Being in Therapy, Being Transgender

By Kate Double, MSW, LCSW

Bathroom Buzz

We’ve all heard talk of the “bathroom bill” in North Carolina, but many of us have very little understanding of the myriad of issues facing those that identify as other than the gender that they are assigned at birth. Relationship Restoration’s clinicians are constantly participating in continuing education to ensure that we have the skills to be inclusive in our work with ALL individuals and couples in the community.

Come One, Come All

In my own personal efforts to be able to better serve those that identify as transgender or non-binary, I attended the 17th Annual Trans Wellness Conference run by the Mazzoni Center in Philadelphia.  I was told that this conference, open to the community for free and having an extensive professional track, attracted over 6,000 attendees.  The audience was comprised of people that are transgender, those that identify as non-binary, family members; allies of the LGBTQ community, social workers, psychotherapists, attorneys, doctors, nurses, educators, and many others.  It was an eye-opening reminder that “you don’t know what you don’t know.”  I was stunned by all that there is to absorb, study, and integrate in my practice: an understanding of the various medical options for transition, unique pelvic pain concerns, the scope of trauma experienced by transgender individuals and the transgender community, the need for informed and appropriate mental health care, and the varied expressions of gender among those that identify as non-binary; among other important topics.

Culture Constructs

Hearing from professionals, family members, and transgender individuals reminded me how much of gender is a social construct.  Most cis-gender individuals, meaning those that identify as the gender they are assigned at birth, take for granted that genitalia determines gender without regard for the internal experience.  Prior to this conference, it seemed reasonable to me to require an evaluation by a mental health professional before pursuing surgical interventions, and for the first time I have a full appreciation for how this “gatekeeper” rule is pathologizing all experiences of gender that fall outside those that traditionally are accepted in our society.  To my knowledge, we do not ask for a mental health evaluation prior to any other type of surgery – we trust this to be a decision between individual and surgeon.  What, other than the lack of social acceptance, is different about this?  And who is better equipped to evaluate internal experience other than the individual with a desire to alter their external expression?

Sex Therapy for ALL

Where does a transgender individual go for counseling, to explore the unique issues surrounding dating, or for sex therapy when they fall entirely outside of the scope of many heteronormative practices?  There aren’t very many well-informed therapists and we seek to fill that gap by informing ourselves, being ready for ongoing learning, and being accepting of ALL. We are safe space where each can be accepted for who they are. While I fully recognize my privilege as cis-gender, straight, and well educated; it’s crucial that I am fully knowledgeable and up-to-date in my work with those in the transgender community. Whether someone is pre-op, post-op, or non-op I am here to explore their journey and deal with other life stresses in an environment of acceptance. Come explore with me!