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Therapeutic Challenges Associated with Gender Identity

What specific challenges with your gender identification would lead you to seek help? The way you identify as one gender may feel different from the norm. It's possible you feel like you were assigned the incorrect sex at birth. You could be transgender or transsexual and be looking for a therapist who is familiar with your experience. You may investigate the psychological and medical means of undergoing a sex or gender transition. Instead, you may like to discuss the challenges of living in a society that treats gender as a binary (feminine women and masculine men).

Transgender (or Trans for short) is an umbrella word encompassing a spectrum of identities that do not adhere to the gender role norms of one's biological or ascribed sex. Some children exhibit stereotypically masculine or feminine behaviors, while others may be non-conforming to either gender (such as the "tomboy" or "sissy" kids) or even androgynous. Most kids (regardless of how they choose to express their gender) grow up with a sense of self that is consistent with their biological sex. Nonetheless, transgender and substantially gender non-conforming children may have difficulties when their sense of self does not align with their physical appearance or the gender signals they get from their family, peers, and society. I do think that the effects of stigma in a transphobic society are typically what lead transgender persons to seek counseling. The idea that differences between the sexes are inherently unhealthy is not one I can subscribe to.

Those who identify as transgender or gender nonconforming seek medical help for the same range of conditions as the general population. Reasons for seeing a therapist outside of the above list might be:

One example is the phenomenon of doubting one's given sex/gender at birth, which has been compared to "coming out" by some. So where do you even begin? How would you describe your own gender identity? What will you say, and to whom? When trying to understand what it means to be gender variant or to experience your sex differently from how society defines it, it might be helpful to talk to a specialist.

Help in overcoming the effects of social stigma: therapy may serve as a protective haven for those who need to mend fences after being hurt by others. Your therapist may also be able to put you in touch with local transgender support groups and other relevant resources.

Gender differences and traumatic experiences: Have you encountered prejudice because of your gender in the areas of employment, housing, or the workplace? Asking whether you've ever experienced any kind of bullying, harassment, or even physical assault. Do you have a history of abuse or rejection in your family? These are all very stressful situations. As many as half of transgender people, according to some surveys, have been victims of sexual assault. You should seek out professional support to help you get beyond these traumatic events, ideally from a therapist who understands transgender experiences and trauma.

You may wish to consult with a knowledgeable and compassionate expert about preparing and educating for your transition with friends, family, and/or coworkers. Possible next steps include researching your available alternatives for making a change. Legal possibilities like changing one's name are discussed, as are medical choices like cross-gender hormone treatment and sex reassignment surgery. Before beginning hormone therapy or surgery, your doctor may insist on an evaluation and/or therapy sessions with a trained therapist. This puts the therapist in an awkward position of acting as a gatekeeper to the therapeutic process. Informed consent is used by certain medical professionals. You can count on me to collaborate with you to ensure that all of your transition needs are met. Not much else matters as long as you get the help you need.

Post-transition concerns: You may need continuous help as you adjust to life as your chosen sex or gender.

Is your cross-dressing connected to your sense of gender? Cross-dressers do not always identify as transgender. One reason people go to counseling is to figure out how cross-dressing fits into their lives.

Therapy for the transgender person's significant other, spouse, or family members: Partners/family members of transgender persons may also seek therapy services for education and support. Information and tools for parents of gender-nonconforming children are essential. Trauma therapy training may be a useful tool in informing loved ones about your gender identity and transition goals. If you are a partner of someone through transition, you may worry about the impact on your own identity and the future of your relationship.

Furthermore, some people experience changes in their sexual orientation throughout the transition. That's the worry of some people. As the spouse of a transgender person, you may find yourself questioning your own sexual identity.

Years of working with transgender groups and individuals have given me extensive knowledge in this area. Several of my clients have come to me for support as they have struggled with questions of gender identity, decided to come out, and explored their options for a successful transition. I've helped clients who identify as gender nonconforming or with a gender variation who don't want to undergo a medical transition but still need a safe space to talk about their experiences and feelings without feeling like they have to first educate their therapist. Several organizations and agencies have benefited from my training and education on transgender issues and how to be more trans-inclusive as a result of my work with them.