LGBTQ

The Importance of Affirming Mental Healthcare for Trans and Nonbinary People

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Picture this: after years of struggling with your gender, you’ve finally realized that you don’t identify with the label that was slapped on you at birth and you’ve decided to work toward becoming who you authentically are on the inside. You’re not sure if you’re relieved, thrilled, or so terrified you can feel it in your bones. You have to decide who to tell, if it’s safe to come out to your friends, partner, or family. You want to change your name, but don’t know what feels right to you yet. You’re thinking about going on hormones, but you don’t know for sure if that’s what you want, and you’re even less sure how you’d get access to that treatment. 

Realizing you’re transgender, nonbinary, or identify anywhere else under the gender diverse umbrella (Note: I will be using “trans” as an umbrella term in this post, but I realize not everyone identifies with that label), is a stressful experience, even when your loved ones support you. And in all likelihood, you have other things going on in your life at the same time. Work or relationship stress, dealing with past trauma, low self-esteem, anxiety, depression… It can all add up, making an already tough transition that much harder. Please believe me when I say that during this time, mental health counseling can be life changing and sometimes even lifesaving.

When it comes to therapy for trans people, however, there has unfortunately been little research conducted both on the competency of mental healthcare providers and what specific counseling strategies are most effective in helping trans clients (Moradi et al., 2016). Even more unfortunately, a large study of individuals in the United States who identified under the trans umbrella (James et al., 2016) found that, of respondents who discussed their identity with a mental healthcare professional, nearly one in five reported that the professional attempted to stop them from being trans. This experience was correlated with a 149% increased likelihood of attempting suicide. And even if mental health care providers do not explicitly try to stop their client from being trans, they may commit microaggressions that create an unwelcoming environment (Morris et al., 2020).

While it is crystal clear that the mental healthcare field as a whole needs to improve here, that may be a long and hard fought battle. In the meantime, I encourage clients who are trans or questioning their gender identity to seek out mental health professionals who are actively affirming and knowledgeable about trans identities.

Before I even realized that I identified as nonbinary, I knew that I wanted to specialize in helping trans folks become their happiest and most authentic selves. I saw the experiences my trans friends and loved ones were going through and felt a deep sense of empathy and a desire to improve the lives of people in this community. Looking back, I think this was in part because I identified with their experiences. 

When I did realize I was nonbinary, I was also just about to start graduate school in the middle of a global pandemic. If I hadn’t had a therapist during that time who walked beside me as I learned more about myself, encouraged me, and gently challenged me when I needed it, I wonder if the stress might have eaten me alive. While she made a few missteps along the way, I am ultimately so very grateful for her help.

Now, as a licensed, openly nonbinary mental health counselor, I hope to be able to be part of the competent and knowledgeable support system that this community needs. If you identify as trans or are questioning your gender identity, you deserve empathetic, affirming support. You deserve to be yourself. You deserve to thrive. 

References

James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality.

Moradi, B., Tebbe, E. A., Brewster, M. E., Budge, S. L., Lenzen, A., Ege, E., Schuch, E., Arango, S., Angelone, N., Mender, E., Hiner, D. L., Huscher, K., Painter, J., & Flores, M. J. (2016). A Content Analysis of Literature on Trans People and Issues: 2002–2012. The Counseling Psychologist, 44(7), 960–995. https://doi.org/10.1177/0011000015609044 

Morris, E. R., Lindley, L., & Galupo, M. P. (2020). “Better issues to focus on”: Transgender Microaggressions as Ethical Violations in Therapy. The Counseling Psychologist, 48(6), 883–915. https://doi.org/10.1177/0011000020924391

Support For Trans Teens

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Things are really hard right now! All of us are grappling with abrupt changes to our routines, habits, and ways we connect to others. If you are a parent or guardian of a transgender teenager, it is possible that these shifts feel magnified and you maybe concerned about supporting your teen. Perhaps you have noticed some changes in behavior, such as sleeping too much or two little, loss of interest in what they used to like, or you are simply concerned about the isolation. What we do know, is that trans youth are more likely to be diagnosed with depression than their cisgender (i.e., non-transgender) peers, and experience up to three times the rate of suicidal thoughts of cisgender youth (Reisner et al., 2015).

