I remember being asked by a teacher to come out into the hallway to talk to her privately. My head had been on the desk for her entire lesson and only a gentle nudge on my arm made me look up. I was 12 years old and sinking into a deep depression from rejection by my family for being queer. I had developed a relationship with a girl from the neighboring middle school, the first person to ever call me a boy, she called me her boyfriend. And at that time our parents forbade us to talk to each other.
“Talk to me,” The teacher said, “What’s going on?”
I felt tingles that felt like little electric jolts across my chest and a rock hitting the pit of my stomach because I was too afraid to tell another adult that I was queer.
“Well, there’s this girl that I am really good friends with. And my parents won’t let me hang out with her anymore. It makes me really angry.”
This well-intentioned teacher gave a deep sigh and replied to me, “Parents always have your best interests at heart. And sometimes parents do things that don’t make sense to you as a kid but try to trust them.”
I did not respond. I went back into the classroom with her. I tried to keep my head up for the rest of the lesson, but I couldn’t. What I learned that day was that adults would not accept me for who I am. I felt that my identity was something I should continue to keep a secret.
A year later as a high school freshman, I shared with an older boy at school that I wanted to be a boy when I grew up. He told me how beautiful I was as a girl and to not do that to myself. This was the same boy who I would weeks later get caught up in a relationship with including intimate partner violence.
When I finally escaped the relationship, I finally felt free enough to embrace myself as a man. I cut my hair, wore the clothing I wanted, asked people to call me with he/him pronouns, and introduced myself with a new name. My parents were relatively supportive now that they saw me as an adult and had years to see the social climate change. However, they struggled, as many families do even when they are learning to fully support their loved one through something completely new.
As part of the requirements my insurance had for medical transition, I would have to complete three months of therapy before hormones and a year of therapy before getting gender affirming surgery. So, I begrudgingly looked up clinics that would be willing to do this and sat with a woman who I had never met and was expected to tell my life story to. She was introduced to me as a student intern.
“Do you think this transition is a way of rebelling against that abusive partner?”
Um, no.
“Can’t you try to see things from your family’s side?”
Can’t I acknowledge with a therapist how much the non-acceptance hurts instead?
“Don’t you think this transition is giving you more trauma than you already have?”
Aren’t you going to name the non-acceptance as the trauma instead of the transition?
To her credit, she was just a student. But I had expected better from a clinic that advertised itself as LGBTQ supportive.
When I finished the amount of therapy I needed to get my gender affirming surgery, it was recommended I stay with therapy due to the level of trauma I had endured. Instead, I left therapy with my trust more damaged than before. Without therapy, without addressing the trauma of experiencing adolescence through an abusive relationship, I had a psychotic break. One that continued to get worse and worse until I finally attempted to take my own life.
The aftermath of this was stressful. There were multiple voices, care managers, psychiatrists, therapists, hospital discharge social workers, my mother, all pulling me in different directions that I didn’t want to go in. I didn’t want to go to therapy. I couldn’t be myself in therapy. So, I went to therapy at everyone’s request but completely guarded. I felt that none of these therapists could understand the depth of my needs. I experienced clinics that got my pronouns wrong and therapists who asked me about my transition with elements of personal curiosity rather than allowing me to lead. Therapists asked me if I was “Male to Female” or “Female to Male” and what medical transition procedures I had undergone after barely getting past asking me my name.
I told my partner (who is now my spouse!) that I didn’t want to go to therapy anymore. “It’s just not helping me,” I told them.
“Wait, just try again one more time,” they encouraged me. They told me to ask for someone who specializes in LGBTQ identities. So, I called a clinic that my insurance company recommended to me.
“Can you give me someone who knows how to work with trans people?” I asked.
“Yeah, we actually have someone who definitely has space on their caseload who also specializes in that.”
Imagine my surprise when I nervously walked into the waiting room, sat down, and was called in by a therapist who was, in fact, a transgender man. It tore down every defensive barrier and showed me just how much I had been holding back. In a way I was completely at a loss for what to say now that I would not need to explain things about being trans, about my gender, and prepare to educate a clinician. I could finally talk about the gravity of the intimate partner violence I faced without tying it to my gender identity. I could talk about what being trans has contributed to my life, the intricacies of it, without having to try to explain it to someone who wouldn’t be able to understand without research and comprehensive training. I could finally get the work done.
For the first time ever, I went back to the comment I had heard all those years ago. “He told me not to do that to my body because I was so beautiful. I felt so disgusted.”
A weight was lifted and it opened the door to talking about the actual relationship between me being transgender and being in a relationship with intimate partner violence without feeling there would be assumptions made about it.
The takeaway from this article is not meant to be that trans people should only get therapy from other trans individuals. Instead, consider the weight of having to explain, educate, and advocate for oneself with a professional who they are expected to give their trust and openness to. For clinicians I would sum it up in three distinct goals for being able to gain the trust of trans clients:
- Get comprehensive training (go beyond LGBTQ 101) and reflect on your own experiences in life.
- Learn from each individual what relevance their gender identity has towards their traumatic experiences and therefore how much of it needs to be discussed in the work together. Check in on those discussions every so often as needed.
- Find lived experience experts and resources to consult when you need to come up with creative solutions.
Practicing humility with transgender individuals at such turbulent times can be life-saving. It’s important to create an environment of grace, dignity, autonomy, and an awareness of how power dynamics might affect your sessions.