of suicidal ideation. The only way either a psychiatrist or therapist would end up in hot water would be if the person on the medication disclosed to them that they were actively suicidal (intent, plans, means), and they did nothing about it. We have mandatory reporting laws that require us to get a person who is actively suicidal some help, and failure to do so can end up in a lawsuit and/or losing your license. The other aspect would be if the psychiatrist failed to provide proper informed consent, meaning that they didn't talk with the person about the increased risk of suicide and didn't say to "stop taking the medication immediately and come back in" if thoughts of suicide got worse.
In terms of hormones, therapists aren't actually prescribing the hormones. The current system exists where only a doctor, usually an endocrinologist, is the one who is able to prescribe hormones and who continues on with the client to manage them over time. However, largely because of health insurance providers wanting to avoid covering hormone therapy, the process necessitates that someone meet with a therapist first who is able to provide a letter saying that the client has a gender identity that they are both "insistent and persistent about", that they meet DSM-V criteria for Gender Dysphoria, and that they are able to provide informed consent about the benefits/risks of hormones, etc.
It's all much more complex, and helpful, than astrology.
