Meet Therapist Anna Lisa Derenthal

Anna Lisa Derenthal is one of the leaders in providing mental health care for transgender persons in the mid-South U.S. Anna Lisa started her mental health career in the public sector. She has been practicing privately for over a decade. She started a support group for transgender persons in the North Fulton section of Atlanta and ran it for many years before turning it over to new leadership recently. She also provides general mental health therapy to her clients. Anna Lisa lives and works in the North Fulton County section of Atlanta. She has been my transgender advisor since the beginning of my transition and I am proud to let the outside world know about her work for the transgender community.

Rogers: Anna Lisa, are you from the Atlanta area?

Derenthal: My family moved here when I was 13 and my father retired from the Army. I’ve lived around various parts of the Atlanta metro area but mostly in the North Fulton community.

Rogers: So your father was in the Army. Did that affect your youth and teenage years a lot?

Derenthal: It did. I had a hard time adjusting to new places. I was very shy. So by the time I was able to get adjusted and make friends, we were moving.

Rogers: I’ve heard a lot of military talk about that.

Derenthal: Yeah. So it was really good to stay in one place. Now I have long-term friends.

Rogers: You said to me recently that you were not always thrilled with your father.

Derenthal: Oh yeah. He was a very tough disciplinarian.

Rogers: That’s what I figured, from the way you talked about it, I gathered you did not like that kind of discipline.

Derenthal: It was very hard on me. I was a very sensitive child.

Rogers: I can easily imagine that.

Derenthal: Yeah. [Laughs].

Rogers: Did you get bullied a lot?

Derenthal: Yeah. I did. I was very shy and introverted.

Rogers: I can understand. Been there, done that. I know that you attended Georgia State.

Derenthal: Yes.

Rogers: And before that, Georgia Perimeter College.

Derenthal: Right.

Rogers: Or whatever it was called in those days. Was it still DeKalb Junior?

Derenthal: It was DeKalb Community College way back then.

Rogers: I can remember when they called it DeKalb Junior College. And now it’s Georgia Perimeter College. You went there before you went to Georgia State. Did you get your bachelor’s and master’s degrees at Georgia State?

Derenthal: Yes.

Rogers: Okay. Was that mostly at the downtown campus?

Derenthal: Just the downtown campus.

Rogers: Did you live on campus?

Derenthal: No. I commuted. I was working full-time for most of the time I was in college and taking night classes.

Rogers: I know that feeling.

Derenthal: Yeah. It’s tough.

Rogers: It is. What kind of work were you doing?

Derenthal: In my previous life I was an executive secretary.

Rogers: I understand. Do you think you missed a lot of the college life because of it?

Derenthal: Oh I did. I think it would have been good for me socially to have that experience.

Rogers: And you’ve also told me that you had a tough time getting into the mental health field.

Derenthal: Yeah.

Rogers: You also said at one point that you were fairly close to deciding to try to do something else.

Derenthal: I was. The barriers of entry were high then and the requirements from the educational system were pretty high as far as getting supervision hours, going through an internship and all that. But I couldn’t get a job at first after I got my Master’s and I was on the verge of just getting some boring job at Movie King when I got the call that one of the jobs that I had interviewed for was accepting me. So that was a lucky break.

Rogers: Was that here in Atlanta?

Derenthal: Yes.

Rogers: From what I remember you were working in the public health sector at first.

Derenthal: Yes.

Rogers: Do most mental health professionals struggle like that?

Derenthal: Yeah. In the beginning. It’s hard to break in and get established.

Rogers: I can easily believe that. But not many of those professionals talk about how hard it is for them to get started.

Derenthal: Yeah.

Rogers: And then as you got started, you have talked to me about networking a lot.

Derenthal: Yes.

Rogers: Is that basically … Did you know from the beginning that you needed to network?

Derenthal: Oh yeah.

Rogers: Did other people tell you that you needed to network?

Derenthal: Yes. It was comfortable for me. Once I grew up and matured I kinda came out of my shell.

Rogers: I was surprised when you told me that you had been very introverted. You did not seem that way now.

Derenthal: It’s kind of my nature, so … it doesn’t show very often. I guess I’m an extroverted introvert.

Rogers: Were there any particular things that you did to get to where you are now that are worth mentioning?

Derenthal: Well, the networking, number one, and getting an Internet presence, which is pretty well established now.

Rogers: Did you build that yourself or did you hire somebody?

Derenthal: I hired someone to do my website and my husband did the Google AdWords thing. But I think you need a lot of networking because once you get in with certain groups, then they list you on their websites and it just kind of takes off from there.

