Gender: A Wider Lens
Gender: A Wider Lens
64 - Pioneers Series: Psychotherapy Pre- and Post-Transition with Az Hakeem

64 - Pioneers Series: Psychotherapy Pre- and Post-Transition with Az Hakeem


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Dr. Az Hakeem was born and brought up in North Wales and has lived and worked in London since studying medicine. He is a Consultant Psychiatrist who previously trained in forensic Psychotherapy, Mentalization-Based Therapy and is a Group Analyst. He previously worked within the NHS in Forensic Psychotherapy specializing in Analytic Psychotherapy for conditions relating to sex, gender, sexual perversion, and violence at The Portman Clinic, part of The Tavistock & Portman Clinics.

Dr. Az Hakeem is unique in that he is the only consultant psychiatrist in psychotherapy who specializes in the specialist application of exploratory psychotherapy to persons suffering from gender dysphoria. He set up and ran the only specialist psychotherapy service for adults with gender dysphoria in the UK in the NHS and is the author of TRANS: Exploring Gender Identity and Gender Dysphoria.

After over 15 years working in the NHS, Dr. Hakeem now works exclusively in private practice.

In addition to his clinical work, Dr. Az Hakeem has worked as a consultant to the media, on-screen specialist, and TV Co-presenter on a number of TV programs in both the UK and Australia. 

Dr. Az Hakeem considers himself a “Gender Critical Psychiatrist.” Today we get to hear about Dr. Hakeem’s facilitated group therapy for gender-distressed adults. He ran these groups for twelve years from 2000 to 2012. Containing a mix of pre-medical-transition individuals who were often gender-euphoric and post-medical-transition individuals who experienced regret, these groups created a fascinating opportunity to give gender-dysphoric individuals more insight into the long-term experience of transition. In this episode. we discuss Dr. Az’s understanding of gender distress and how he contextualizes ROGD kids into this framework.


TRANS: Exploring Gender Identity and Gender Dysphoria:

The Curious Incident of the Dog in the Night, by Mark Haddon:

“Development and validation of a measure for assessing gender dysphoria in adults: The Gender Preoccupation and Stability Questionnaire” Hakeem, A., Črnčec, R., Asghari-Fard, M., Harte, F., Eapen V. International Journal of Transgenderism (26th August, 2016)

“Psychotherapy for Gender Identity Disorders” Hakeem, A. Advances in Psychiatric Treatment (2012), vol.18, 17-24

“Study Protocol for a randomized controlled trial of mentalization based therapy against specialist supportive clinical management in patients with both eating disorders and symptoms of borderline personality disorder” Robinson, P., Barrett, B., Bateman, A., Hakeem, A., Hellier, J., Lemonsky, F., Rutterford, C., Schmidt, U., Fonagy, P. BMC Psychiatry 14(1): 51. 2014

“Deconstructing Gender in Trans-Gender Identities” Hakeem, A. Group Analysis. The International Journal of Group Analysis Volume 43 Issue 2, June 2010

Extended Notes

  • How did Dr. Az get involved in gender identity?

  • Dr. Az was really curious to understand what was really going on inside the heads of people with gender dysphoria.

  • Dr. Az knew about two gender dysphoria groups, one who regretted their sex change and another who were thinking about doing a sex change. Dr. Az decided to merge them together.

  • Why is a group setting slightly different/better than a one-on-one session with a therapist? Dr. Az offers his thoughts.

  • Unfortunately, there have been no follow-up studies on those who deeply regretted their gender transition.

  • From observation, Dr. Az saw a lot of these transitioned patients feeling inauthentic in their skin.

  • Why are pronouns, in particular, so important for people with autism?

  • What is an “autistic meltdown”?

  • Dr. Az thought for the longest time he was the only one who was seriously questioning and criticizing gender transitions. It seemed everyone in his field was going along with it.

  • The general critique Dr. Az got in the public eye was, “Why are you here? You’re terrible and not gender-affirming.”

  • Let’s talk about the difference between sex and gender. The idea that we don’t have biological sex is complete insanity to Dr. Az.

  • There’s a demand to be recognized and seen by the outside world.

  • You can’t have gender ideology without gender stereotypes.

  • Dr. Az breaks down all the confusing terminologies being used in gender identity right now and how it’s very hard to get a good grasp of it all.

  • Dr. Az finds it very sad that we’ve decided to ditch reality and science for fiction and fantasy.

This podcast is sponsored by ReIME and Genspect. Visit and to learn more.

For more about our show:

Gender: A Wider Lens
Gender: A Wider Lens
Therapists Stella O’Malley and Sasha Ayad explore diverse perspectives through a psychological lens, fostering open dialogue on gender identity, transition, and the transgender umbrella. Their work with gender dysphoric clients and unique experiences yield an informed outlook delving into gender's psychological nuances. Interviews with clinicians, academics, transgender individuals, parents, detransitioners, and others touched by gender provide varied insights and intimate inquiry into the taboo yet relevant topic.