The good news is, there are plenty of things that will help buffer and support teens as they grow into adulthood, such as helping the teen strengthen their self esteem, connecting with an affirming and supportive trusted adult, and connecting them with community-specific resources.

Self esteem is an important factor and internal support that teens can develop and strengthen in order to stay healthy mentally. Ways to help foster healthy self esteem in your teen include offering sincere praise for their efforts as well as their accomplishments, and to find ways of encouraging the teen’s own ability to make decisions and explore their talents.

Another protective support that we know helps transgender teenagers, is an accepting and affirming relationship with a trusted adult. That means, if you’re reading this, and you have a trans teen in your life, congratulations! You have the power to make a positive impact on that teen’s wellbeing.

In particular, “Transgender college students reported that support and acceptance by family improved their mental health and contributed to a positive sense of self; the types of support that were perceived as positive were asking questions to understand transgender experience & assisting with/affirming participants’ transition” (Johns et al. 2018). This may look like approaching your teen with a respectful curiosity, and inviting conversations around what different experiences are like for your teen.

That being said, it is normal if there are some things your teen may feel more comfortable discussing with peers than with a parent. Connecting transgender teens with community specific services is a wonderful support. Corliss et al. note, “transgender youth discussed how workshops and support groups for transgender people increased feeling of social support and added comfort with their identity” (2007). Groups where teens are able to connect with people who are similar to them, increases their comfort with their own identities and decreases their sense of isolation.

One such group is the Group for Transgender and Gender Questioning Teens, which is held virtually on Saturdays at 3:30. This group would be a wonderful fit for any transgender or gender questioning teens who are looking to develop more skills to handle the stresses of life, or who would like to work on their identity and becoming more comfortable in it.

These are just a few methods to help support your transgender teenager. For more information, or to sign up for the group, please contact Ashley Parks at ashley@bullcitypsychotherapy.com

 

References 

Johns, Michelle Marie et al. “Protective Factors Among Transgender and Gender Variant Youth: A Systematic Review by Socioecological Level.” The journal of primary prevention vol. 39,3 (2018): 263-301. doi:10.1007/s10935-018-0508-9

Corliss HL, Belzer M, Forbes C, Wilson EC. An evaluation of service utilization among male to female transgender youth: Qualitative study of a clinic-based sample. Journal of LGBT Health Research. 2007;3(2):49–61.

Reisner S.L., Vetters, R., Leclerc, M., Zaslow, S., Wolfrum, S., Shumer, D., and Mimiaga, M.J. Mental health of transgender youth in care at an adolescent urban community health center: a matched retrospective cohort study. J Adolesc Health. 2015 Mar; 56(3):274-9.

 

What does “transgender” even mean?

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transgender-bull-city-psychotherapy-llc-feature

Really though, WTH does “transgender” mean?

Quick Hits:

  • If you don’t know something, that doesn’t make you a bad person.

  • Anatomy, identity, expression, sexuality – are four distinct components of our lives that deal with gender.

  • These four components, like most things in life, exist on a spectrum, which is to say, they are non-binary or have more than two possible outcomes.

  • To be transgender is defined by each individual, but basically refers to the extent to which a person’s gender identity, role, or expression is different from the cultural norms prescribed for people of a particular sex.For example – a person could have the anatomy of a female but identify and/or express themselves in a way that is less feminine, or more masculine, than cultural norms.

  • Transgender / Gender nonconforming people have been around forever.The way cultures have responded to them has changed.For example, indigenous cultures referred to GNC people as “Two Spirited”, and they were revered as healers and visionaries.

  • Gender nonconforming (GNC) folks are not dangerous.Tragically, GNC folks are much more likely to be the targets of violent crimes than to be perpetrators.

First off – not knowing something is nothing to be ashamed of.  If you’re confused about some aspect of identifying as transgender, there is nothing wrong with you!  This post is designed to help.  My goal is to provide some basic factual information on this topic.  My hope is that this information will help you be more comfortable and feel better informed when you interact with folks who identify as transgender, or gender nonconforming (GNC). 

Let’s dive in! Read more What does “transgender” even mean? ›