Rogers: I’m not sure if I mentioned it specifically here, but you told me at one time what led you toward working a lot with transgender folks.

Derenthal: I had a lot of gay and lesbian clients. I’ve always been drawn to people outside the norms, if you will, of society. And before I got my license, when I was still working in community mental health, I had a trans man client for years who had been through the wringer in every possible way—discrimination, rejection from family, loss of job, etc.

Rogers: That was outside Atlanta, wasn’t it?

Derenthal: Yeah.

Rogers: Okay.

Derenthal: And he just grew on me, and from that point on I knew I wanted to work with this population. So once I got my license, I put it out there that I work with LGBT folks and at that time, there weren’t very many therapists that did. So the timing was right.

Rogers: What is your basic idea about what types of therapy you like to do and your approach to trying to help people get through their issues? Most therapists have something.

Derenthal: I use a lot of cognitive behavioral therapy in how I work, and also person-centered therapy, which originates from humanistic psychology and is based on relationship first and communication and it’s a collaborative relationship, whereas a lot of traditional therapists don’t say much. They just …

Rogers: The more Freudian therapists …

Derenthal: Yeah. But I’m very interactive and interpersonal.

Rogers: I would not have said you were a Freudian. I could not see you sitting there, just taking notes while the person was laying on the couch.

Derenthal: (Laughs)

Rogers: You’re probably the leading mental health professional working with transgender folks here in the South.

Derenthal: Well, I don’t know. There’s a lot of them now. When I first started out there was just a handful of them. I got in at the right time.

Rogers: I suspect you are, even if we can’t prove it.

Derenthal: Erin Swenson and Virginia Erhardt, who both I think are retired now. So I got in at a good time and got pretty well established and well known, but there’s a good bit of them now. [Note: Virginia Erhardt is now deceased.]

Rogers: I still suspect you are one of the leaders, at least in this part of the world.… Even though we’re talking about you working with transgenders, that is not your entire practice by any means. You’ve talked about working with trauma victims.

Derenthal: Yes.

Rogers: And I also know you do general therapy work as well.

Derenthal: Yes.

Rogers: So how is that different from the work that you do specifically with transgender folk?

Derenthal:Well, it’s a whole different population and set of issues. However, there is overlap. Often, people growing up trans and having to keep it a secret or not being in an accepting environment can be traumatic. Or if they are abused by their family, rejected, kicked out of the house, whatever, that’s trauma. So a lot of times there’s overlap. But I have a lot of trauma clients that have no experience with transgender, as well. But there’s a similarity in feeling rejected, feeling misunderstood, people that have not been through serious trauma have no clue what it’s like and can dismiss it or minimize it. That sort of thing.

Rogers: Is there anything else about your practice specifically that you think people should hear?

Derenthal: I do specific forms of therapy for trauma. I do EMDR (eye movement desensitization and reprocessing). I do brainspotting. And I do internal family systems therapy.

Rogers: Okay.

Derenthal: Those are specialized forms of therapy for trauma.

Rogers: I think you and I talked about how your fees compare with others, and you were saying you thought you were roughly in the middle.

Derenthal: I’m somewhere in the middle, maybe a little on the higher end.

Rogers: But certainly not at the top by any means.

Derenthal: No.

Rogers: You are married.

Derenthal: Yes.

Rogers: How long have you been with your husband?

Derenthal: Twenty-eight (28) years.

Rogers: Twenty-eight years? That is to be commended.

Derenthal: Thank you.

Rogers: So how did you meet him?

Derenthal: We met in a nightclub, actually. On New Year’s Eve. (laughs) A great way to start out the year.

Rogers: It seems like something out of a movie.

Derenthal: It was. It was very romantic.

Rogers: I can tell from the way you talk about him that you definitely care about him a lot.

Derenthal: Oh yeah. He’s a wonderful man and we’re a good couple. We work well together.

Rogers: Okay. Were there any other major relationships before him?

Derenthal: Oh yeah.

Rogers: Okay. And if anyone has any questions, you are straight.

Derenthal: I am heterosexual.

Rogers: Now in addition to being a mental health professional, you are also a businesswoman.

Derenthal: Right.

Rogers: A small businesswoman. Do you ever get the feeling that some of your clients don’t understand that….

Derenthal: Yes.

Rogers: … that side, that you really do have to charge a price in order to …

Derenthal: Yes.

Rogers: … in order to survive?

