Dr. Az Hakeem on Gender Dysphoria and the Psychotherapy of Perversion
A specialist psychiatrist explores the roots of gender identity through the lens of trauma and psychoanalytic exploratory space.
The conversation around gender has become increasingly polarized, often retreating into the rigid camps of medical affirmation or political skepticism. Yet, beneath the headlines and the heated debates lies a complex psychological landscape that few have explored with the clinical rigour of Dr. Az Hakeem. A consultant psychiatrist and psychotherapist, Hakeem occupies a rare position in the medical world, bringing a psychoanalytic lens to a field now dominated by biological interventions. For twelve years, Hakeem ran a specialist service within the NHS—an exploratory space dedicated entirely to psychotherapy for gender dysphoria. Unlike traditional gender clinics, his service did not act as a "gatekeeper" for surgeries or hormones. Instead, it offered a neutral territory where adults could honestly investigate the origins of their distress. In this deep dive into the roots of gender identity, Hakeem suggests that the modern "trans" label is a blunt instrument used to describe a wide array of psychological phenomena. By looking at the intersection of trauma, development, and the mechanism of perversion, he provides an analytical framework for understanding why an individual might seek to transcend their biological sex.