Advertisements
Feeds:
Posts
Comments

Posts Tagged ‘transgender’

This week’s question come from Dwyn and Marissa:

And here’s my answer:

To submit a question to Ask The People’s Therapist, please email it as text or a video to: wmeyerhofer@aquietroom.com

If I answer your question on the site, you’ll win a free session of psychotherapy with The People’s Therapist!

Add to FacebookAdd to DiggAdd to Del.icio.usAdd to StumbleuponAdd to RedditAdd to BlinklistAdd to TwitterAdd to TechnoratiAdd to Yahoo BuzzAdd to Newsvine

Advertisements

Read Full Post »

Towards the end of a session a while back, one of my patients, who was African-American, laughed out loud, like he was sharing a personal joke.

“What’s so funny?” I asked.

“Oh, I don’t know.  I still can’t get over the fact that my therapist is a white guy.”

I shrugged and smiled – there wasn’t much else I could do.

But I was pleased.  I admit it.  I liked being his therapist.  And that patient has referred a bunch of people to me since, mostly African-Americans.  That felt good, too.

I wish I had a simple, clear answer to the question posed by the title of this posting.  But like so much else in psychotherapy and human life in general – it’s complicated.

On the one hand, a strong case could be made that a person’s background, and his experiences, should shape who he is, and his ability to connect with someone who has had a similar or different background or experiences.  By that logic, an African-American should be better off with an African-American therapist.

But it doesn’t always work out that way.  For one thing, the patient I was working with was gay – so did he have to find a gay African-American therapist, or was a gay white therapist okay, or a heterosexual African-American therapist?  And what about the fact that I’m Jewish?

I think one of the reasons I worked so well with that patient was that I studied African-American history and literature in college, and am a connoisseur of jazz and other African-American music.  It might also have helped that, as the Program Coordinator for a counseling program at a large urban hospital for a few years, I assigned myself lots of African-American patients, partly because I was interested in learning more about their culture and experiences, and partly from necessity.  We had a small, mostly-white staff, and the other full-time counselor spoke Spanish and Portuguese, so he was occupied with immigrant patients.  I became a sort of resident African-American expert.

Maybe that’s why I did so well with this patient.  Or maybe we just clicked.  He was an elegant, educated man, and a jazz fan, and, well, we liked each other.

Choosing a therapist is a bit like choosing a Supreme Court justice.  You collect all the information you can – and then you take your best guess.  An African-American jurist ought to have a better understanding of the issues affecting African-Americans – right?  But then, sometimes you get Thurgood Marshall – and sometimes you get Clarence Thomas.

Many therapist list their “specialties” on their websites, or even their business cards.  I don’t, because I find it limiting.  I don’t see why, if a patient with a new issue comes into my office – whether it’s bulimia or childhood sexual abuse or crystal meth addiction – I shouldn’t be able to get some books, talk to colleagues, and do whatever it takes to get myself up to speed. That goes with human diversity as well.  I’ve treated Kazakhs, Navahos, Cameroonians, Indonesians, Peruvians and Dubaians, among others.  They all taught me something about who they were and where they came from.  That’s part of my job – a fun and necessary part.

I once commented to a transsexual psychotherapist that it must be great to help others within her community.  She let out a rueful sigh.  Sure, she admitted.  But the real issue was that she worked within a ghetto.  She wanted to treat all sorts of people, not just transgendered patients.  Being seen as someone who worked only with other transsexuals limited her practice, and her ability to grow as a clinician.  I realized I was losing something, too, when transsexuals went to see her instead of bringing their unique diversity to my practice.

Seeking out the “logical” therapist for you can have drawbacks for the patient as well.  I once did a session with a deaf woman who was dealing with a domestic violence situation.  We worked with a sign-language translator, but afterward I discovered the hospital had a limited budget for translation services.  An administrator recommended I refer this patient to an American Sign Language-fluent psychotherapist.  I found two names, and gave them to the patient.  She only rolled her eyes.  She didn’t want to see a psychotherapist who worked with the deaf – those two therapists were already seeing all her friends in the deaf community, and she didn’t feel comfortable opening up to them.  She said she would much rather work with me, through a translator.  I was surprised – but I got her point.  I wanted to work with her, too – but I couldn’t find an ASL-translator, so we didn’t have that option, which was heart-breaking.