Derenthal: Right. Some therapists take a vow of poverty, maybe not literally like priests or monastics do, but they have that kind of mindset that they’re working for the good of or the betterment of the people or whatever and that they shouldn’t get paid well. And that’s a whole mentality that gets in the way. But for the amount of schooling and experience and hard work that it takes to get here, I believe it’s reasonable to be paid for…

Rogers: You’ve earned it.

Derenthal: Yeah. For your services.

Rogers: Is there anything else you want your clients to know about you as a businessperson?

Derenthal: Yes. And that is that I’m self-employed. I’m a solo practitioner like most of my colleagues. And so I am … it’s just me. I set my schedule, I schedule appointments, I do the billing, all that stuff. And I don’t have a salary. I don’t have sick leave. So if I’m not sitting face to face with a client, I’m not making money. And so I have a 24-hour cancellation policy. And if I don’t have 24 hours notice prior to the appointment time, I charge for the appointment. And that’s hard for people to accept sometimes, because unforeseen things happen. And I feel bad for them, like if you have car trouble or your kid is sick or whatever, but if it’s not an emergency then I still need to charge.

Rogers: How many of your clients ask you for reduced fees? Just as a percentage.

Derenthal: How many ask? I would say maybe 25% to 30%. And I do always provide a certain number of reduced fees. I actually have a client now that’s full pro bono, who doesn’t pay anything. And most therapists do that as part of their practice.

Rogers: I hope I understand you as a businessperson, not just a mental health person.

Derenthal: Yes.

Rogers: The political climate towards transgender people, especially here in the South, is not a good one right now.

Derenthal: Right.

Rogers: We’re seeing a lot of politicians trying to make political capital by coming after us.

Derenthal: Right.

Rogers: I mean, is it gonna get better, is it gonna get worse? I won’t put a time on it.

Derenthal: I don’t know. That’s a big question and a scary one. A lot of trans folks are very frightened and planning on moving out of the country. And some of them are becoming activists. And all of that makes …

Rogers: I can see myself becoming an activist if it comes to that point.

Derenthal: Yeah. Scary times.

Rogers: I’m not scared. I’m concerned, put it that way.

Derenthal: Yeah.

Rogers: Especially in the state where I live where some of our legislators are very definitely anti-trans.

Derenthal: Yes

Rogers: Okay. Let’s go on then, unless there’s anything else you wanted to say about that.

Derenthal: No.

Rogers: Do you want to talk about the next question?

Derenthal: One of the reasons that I am in this field is because I have always had a deep personal interest in all things having to do with sexuality and gender. And the reason for that is because I myself am intersex. Actually, the newer term for that is “disorder of sexual development” (DSD). What that means basically is that my anatomy, my body, isn’t 100% typical female. And there are a lot of us, actually. The percentage is much higher than originally thought. And there were so many different types of intersex conditions. And the reason is because nature is very variant. It’s not perfect. And there are a lot of mutations and a lot of things that go wrong in the developmental process, that produce babies that are not completely female or completely male in anatomy.

Rogers: Yeah.

Derenthal: And so it can be a huge problem for a lot of people who are very ambiguous in appearance and in how they feel. And I have met some of those people and they are heart-wrenching stories. Fortunately for me, I’m very feminine. I have a female brain. I’m all girl. And I’ve never had a problem with my anatomy. It functions. I can’t have children, but exteriorwise, everything looks like…

Rogers: I admit I was shocked when you told me. Because I had never had any reason to think that you were ever anything but female.

Derenthal: It’s just not being able to have kids when I was a young adult that was hard for me, but that was a long time ago and I have long since accepted not having children.

Rogers: Just to follow up on that, if you could have the standard female body…

Derenthal: You mean all the internal organs and stuff?

Rogers: Yeah.

Derenthal: Nah. (Laughs)

Rogers: So you can live with it as it is?

Derenthal: Yeah. Yeah. At this point. Because it’s been a long time.

Rogers: Is there anything else that we haven’t talked about that you want to talk about?

Derenthal: Just that the whole experience of being transgender is so difficult and painful and confusing, and it literally pains me whenever I encounter people who don’t have any experience with trans, personally or in their family or extended network. And they just rush to judgment. One of my pet peeves is people who are very intelligent in certain areas, and they assume that means they’re intelligent in all areas. And they aren’t. But people look to them for advice because they’re intelligent in some areas. And then they just bloviate on every other subject that they don’t know anything about, because they have that platform. And it just aggravates the hell out of me.

Rogers: I can believe it. Thank you for sharing all of this.

Derenthal: Thank you.

Rogers: I believe other people will find you as interesting as I do and as fascinating.

Derenthal: Thank you, Michelle.

Rogers: Thank you very much.

Derenthal: You’re welcome.

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Category: Interview