The Transgender Spectrum: Where do I fit? Part two

In last month’s column, I presented the first part of a workshop I gave at the Keystone Conference on the transgender spectum. This month’s column completes my talk with a few more therapy vignettes of people along the transgender spectrum.  In closing, I return to Julia Serano’s book, Whipping Girl wherein she gives a compelling description of the pain caused by gender dysphoria for the benefit of who are unable to relate to the experience.

There are some individuals who identify within themselves a transgender component, but who hesitate to say they would consider transitioning, even if there were no obstructions. These clients are not particularly unhappy with their assigned gender, but feel strongly compelled toward some degree of cross-gender expression.  Their motivations can range from “just fun” to sexual gratification, to a need to move beyond the perceived confines of their assigned gender role. For those individuals who fall within this part of the transgender spectrum, problems identified in therapy usually involve either insufficient self-acceptance or difficulties negotiating with their social environment, particularly significant others.  To be fully candid, I have never had one of the “just fun” people in therapy, although I know of some indirectly. I had one client whose motivations were as far as I could tell highly eroticized — he did not show a desire to transition publicly or even to leave his home en femme, but was very interested in the idea of obtaining hormones and breast implants in order to enhance his female appearance when crossdressed. He did not have a female name in mind, but was eager to show me suggestive photos of himself in female underwear.

More commonly reported among my non-transitioning transgender clients are problems with self-acceptance or in negotiating terms with others. Consider Brad, a 42 year old separated father of two whose growing need for cross-gender expression was met with intensifying rejection by his wife of 20 years. He first needed to find a way to accept and embrace his female side before addressing his wife, whose anger and resentment led her to condemn and ridicule him in front of their adolescent children. Brad’s excessive guilt led him to take on more than his share of the responsibility for the breakup of the marriage, and this made it difficult to have terms of his own with his wife, while their children were caught up in a split loyalty. I encouraged Brad to continue to try to connect with his children, despite their overt rejection and siding with their mother, because it would lay the groundwork for a future relationship when they were not so strongly influenced by her.

Mike, a 50 year old self-identified crossdresser first came to my attention when his fiancée, Julie, came in to talk with me after having just learned that her dream husband–to-be had a secret life.  Julie is a very open-minded person and seemed unfazed by the news, but wanted to learn more about what to expect. After they married several months later, Mike came to see me on his own behalf because he had violated agreements with Julie about the limits of his gender expression. Over almost a year of individual work and some couple sessions, Mike has come to identify more clearly what role that Kelly, his femme persona, will play in his life. Julie has tried to accept Kelly as part of their life and has also expressed her desire that Mike and Kelly integrate more fully.  However, it seems clear that Julie ultimately wants to be married to Mike. For his part, Mike loves Julie and enjoys their heterosexual partnership. Notwithstanding his commitment to remaining Julie’s husband, Mike continues to find himself pushing and secretly crossing over the behavioral limits that the couple agreed to, and the reasons for these transgressions are currently being examined in therapy.

Feeling free to explore the full contours of one’s gender identity is, I believe, one of the most valuable aspects of therapy with a trans-knowledgeable therapist. Following close behind would be finding support for identifying what one deserves (entitlement) and what one owes to significant others on the journey toward gender authenticity. Significant others are almost always caught off guard and overwhelmed by this disclosure, and paying attention to their transition without abandoning my transgender client is a tricky balancing act, not for the inexperienced clinician. It has been my consistent observation that the options for gender comfort available to most transgender clients depend in part upon the balance between their emergent need for self-delineation and their willingness to honor their relationships by considering the needs and feelings of their loved ones.

As one final example, consider my recent meeting with a young emergent transman, Josh, and his newly informed parents, who are still calling him by his girl’s name, Alana. Mom has done all the reading and is working hard to wrap her mind around her child’s revelation that he wants to transition before graduating from college, even if it requires taking a leave of absence. She is trying to be reasonable, but her swarming fears for her child are evident, although she focuses on the problems with maintaining him on the parents’ health insurance during an absence from full-time study. In the meantime, I am watching Dad, who looks as if he will either explode or break down in tears. He explodes, cursing and letting his contempt for the whole enterprise be known in a way that must be very hurtful to Josh, although he appears unmoved throughout. Dad expresses anger that Josh has “led a secret life” and frustrated by the fact that it may be too late to do anything to change the course of events. Mom tries to tell Dad that it might not have felt like such a secret if he had paid attention to what was in front of him.  But she, too, is feeling frustrated by Josh’s apparent disregard for their anguish. She begs Josh to just slow down. I try to validate the parents’ reasonable fears for their child and at the same time to assure them that psychological interventions will not change their child’s gender identity any more than we can make a gay person straight. Josh finally erupts in a volcano of his own frustrations, calling out his parents on all the suffering he has endured since childhood.

These snapshots provide a quick window into the ongoing scenes within my therapy practice, working as an ethically grounded therapist with people who are navigating the rocky shoals of transgender discernment and decision-making. I guess there are those lucky people who can do this with less drama, but they never make their way to my office. Perhaps that’s a good sign. Then again, maybe it’s not. I’ll close with a quote from Julia Serano’s very moving and illuminating description of her own early experience wrestling with a transgender identity:

“Sometimes people discount the fact that trans people feel any actual pain related to their gender. Of course, it is easy for them to dismiss gender dissonance: It’s invisible and (perhaps more relevantly) they themselves are unable to relate to it. These same people, however, do understand that being stuck in a bad relationship or an unfulfilling job can make a person miserable and lead to a depression so intense that it spills over into all other areas of that person’s life. These types of pain can be tolerated temporarily, but in the long run, if things do not change, that stress and sadness can ruin a person. Well, if that much despair can be generated by a forty hour-a-week job, then just imagine how despondent and distressed one might become if one was forced to live in a gender that felt wrong for twenty-four hours a day, seven days a week.”

I’m grateful to Julia for her attempt to help those of us who are blessed with the comfort of a congruent gender identity get a glimpse of what it’s like to live with the internal conflict of gender dissonance. Now I’d like to invite those of you who are so inclined to add your voices to this dialogue by sharing your own experience with navigating the transgender continuum.

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Category: Transgender Body & Soul