Via Muldoon in the comments – and the pages of Psychology Today – the evaporating standards of “affirmative psychotherapy”:

Sharp-eyed readers may have registered the seeming absence of curiosity, of enquiry – say, regarding very common causes of the phenomenon in question. Readers may also wish to ponder the inevitable tensions between affirmation and investigation – and to place bets on which will be dispensed with in favour of the other. In this Yes, You Are Napoleon school of psychotherapy, where the unwell must always be told whatever they want to hear. Possibly before being steered towards irreversible mutilation and lifelong pain.

That gender-affirming care.

Readers may also wish to ponder how a similarly affirming approach might fare with other mental health issues – such as anorexia, with alarmingly cadaverous young women being told, “Yes, dear, you are every bit as fat as you imagine and should definitely continue starving yourself.”

A consequence of all this affirmation and declared solidarity is a hasty jumping to conclusions. A begging of questions. For instance:

The author of the above, Tess Kilwein – PhD, pronouns “she/they” – would have us believe, and would have her patients believe, that the most pressing and fundamental causes of woe are “bias,” “microaggressions,” and “anti-trans bills” – among which, laws that restrict women’s changing rooms and other intimate spaces to use by actual women, rather than delusional and/or predatory men.

And yet, a person with sexual dysmorphia – someone vehemently alienated from the physical reality of their sex – would presumably still feel that way even if stranded on a desert island. Just as they do now, when alone – say, in the shower or when making tiresome TikTok videos. Seems to me it ain’t the world that’s causing the problem.

This willingness to pretend – and to then applaud oneself as righteous and heroic – is, I’d suggest, a less than ideal tendency for a mental health professional. Someone to whom a person’s wellbeing, or hope of wellbeing, has been entrusted. Likewise, the rush to externalise all causes of misery. While social interaction – knowing that other people are likely to perceive you as you actually are, not as whatever it is you wish you were – may amplify the existing dissonance, such interaction doesn’t cause it. It isn’t the root of the problem.

That’s an, as they say, you thing.

In this supposedly therapeutic context, the words affirmation and validation translate as a willingness to lie. A willingness to indulge obvious bollocks and play along. And so, one might wonder how Dr Kilwein might affirm and validate some of the chaps seen here. Or this merry bedlamite, who violates women’s toilets and pushes his phone camera under the doors of occupied stalls in order to livestream to his admirers, all those affirming fans, the protests of his latest victim.

But, says Dr Kilwein, we must “validate without hesitation.” Because this practised, habitual dishonesty is, she says, “justice” and “courage.” And therefore, a basis for in-group status. At which point, the nakedly partisan activism of such people – and the abandonment of anything approaching detachment and objectivity – even basic curiosity – appears jarringly at odds with any claims of professionalism.

We are, however, assured that Dr Kilwein is a proponent of “bold storytelling.” Which is just what a patient needs when their perceptions of reality are wildly unreliable.