Do you have persistent feelings of being of the wrong gender? Did you feel this way as a child but rationalize it away as a mere phase? Do you now have those same feelings as an adult?
Gender therapy is currently the only evidence-based treatment plan for transgender people. As such, it’s imperative to seek out a gender specialist with good credentials rather than using the advice of friends or acquaintances. For example, I have heard horror stories of a transgender person being ‘talked out’ of transitioning by other therapists. However, if you are confident in your gender transition, it’s essential to find a gender therapist with whom you have a good rapport.
What Is Gender Therapy?
Mental health professionals who work with transgender people or transgender therapists are there to facilitate the transition. You can use the phrase “transition” to refer to many things: beginning hormone replacement therapy (HRT), having surgery, or social transitioning (presenting as a new gender in public).
You can transition in any combination of these ways at your own pace.
“Don’t transgender people just go to regular therapists?” No. Therapists do not typically work with transgender people unless they are specifically trained to do so – many therapists lack basic knowledge of gender dysphoria and transgender. The American Psychiatric Association (APA) has a special division of specialists, the Harry Benjamin International Gender Dysphoria Association (HBIGDA), approved by WPATH to provide this specialized training.
What Do You Talk About In Gender Therapy?
It depends on the mental health professional. In general, you will present your history and current situation to the therapist, who will listen attentively. They may ask you many questions, but this is because they are trying to understand how it feels from your perspective—not to make you uncomfortable or judge you.
They want to help you and work with you to help resolve these feelings, allowing you to be in a happier place. You will never be asked to discuss the details of your sexual activity.
What Type Of Therapy Is Used For Gender Dysphoria?
Gender dysphoria is treated by talking to a therapist and using their insight to discover how you feel inside.
For some people, this means seeing a psychiatrist and proceeding with hormone therapy or surgery.
Others may find that transitioning isn’t right for them, and they can achieve comfort without having their bodies changed.
How To Get Assessed For Gender Dysphoria
It’s possible to get assessed for gender dysphoria at any age. It just means seeing a therapist that specializes in this topic. A good place to start is by asking friends, family members, or your primary care doctor if they have recommendations on where you can find a qualified specialist.
Questions Asked During Gender Therapy
As a general rule, your therapist will not directly ask you about your sexuality or sexual practices. They may ask you to describe your ideal gender expression and how it relates to sex for you. For example, if you are a female bodybuilder attracted to more masculine women, they may ask what that means for your sex life and romantic preferences. If you are a male who enjoys wearing makeup and skirts around the house, they may ask what that means for your sex life or romantic preferences.
There will be no direct questions about your sexual orientation or practices. In this way, trans people have a degree of confidentiality between themselves and their therapist, which gays/lesbians do not have with their therapists.
Note: Gender therapy has little to nothing to do with sexual orientation and practices. A gay man who is sexually attracted to men does not transition into a woman to have sex with men; he transitions because he identifies as a woman and is attracted only (or primarily) to men.
Questions About Gender Identity Issues
If you are ultimately diagnosed with gender dysphoria, your therapist will likely begin to ask questions about your childhood. These questions typically outline the history of identifying as the ‘wrong’ gender, behavioral issues in childhood, and current development.
Examples: Did you play with dolls or dress up when you were a child?
Did you have a preference to play with girls as a child?
Did you take on female roles in your school plays as a child?
Did you socialize primarily with girls as a child?
Did you avoid rough and tumble sports or dislike playing outside with the boys?
If any of these questions apply to you, they may ask if you knew you were a girl but felt like the boys made fun of your behavior. Or maybe you didn’t know why they mistreated you; all you knew was that it had to do with your gender expression.
If yes, they will ask if any men in your life made you feel special or protected when you were a child. For example, a father’s best friend or a grandfather who took you fishing. These men may have represented to you the idea of being a man and having masculine traits.
If your childhood is relevant, they will ask if you remember feeling that this special male figure was important to your mental health treatment because he was masculine, and you identified that way.
Questions About Blocking Out Childhood Memories
If it seems relevant, they may ask if you ever blocked any memories from your childhood. For example, did you have a lot of nightmares as a child about being chased or attacked by men? Were these nightmares so vivid and disturbing that you can remember them in great detail?
If yes, they may ask if you blocked out the memory of experiencing physical assault as a child. If so, they will want to know these memories in detail. Asking about nightmares is not a standard procedure for gender therapy; however, some therapists believe that childhood trauma impacts harboring early dysphoria and transitioning later in life.
Questions About Dating and Romantic Interests
As a general rule, your therapist will not ask you direct questions about who you are currently dating or the kind of sex life you have with that person. Their relationship status may be relevant only if there seems to be a connection between intimacy issues and dysphoria. In this case, they may ask if you have a history of being attracted to women and having difficulty connecting with them.
Or, maybe you don’t feel your sex life needs to consist of penetration, but oral sex or mutual masturbation. In other words, they may ask if you have a history of being intimate with women as a woman.
Questions About Social Behavior
Your therapist may ask you to look at your current social life and explain how you behave in public. They may ask if there are times where you feel pressure to be masculine because it is what society dictates a man should be. And, does this make it difficult for people to see the woman that’s inside of you?
If so, they may ask how it makes you feel when people assume that because you are masculine or not ‘femme’ enough, that you are gay. Or, maybe the opposite is accurate, and your therapist wants to know if there were times in your life where you wished people would assume that you were straight because having feminine qualities was more socially acceptable.
Questions Designed to Gauge Your Comfort Level
Your therapist may ask you about your comfort levels and feelings of dysphoria in general. A question like: Do you feel safe as a woman? How often do you experience dysphoria, and how long does it last?
People’s responses usually fall into one of three categories:
1. They experience dysphoria daily, and its impact on their life is significant.
2. They experience dysphoric feelings occasionally, and the intensity is mild to moderate.
3. Dysphoria isn’t a problem at all. What gender therapists do is explore any of these options with you if you feel that gender dysphoria plays a role in your identity.
Questions About Objectivity
As you can probably guess, gender therapists are concerned with how objective you are about your own life. If your therapist feels that your dysphoria is clouding your judgment, they may ask if there is any other way to view the situation. For example, does this make sense? Would an average man think or feel the same way that you do?
These specialists are trained to prevent the trans-cisgender binary. They will encourage you to explore other possible alternatives if they feel as though you are black or white in your perspective on things. Their goal is to get to the root of your discomfort and not simply hand you a script for transitioning.
What Are Therapists Required To Tell?
Your therapist is required to report any concerns that they have about your intentions, mental state, or wellbeing. They are not allowed to disclose involuntary psychiatric hospitalization due to gender dysphoria without your consent.
Therapy for either gender is intended to help people be as objective as possible about their identity and what steps make sense in helping them improve their quality of life. The focus of gender therapists is not on procedures but rather on how said procedures can help clarify what makes people comfortable.