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