I ran into a similar situation with a Japanese patient.  His English wasn’t very good, but he could communicate.  I suggested he might be more comfortable working in Japanese instead of English, and proposed two Japanese-speaking therapists.  The problem, he confessed, was that he was gay, and working on coming out to his friends and family.  Of the two Japanese therapists, one was straight, and the other knew all the other gay Japanese people living in New York City.  He wanted a gay therapist to work on gay issues, which are sensitive in Japanese society – but he didn’t want someone who knew his friends.  He decided to stay with me.  Yes, he sometimes had to repeat things two or three times so I could understand him, but we did okay.  He’d come to America, he said, to live like an American – and he liked having an American therapist.

It’s worth pointing out that therapists spend most of their time listening, not talking.  When I do talk, I’m usually asking questions or taking a guess at interpreting something I’ve heard.  My job is to listen, and try to understand.  Theoretically, I should be able to listen to anyone – anyone – and understand him, whether he’s black, white or purple.

I take pride in showing off my bits of cultural competence.  I enjoyed greeting a Chinese patient from Hong Kong the other day with “Please come in!” in Cantonese.  Last month I shared a laugh with a Dominican patient when we realized we both have little half-Dominican nieces who call us “Tio.”

These touches might help make a patient feel more at ease.  But in the big picture, they’re minor details.

What really matters isn’t whether your therapist looks like you, or acts like you – it’s whether he understands you.  Just like a Supreme Court Justice – his competency depends not only on his background or experience, but how well he does his job.

Add to FacebookAdd to DiggAdd to Del.icio.usAdd to StumbleuponAdd to RedditAdd to BlinklistAdd to TwitterAdd to TechnoratiAdd to Yahoo BuzzAdd to Newsvine

Read Full Post »

Christine Daniels was a transsexual sportswriter.  For many years, she was known to thousands of sports fans as a columnist for the Los Angeles Times, writing under the byline “Mike Penner.”

Christine transitioned into a woman in April 2007 and began using her female name on her column.  In late October 2008, she returned to appearing, and writing, as Mike.  On November 27, 2009, she chose to take her own life.

This is a tragic story.  It’s also an opportunity to talk about gender – an important and often misunderstood topic.

We’ll begin by differentiating, and then examining, three gender-related variables that define all of humanity.  They are:

(1) gender assignment at birth;

(2) sexual orientation; and

(3) personal gender identity.

You can think of these variables as three separate sliding scales – everyone falls somewhere on a continuity within each one. You – like everyone else – had a gender assigned to you at birth, awakened in childhood or adolescence to some sort of sexual orientation and discovered within yourself some type of personal gender identity.

1. Gender assignment at birth: I’ll take this one first because it seems simple.  What could be more obvious that the gender you’re born with?  We’re all born either a boy or a girl, right?

Actually, that’s not the case.  Perhaps as much as 1.7% of the human race is born with a degree of sexual ambiguity, and between 0.1% and 0.2% of people are ambiguous enough to attract specialist medical attention, including, in some cases, surgery to disguise or correct sexual ambiguity.  These people used to be called “hermaphrodites” but the modern term for them is “intersex.”

Intersex people exist and always have.  They are a normal part of the range of human difference.  Unfortunately, they live in a world that mostly ignores their existence or treats them like freaks.  And they can have a tough time of it, dealing not only with the medical issues involved in their difference, but also the accompanying stigma of not looking, or feeling, like everyone else.

2. Sexual orientation: This variable should be familiar enough to most people.  Orientation refers to which gender you choose for a sexual partner – essentially, with which gender you choose to fall in love.

