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AAMFT Consumer Update
Gender Identity
Transgender
is an umbrella term, encompassing all nontraditional gender expressions,
including, but not limited to: transsexual, cross-dresser, gender-bender,
gender outlaw, gender queer, and drag king/queen. There are many diverse
ways of being transgender. For example, not every transgender person is
interested in changing his or her gender presentation (such as from male
to female). Instead, some transgender people wish to expand or discard
traditional definitions of gender.
How can Family Therapy Help Transgender Clients?
Transgender clients and their families seek therapy for multiple reasons,
which are not always because of gender-related concerns. Thus, family
therapists do not assume that gender is at the center of the family
problem. However, family therapists find it helpful to be sensitive to
transgender issues in order to identify when/if gender-related issues may
be intersecting with other issues. Conversely, many transgender people do
seek therapy for gender-related concerns and the direction of therapy will
differ depending on the client’s needs. Typically, transgender people and
their families seek the services of family therapists for issues related
to gender questioning and exploration, assistance in obtaining medical
treatments, and relational difficulties.
Types of Transgender
Issues
The first group of clients recognizes feelings of gender variance, but may
not know what to do about their feelings. When clients seek therapy while
questioning their gender identity, family therapists adopt a
client-centered stance, understanding that different clients see the
issues differently. Because there are many possible expressions of
transgender, when clients do not have a clear picture of how they wish to
express gender, family therapists assist them in exploring possibilities.
The goal is to find an expression of gender that feels most genuine.
During this exploration process, therapists often assist clients in
developing social and self-help connections with other gender variant
people. With gender-questioning clients, therapy also includes a critical
examination of the societal constructions of gender, opening up options
outside of the traditional female and male identities.
While a full gender transition may be the best option for some, therapy
explores other gender expression possibilities. Therapists often do this
by discussing with clients what it will be like if their real desire is
not to transition, but to blur the lines of gender. Complete gender
transition may seem like a simple solution at first for many transgender
people, however the realities of transitioning and passing can be
difficult and sometimes unrealistic (financial limitations, passing
prevented by body type). Some clients feel more comfortable when they stop
focusing on passing as their preferred gender. Thus, clients may choose to
take steps towards altering their presentation of gender (like a name
change or hormone treatment) and choose not to pursue other steps, like
surgery. There are as many different healthy expressions of gender as
there are transgender individuals.
The second group of clients seeks therapy with the primary goal of
obtaining a recommendation for medical treatment. These clients have a
clear vision of gender transition and therapy is structured to assist them
with this goal. Family therapists work to ensure that clients have the
emotional stability and social support needed to cope with the challenges
of transition. Due to society’s rigid gender conceptualization,
transgender clients are subject to the stress of not fitting the norm. Not
surprisingly, it is common for transgender people to exhibit mental health
symptomology.
Therapists will consider accompanying mental health symptoms and help
stabilize clients so they can make centered decisions about transition.
Assisting clients in gender transition often reduces gender-related
stress, possibly helping to also reduce mental health symptoms.
The third group of clients seeks therapy for relational issues. In these
cases, the family or partner of the transgender person is typically
involved in therapy to create deeper understanding and integration of the
transgender identity within a relationship. While some parents do not
react intensely to their transgender child’s disclosure, other parents
have described it as a profound, personal crisis, characterized by strong
emotions such as shock, confusion, devastation, fear, and grief. Partners
of transgender people may have similar responses if they were unaware of
the transgender identity; however, many partners are supportive and
couples may seek therapy to deal with the implications of transition, like
a new definition of the relationship. Family therapists working with
transgender clients and their families both acknowledge and normalize the
seriousness of the family disruption.
Ways to Support Transgender People
Due to the challenging and life-changing effects of transition,
transgender clients are in need of social support. This support may come
from inside and/or outside the family system. Family therapists inquire
about the coming out process and explore the risks and dynamics of further
disclosures. When adequate support is not found within the family,
therapists assist clients in finding alternative support systems, such as
continued therapy, connections with other transgender people, friendships,
and the Internet.
As clients take steps in gender transition, the decision naturally becomes
apparent to more people in their lives, whether or not the client
discloses the information. Coupled with society’s low level of
understanding transgenderism, gender transition is a process often
characterized by stress and misunderstanding. For example, clients often
face opposition in the workplace, such as conflicts over whether the
employee should use the women’s or men’s bathroom. Therefore, the role of
family therapists may include advocating, educating, and consulting with
employers, co-workers, teachers, family members, neighbors, and friends.
In cases where family members are angry, intolerant, and/or rejecting of
the transgender identity, sessions may not initially include the
transgender family member. Family therapists can serve as a sounding board
for negative emotions, educate family members on transgender issues, and
explore new understandings of the transgender individual. Therapists
assist family members to: seek information, exposure, and support;
understand their transgender person’s suffering and alienation related to
gender identity; understand the politics of gender; help navigate how to
disclose the information to others; and realize that the transgender
person is essentially the same person on the inside as they always were.
Once family members have had time to process some of their own experiences
around the disclosure, family therapy including the transgender person may
help families repair and redefine relationships, foster healthy
communication of emotions, and nurture closeness.
Consumer Resources
Transsexual Roadmap: Family Issues.
http://www.tsroadmap.com/family/index.html. This site provides helpful
information for transsexual people and their parents, partners, and
children.
Gender Outlaw: On Men,
Women, and the Rest of Us,
by K. Bornstein, 1994.
New York: Vintage Books. Written by a male-to-female transsexual, this
book challenges cultural assumptions of gender. The author invites new
possibilities for thinking about gender in a conversational, easy-to-read
format.
My Gender Workbook:
How to Become a Real Man, a Real Woman, the Real You, or Something Else
Entirely,
by K. Bornstein, 1998. New York: Routledge. This book provides activities
to help explore gender identity and beliefs about gender.
Body Alchemy:
Transsexual Portraits,
by L. Cameron, 1996. San Francisco: Cleis Press, Inc. Compiled by a
female-to-male transsexual, this book is a collection of powerful
portraits and stories of transsexual men, including photos of the effects
of hormones and surgeries.
The text of this
brochure was written by Deborah Coolhart, PhD and Anibal Torres Bernal,
PhD.
Stock # I110
Marriage and family therapists are mental health professionals who treat a
wide array of disorders, working with individuals, couples, and families.
Marriage and family therapy clients report that they are highly satisfied
with the services they have received, and research shows that marriage and
family therapy is a cost-effective, short-term, and results-oriented form
of treatment.
The American Association for Marriage and Family Therapy (AAMFT), the
professional organization representing marriage and family therapists,
believes that therapists with specific and rigorous training in marriage
and family therapy provide the most effective mental health care to
individuals, couples, and families. This brochure is courtesy of:
the AAMFT.
Visit the AAMFT
TherapistLocator.net, a public service of the
AAMFT. There you will find information about a range of problems facing
today's families, and you can search for a qualified family therapist in
your area.
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