Everyone dies but not everyone lives. Live your life in a way that makes you happy and proud. It takes courage to push yourself to places that you have never been before... to test your limits... to break through barriers. And the day came when the risk it took to remain tight inside the bud was more painful than the risk it took to blossom
- Anais Nin
Some helpful terminologies:
Discussing gender, gender identity, gender variance and sexuality can seem like a simple conversation. However, this is not often the case. To assist in facilitating a better understanding of these topics, some basic definitions can be helpful.
Natal Sex: Refers to the sex, male or female, that one is born into. In some cases, people are born inter-sexed, having genital components of both male and female, or are born with ambiguous external genitalia, clouding at that moment, simply identification of one’s natal sex.
Gender: A construct which attempts to assign characteristics of behavior and interpersonal interaction to biological males and females
Gender Identity: In it’s simplest terms; gender identity refers to the internal experience of identifying as either male or female. However, there remains some controversy over this binary notion sex, gender and gender identity.
Gender Expression: Refers to the manner in which one expresses their gender identity.
Gender Role: behaviors, attitudes and personality traits that designate masculinity and femininity. Gender roles tend to be determined by the culture and society in which one lives.
Sexual Orientation: In it’s simplest terms; sexual orientation refers to the sex that one is sexually attracted to. The most commonly identified sexual orientations are heterosexual, homosexual and bisexual. However, as in many areas related to human sexuality, there exists controversy over these terms, as some feel they compartmentalize human sexual expression and limit the full sexual potential of human beings.
Sexual Identity: Refers to how one identifies oneself as a sexual being vs. one’s actual attractions and sexual behaviors. People can have sex with members of the opposite sex and not necessarily identity as heterosexual, just as people can have sex with members of the same sex and not identify as homosexual or even bisexual.
Therapy for Trans and Trans Questioning Individuals:
Transgender, or trans, is an umbrella term used to describe the experience of people who feel that their gender identity, or how one perceives their sense of being male or female, does not align with their natal sex, or the sex that one is born with. Other terms used by people to describe their gender experiences include “gender variant”, “gender-queer”, “two spirited”, “gender fluid”, “third sex” and “transsexual” to list only a few of the ways people describe their experience of gender.
People come to therapy to address gender issues for a variety of reasons, including;
* Needing a safe place to discuss discomfort with ones biological
sex,
* Being discovered cross-dressing by a spouse,
* Wanting to accept and express their “true” gender identity,
* Exploring assistance in moving towards transition towards ones
“true” identity
* Wanting to disclose ones gender identity to ones friends, family
and employers.
Below are some frequently asked questions and explanations that trans, and trans questioning, people encounter when beginning the journey of gender exploration.
What is transition?
Transitioning means accepting ones “true” gender identity.
Transitioning is often referred to as the spiritual, physiological and psychological process of pursuing hormonal and / or surgical options to align ones body and appearance with ones gender identity. Transitioning also refers to legally changing one's name and gender designation on legal documents, e.g., driver's licenses, life insurance policies, mortgages, etc. There is also an interpersonal process to transitioning that includes “coming out” to friends, families, and partners, employers and professional colleagues. Some people choose to transition openly with the love and support of supportive others. Some people in transition choose to transition in "stealth", keeping their past lives and birth gender hidden from others.
Do I have to transition?
No - Transitioning is a very personal decision that only you can make. Some people choose to transition and never alter their bodies, while others choose to have some medical interventions, and others still choose to pursue full gender reassignment surgery. The extent of your transition is always your decision and is impacted by a variety of factors such as the degree of comfort with ones body and, unfortunately, financial resources.
Does my age impact my ability to transition?
This is a complex question and one that requires a more detailed explanation. However, the immediate answer is “Yes and no”. The “yes” part of this response is, if you are under the age of 18, AND IT IS SAFE TO DO SO, you will need to have your parents approve any form of counseling or medical intervention. Once you have parental consent I will work with you, your family and other involved providers to determine the “next steps” towards beginning transition. For the parents of trans-gendered children, this can be a difficult process to understand and I will work with you to locate other parents, if you feel this would be helpful, who are at various stages in this process. Older adults can transition successfully if there are no medical conditions that would prevent hormone therapy or surgical intervention.
I’ve heard that there are guidelines that therapists follow to determine if someone is ready to transition?
This is a complex, and controversial, question that is best answered by saying Yes and No. The World Professional Association for Transgender Health has developed a document that is referred to as “The Standards of Care” or SOC. This document is designed to guide clinicians working with trans and trans-questioning individuals to ensure that trans people are receiving quality care before, during and after a major life altering experience. The SOC recommends a minimum of three months of psychotherapy, with no predetermined number of sessions to evaluate the psychological well being of individuals exploring transition. In addition, the SOC also recommends that the individual seeking to transition live full time, for a period of 12 months, in the gender role that corresponds with their gender identity before starting hormone treatment. So in this case, yes, there are certain requirements that the trans person seeking transition must follow before a therapist can recommend hormones, and or, surgical intervention. The SOC also recognizes the differences in how gender identity develops in different ways and at different stages in ones life. The SOC can only serve to inform what the therapist does and not dictate who “gets” to transition and who “does not” get to transition. So in this way, the answer is No, The Standards of Care do not determine who gets to transition and who does not. I recommend that the individual seeking transition obtain a copy of the SOC and review this document for themselves, and bring any questions they may have to their therapist for discussion.
These books may be helpful in answering other questions that you have about gender, gender identity and trans issues. For even more information about gender and gender identity please feel free to explore the resources page of this website.
Bornstein, K. (1994). Gender Outlaw: On Men, Women and The Rest of Us. Vintage Books, USA.
Brown, M., L., Rounsley, C. (1996). A. True Selves: Understanding Transsexualism For Families, Friends, Coworkers, and Helping Professionals. Jossey-Bass, San francisco. Ca.
Cromwell. J. (1999). Transmen and FTMs: Identities, Bodies, Genders, and Sexualities. University of Illinois Press.
Feinberg, L. (1998). Trans Liberation: Beyond Pink or Blue. Beacon Press. Boston.
Lev, A., I. (2004). Transgender Emergence: Therapeutic Guidelines for Working With Gender-Variant People and Their Families. The Hawthorn Clinical Practice Press. New York.
Lourde, A. (1984). Sister Outsider: Essays and Speeches. The Crossing Press.
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