Telling depressed people that it's "in their head" is basically how we treat depression. People who are depressed think that they are depressed for a reason: nobody loves them, they're worthless, their family would be better off without them, etc. More often than not, it's a clinical condition and we treat it with medicine and therapy. We say, "you aren't worthless, you're feeling this way because you're sick, it's all in your head." There are psychological techniques that doctors have developed to help people with depression lead normal, productive lives.
but that's the initial reasoning. depression is caused by a billion different things, the most common ranging from: personal failures, financial issues and social issues.
the trick to solving depression is to legit get them to resolve that underlying problem. sometimes they over exaggerate minor issues which can lead to such an issue. you don't tell them it's in their head but rather, help them fix their stuff to the best of your abilities. which is also why treating depression in the US has major issues ($$$ related)
if you're charging someone who doesn't really have all that much money for therapy and medicine, don't be surprised if he doesn't go and get that therapy and medicine. depression isnt as simple as telling them its in its head in some super glorified way, trust me, we wish it was.
If they say, "the world would be better off if I just killed myself," we don't smile and hand them a loaded gun.
no stuff
This isn't the case with patients who are gender dysphoric. A genetically-male patient says "I feel like I was born a girl," and the doctor says "you're right, you ARE a girl." The patient says, "I feel like life would be better if I got my richard cut off," and the doctor says "you're right, life would be better if you cut your richard off!" This is a strange case of medical resources helping to maintain an illness rather than treating it. Again, it'd be like a doctor telling a depression patient that "your family actually DOES hate you and your parents divorce actually IS your fault."
except there's one major problem, at least in the US: there's gatekeeping out the ass that you would honestly think that they guard the treatment like they do the white house.
seriously we loving try it all before actually going through that.
you name it, therapy, long ass waits, trying medicine even.
and they will desire it through all of that.
they get depressed when they didnt know their appointment and you say it will be months maybe even a year before they can get one. then once they pass all the checks they start feeling a bit better and it just goes up until they actually do it.
before we go any further, i'd like to clarify something: HRT is reversible, SRS (the actual richard mutilation) is not.
we wait till they're late HRT (2-3 years) before they even have a chance to pull off SRS. mostly because gatekeeping.
most transgender people actually choose
not to do SRS
and to go further: most transgender people who commit Self Delete usually do it during early-mid HRT, so it's obviously not the fact that it's irreversible causing it, it's mostly believed that harassment (due to common sense or something) causes this, but it obviously isn't the only reason and it can't be recorded through that god awful hate crime statistic solely because it's harassment, not loving assault.