You’re probably used to hearing about lesbian and gay people and their lives, but even sexual orientation can get a bit tricky to parse.  Bisexual people exist, and sexual attraction can be fluid and change over time.  Sometimes people are surprised by an attraction they weren’t expecting to feel.

It should be common knowledge that gay, lesbian and bi people face discrimination and even violence in their lives, as they fight a campaign for greater understanding and acceptance of their difference.

3. Personal gender identity: This is where things get really interesting.  There are countless ways to experience one’s own gender, and perhaps even more ways to express it outwardly.

The transvestite – or “cross-dresser” is a person who enjoys dressing like someone of the opposite sex.  There are male cross-dressers and female cross-dressers.  A “drag queen” or “drag king” is a man or woman who is a performer, and cross-dresses as part of his or her work as an entertainer.

A transsexual is a person who feels that his or her gender assignment at birth incorrectly represents who he or she really is.  For example, a person with the outward appearance of a male at birth, but who is transsexual, will come to understand (usually during his early childhood) that he is actually female.  It is as though a female brain were placed in a male body.  Transsexuals often take hormones supplements or seek gender confirmation surgery to confirm their personal gender identity by matching it with the outward appearance of their bodies.

If this is beginning to sound complicated, that’s because it is.  There are countless terms used to describe people who express their gender in ways that don’t conform to societal norms.  My favorite, for its sheer simplicity, is “trans” – a sort of catch-all word for people who experiment with gender appearance and identity.  But there are many people who would argue with that definition and that usage.  That’s the nature of gender – it’s complicated, everyone is different, and the topic triggers fervent debate.  Mix in the additional complications of gender assignment at birth and sexual orientation and – well, you’ve got nearly endless diversity and plenty of room for misunderstanding.

Christine Daniels was a transsexual woman.  She decided to return to her male identity and live as Mike for the final year of her life, but I have chosen to honor the women whom I suspect she really was by referring to her as a female.

I have had the privilege and honor over the years to know and work with many trans people, including transsexuals and cross-dressers, as patients and as friends, neighbors and co-workers.  I have also known and worked with a number of transsexual psychotherapists, who remain valued and respected colleagues.

If it’s tough negotiating society as an intersex person or a gay man or lesbian, it is even tougher to live each day as a trans person.  I don’t know what it is about gender in particular, among the vast array of human differences, that ignites such misunderstanding and hatred.  Perhaps it is simply sexism.  The widespread oppression of women across the globe is an example of humanity at its very worst.  However you account for it, trans people face horrendous discrimination and persecution.

I have no doubt that Christine Daniel’s life was made more difficult by the misunderstanding of her trans identity.  Her death was a terrible waste.  We lost a talented, valuable, unique person.

You might think you don’t know any trans people.  Perhaps you do not.  It is far more likely that you do, but don’t realize it. Many transsexuals are “stealth” – they do their best to disappear into the background.  Their only desire is to live in a way true to themselves, and they are well aware of the persecution and violence that could greet them if they were found out by the wrong elements.

If you do have the good fortune to welcome a trans person into your life, I implore you to be gentle, and supportive, and sensitive. These are some of the best people you could ever meet and know – and, if you win their trust, they might introduce you to a world of  folks who do things their own way, in their own inimitable style.  They are a group of human beings whose path in life has taught them profound lessons in compassion, understanding and personal strength.

I’ll close with a link to a site that I wish didn’t have to exist.

Remembering our Dead, and the International Transgender Day of Remembrance, were created to honor trans people who have been victimized by violence.  It is a sad statement on the condition of humanity that these innocent people were murdered simply for being true to who they were.

In honor of Christine Daniels, please vow that you will become one more voice on the side of acceptance, and celebration, of trans people and transgender identity.

Add to FacebookAdd to DiggAdd to Del.icio.usAdd to StumbleuponAdd to RedditAdd to BlinklistAdd to TwitterAdd to TechnoratiAdd to Yahoo BuzzAdd to Newsvine

Read Full Post »