What Psychologists Need to Know
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EXPANDING OUR UNDERSTANDING OF GENDER: What Psychologists Need to Know MARGARET DREWLO, ma. A clinical psychology doctoral student at Antioch University, a school with a strong social justice focus. She works at Three Bridges Primary Care Clinic in Vancouver as a mental health counsellor. A large percentage of the clients she sees are self–identified trans or genderqueer. A story my mother often related to me about my or underprepared for work with trans clients and birth was what a nurse said to her the moment their families and loved ones. This article outlines after I was born. “Another little skirt for you!” suggestions for psychologists working with trans Since I was raised in a family and a community clients so they might examine their own notions open to a range of female gender expression, it and understanding of gender. Ideally, the benefits was a gender assignment that has always fit me of one’s greater understanding of trans gender well. Therefore I identify as cisgender, meaning issues are improved cultural competence and that I am comfortable with the gender I was stronger therapeutic relationships. assigned at birth. Progressively more clients who are trans–individuals who do not identify as the Educate YOURSELF ABOUT GENDER. sex they were assigned at birth—are presenting to To understand gender in others it is best to begin psychologists and other therapists for supportive by looking at one’s self. Ask yourself questions counselling, relationship counselling, and mental such as “How do I know which gender I am?” health care. Many psychologists are unprepared “How do I demonstrate my gender to others?” bc psychologist 19 “What is the process by which I perceive gender task involves supporting the transgendered in others?” “What role does gender play in my person’s integration in the family system. thoughts about others? 4. Exploration: Identity and self–labelling. KNOW that SOME trans PEOPLE have — The fourth stage involves the exploration IDENTITIES that extend beyond male AND of various (transgender) identities. The female. therapeutic task is to support the articulation They may refer to themselves as Trans, and comfort with one’s transgendered Transgender, Transsexual, Genderqueer, MTF (male identity. to female), FTM (female to male), Trans woman, Trans man, Cross dresser, Drag King, Drag Queen, 5. Exploration: Transition issues/ possible rd Two Spirit, 3 Gender, Pan–gender, Zie, Hir, or body modification — The fifth stage involves They. As gender language evolves, the descriptions exploring options for transition regarding of identities evolve. Make it easy for clients to identity, presentation, and body modification. disclose gender by using an open-ended question The therapeutic task is the resolution of about gender in the demographics section of your the decisions and advocacy towards their intake forms. This is also a signal to clients and manifestation. colleagues that you have ‘thought outside the gender–binary box’ (Manders & Drewlo, 2011). 6. Integration: Acceptance and post transition issues — In the sixth stage the gender variant AN excellent PRIMER FOR trans person is able to integrate and synthesize KNOWLEDGE IS Lev’S (2004/2007) TRANSGENDER EMERGENCE: THERAPEUTIC GUIDELINES FOR WORKING (transgender) identity. The therapeutic task WITH Gender–VARIANT PEOPLE AND THEIR FAMILIES. is to support adaptation to transition related This volume is the winner of an American issues (Lev, 2004/2007). Psychological Association Div. 44 Distinguished LEARN ABOUT THE history AND PRESENT Book Award. circumstance OF overt AND covert discrimination against trans PEOPLE. Lev describes six stages of gender emergence: The reality is that trans people are regularly watched and have their gender assessed by others 1. Awareness — In the first stage, gender– in a constant Foucaultian form of surveillance variant people are often in great distress. (Foucault, 2009). This is but one form of The therapeutic task is the normalization discrimination they receive (Tebbe & Moradi, of the experiences involved in emerging 2012). Consider how discrimination affects them transgendered. as they move through their daily lives as well as how discrimination may affect their mental health 2. Seeking information/reaching out — In status. the second stage, gender variant people seek to gain education and support about ASSESS yourself. transgenderism. The therapeutic task is to A novel concept for psychologists who are used to facilitate linkages and encourage outreach. assessing others! You may want to reflect on items in the Transphobia Scale (Nagoshi et al, 2012) 3. Disclosure to significant others — The third which consists of statements like, “I avoid people stage involves the disclosure of transgenderism on the street whose gender is unclear to me” and to significant others—spouses, partners, “I think there is something wrong with a person family members and friends. The therapeutic who says that they are neither a man or a woman”. 20 summer 2012 Or, consider where you are on the continuum 6. Reduce your bias through reading, self- of Repulsion to Nurturance on the Riddle Scale reflection, your own therapy, or any other Adapted for Transphobia (Drewlo & Manders, ways you have found helpful in dealing with 2011). other biases. RecogniZE that WE ARE ALL products OF Move away from an expert stance. This is our intersecting states of age, class, especially appropriate and useful when you are ethnicity/culture, race, nationality, physical and mental ability, sexual both in a learning phase and working with a orientation AND location IN history stigmatized client group. (Mitchell, 2009). Because of our socialization, our attitudes and You will learn much from your trans and practices in our work with clients are largely taken gender diverse clients. However, don’t expect a for granted and sometimes invisible to us. Accept trans client to educate you about trans issues. that you may have been socialized in a society In addition to the valuable lessons our clients with rigid concepts and prescriptions for gender, provide, seek out resources, especially the and thus have been left with biases. educational talks and workshops facilitated by trans people within your community or online. We can improve our cultural competence with trans clients through the following steps: Expanding our understanding of gender makes for more competent psychologists. It moves us along 1. Admit we possess biases about gender. in our quest to reduce suffering. In the larger picture, it contributes to a more fair and equitable 2. Identify our biases by paying attention to our world for everyone. areas of defensiveness about gender issues. 3. Investigate our biases through self-reflection. 4. Choose a bias to challenge (for instance, individuals whom you perceive to be male should not wear “feminine” clothing). 5. Reflect on where you learned that bias and give thoughtful consideration to related thoughts and feelings you have. References Drewlo, M. & Manders, K., (2011). The Riddle Scale adapted for transphobia. Adapted with permission of the author. Riddle, D. (1994). The Riddle Scale. Alone no more: Developing a support system for gay, lesbian and bisexual youth. St Paul, MS. Minnesota State Department. Foucault, M. (2009). Alternatives to the prison. Theory, Culture & Society, 26(6), 12-24. doi:10.1177/0263276409353775 Lev, A.S. (2004/2007). Transgender Emergence: Therapeutic Guidelines for Working with Gender-Variant People and Their Families. Binghamton, NY, The Haworth Press. Nagoshi, J. L., Adams, K. A., Terrell, H. K., Hill, E. D., Brzuzy, S., & Nagoshi, C. T. (2008). Gender differences in correlates of homophobia and transphobia. Sex Roles, 59(7-8), 521 - 531. doi:10.1007/s11199-008-9458-7 Manders, K. and Drewlo, M. (2011). Expanding gender: An introduction to counselling trans clients. Workshop presented for Employee and Family Assistance psychologists and counsellors. June 28, 2011. Vancouver, BC. Mitchell, V. (2009). Developing the therapeutic self: Supervising therapists with lesbian, gay, bisexual, and transgender clients in the 21st century. Women and Therapy, 33:1-2, 7-21. Tebbe, E. N., & Moradi, B. (2012). Anti-transgender prejudice. Journal of Counseling Psychology, 59(2), 251-261. doi:10.1037/ a0026990 bc psychologist 21 .