Even if you do specifically have gender dysphoria, jumping to gender affirming care is radical. It's not how we treat any other kind of disordered thinking

Gender Dysphoria is not disordered thinking. That’s exactly why the name was changed in DSM-5 (formerly Gender Identity Disorder in DSM-IV). Or if you prefer, it’s exactly why ICD-11 renamed it to Gender Incongruence and moved it out of the “Mental, Behavioural, and Neurodevelopmental Disorders” section. Shouldn’t a former therapist commenting on the issue know that?

Does Gender Dysphoria present alongside disordered thinking? Quite often! But that doesn’t invalidate one’s gender identity. Transition didn’t make my F33.2 Major Depressive Disorder, Recurrent Severe magically go away, but it sure is easier to cope with and treat these days. (Well, I guess it’s 6A71.3 now that ICD-11 is out.)

I think people who can only find relief for their dysphoria by transitioning should be allowed to

And there we have it: the core of the argument you’re making is that people should only be allowed to transition if a gatekeeper is satisfied it’s the only way they can get relief. And the only way to “show” that is to suffer more and more — unnecessarily! — until someone like you finally believes them, which might never happen. Do you believe trans people genuinely have the gender we say we do? If so, withholding treatment is simply cruel. Or do you not believe us and just think it’s okay for us to “pretend” if nothing else works? That’s not real acceptance.

There is no medical reason not to try more traditional forms of therapy and medications before pursuing the less understood and riskier treatments.

Scientists still don’t fully understand how antidepressant medications work. They come with a black-boxed warning (the strongest kind) in the US, and similarly strong warnings in the Canadian product monographs. Benzodiazepines commonly used for anxiety disorders can be extremely risky. Puberty blockers and hormone treatments are better understood and carry less risk in many cases.

I very much wish the LGBT community could try to understand where moderates like myself are coming from.

Oh, believe me, we understand exactly where you’re coming from… quite possibly better than you do. You’re only fooling yourself with that “moderate” label.

And that’s why I wrote this reply out for the bystanders — it’s not actually for you.