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Thrive Therapy & Counseling provides high quality therapy to Highly Sensitive People and to kids, teens or adults struggling with anxiety, depression or self-esteem.

3 Ways to Improve Outcomes with Transgender Clients

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This blog is written by a therapist in midtown Sacramento and focuses on the concerns and struggles of highly sensitive people (HSPs) and of kids, teens and adults struggling with depression, anxiety or just trying to figure out what they want for themselves.  There's help and hope through counseling and therapy!

3 Ways to Improve Outcomes with Transgender Clients

Ivy Griffin

Transgender lives and experiences are coming more and more into the public domain, and naturally the cultural discourse surrounding gender is becoming increasingly complex! With all of this comes the need and opportunity to be more inclusive and intentional about how we conceptualize and navigate gender, not just with our clients, but also with ourselves! Here are three ways to begin that process as well as improve gender inclusivity and positive therapeutic outcomes with trans clients.

1. Pronouns, pronouns, pronouns!

One of the most distressing experiences that trans folk undergo is being misgendered - that is, being assumed to be a different gender than one actually is. This most commonly occurs when someone uses the wrong pronouns for a person, such as calling someone “he” instead of “she”. Often times this occurs as an accident, which is why it is important to ask, not assume, someone’s pronouns. Some other ways to help normalize this are to include pronouns on things like

- Resumes

- Bio pages

- Email signatures

- Name tags

And remember, pronouns are not “preferred pronouns”, they are simply, well, pronouns! Saying “preferred pronouns” implies that they are optional, or worse, not someone’s “real pronouns”. Normalizing this shows a concerted effort to be considerate and trans inclusive!

2. Work on deconstructing gendered language.

With the many ways our culture genders individuals based on their appearances and anatomy, it follows that much of our language is also steeped in those assumptions. Though we have seen cultural improvements in shifting gender stereotypes in language, such as saying “mail person” rather than “mail man”, there are many common phrases that continue to marginalize transgender people.

Instead of saying: “Pregnant women

You might try: “Pregnant people” - Transgender men, non-binary people, and plenty of other genders that are not women can (and do!) get pregnant.

Instead of: “That woman over there with her friend”

Try: “That person over there with their friend”

- It is not possible to guess someone’s gender based merely on their appearance. Using neutral terminology when referring to people we don’t know helps normalize this.

Instead of: “Born a man”, “Used to be a man”, “Male bodied”

Try: “Assigned male at birth” or “assumed male at birth”

- There is a difference between sex/genitals and gender. A trans person’s body (regardless of any medical or other transition choices), is the body of their current gender.

3. Know when to refer out.

Ok, this is a tough one, because as clinicians I think most (or hopefully all!) of us want to do everything to help our clients and potential clients. All too often, therapists think that being queer friendly and a well-intentioned ally is enough to qualify them as being a good fit to work with a transgender person. After all, we’re therapists! Of course we’re open minded!

I am telling you both as a clinician and also as a trans person with lived experience going to (plenty of) therapy that this is not true. There is a difference in being trans friendly and trans affirmative and competent. Therapists need to be sufficiently versed in trans issues and experiences before working with trans clients, so as to avoid subjecting trans folks to accidental microaggressions or burdening them with needing to educate the person who is supposed to be helping them. Even the most well-intentioned mistakes can have very harmful impacts.

So please, if all of this is new to you, please don’t hesitate to refer out to a therapist with more experience in this area. In the meantime, you can keep practicing using pronouns and new language and seek out more education.

If you’re looking for a place to start, the World Professional Association of Transgender Health (WPATH) is a great resource. You can also keep an eye out in your CAMFT and local newsletters for workshops and trainings presented on transgender care - extra points if they are presented by people with lived trans experience!

Take care, 

Leigh Johnson, AMFT #117551

Supervised by Alexandra Garton, LMFT #84263

Thrive Therapy and Counseling

916-287-3430

leigh@thrivetherapyandcounseling.com