PROFESSOR ESBEN ESTHER PIRELLI BENESTAD MD FAMILY THERAPIST

PROFESSOR ESBEN ESTHER PIRELLI BENESTAD, MD, FAMILY THERAPIST, SPECIALIST IN CLINICAL SEXOLOGY NACS PROFESSOR ELSA ALMÅS, PSYCHOLOGIST, FAMILY THERAPIST, SPECIALIST IN CLINICAL SEXOLOGY NACS UNIVERSITY OF AGDER, NORWAY

IMAGINE! Imagine that you looked into a mirror and no image of you appeared. Or an image popped up that did not affirm you the way you see yourself This is an incongruent and dysphoric experience.

GENERAL BIOLOGICAL METAPHOR Haevier on the female side Heavier on the male side

GENDER EUPHORIA • THE AIM OF ALL TREATMENT IS NOT ONLY THE REDUCTION OR ELIMINATION OF GENDER DYSPHORIA • THE AIM IS ALSO TO ASSIST GENDER EUPHORIA • KIM (14) ASSIGNED FEMALE AT BIRTH, GOT TESTOSTERONE: N «OW I KNOW WHAT HAPPINESS IS»

TWO WAYS OF THINKING How can we assist a good future for you with your special talents of gender? Unusual selfperception of gender We must focus on what might have gone wrong

SOME WELCOMING WORDS AND CONCEPTS TO ENHANCE GENDER EUPHORIA • TRANS TALENT (TT) • TRANS GIFTED (TG) • GENDER TALENT (GT) • TALENTS OF INCONGRUENCE (TOI)

• THERE IS A GROWING GROUP OF INDIVIDUALS WHO DEFINE THEMSELVES OUT OF THE GENDER BINARY. • THERE ARE SEVERAL WAYS TO DO THIS: • BY WANTING LESS THAN BRINGING THE BODY IN LINE WITH THE OTHER GENDER MAJORITY WITHOUT ANY IDEOLOGICAL DRIVING FORCE. O ( N THE INNER ARENA THIS MAY NOT BE PERCEIVED OUT OF THE BINARY) • THROUGH AN IDEOLOGICAL DRIVING FORCE • COMBINATIONS OF THE TWO • AND/OR SIMPLY CROSSES OUT NON-BINARY CONCEPTS OF GENDER IN SCIENTIFIC RESEARCH • THERE ARE MANY WAYS TO PERFORM THESE STANDS!

NON-BINARY PREVALENCE (AND WHERE HAVE THEY BEEN HIDING? ) • PREVALENCE: 2 -5% IN DIFFERENT RESEARCH PAPERS • MANY ARE NOT IN CONTACT WITH CLINICS • MANY HAVE HIDDEN IN F 64. 0 • MANY HAVE HIDDEN IN F 64, 8 AND F 64. 9 • F 64. 0, F 64. 8 AND F 64. 9 DISAPPEAR IN THE ICD 11, THAT MIGHT BRING MORE PEOPLE TO SEEK THERAPY (IN AN OFFER AND DEMAND WAY OF THINKING)

• AS NON-BINARY NARRATIVES APPEAR IN PUBLIC AND IN THE MEDIA, THESE OPTIONS BECOME ACCESSIBLE FOR MORE INDIVIDUALS, WHO IN TURN MAY NUANCE THEIR NARRATIVES INTO NEW OPTIONS FOR OTHERS AND SO ON AND SO FORTH. • THE CHALLENGE FOR THE HEALTH CARE SYSTEMS, FOR THE LAW MAKERS AND FOR US ALL, IS TO ADJUST TO THESE CHANGES IN ORDER THAT THE CLIENTS/FELLOW HUMAN BEINGS WITH NARRATIVES OF TODAY ARE NOT MET WITH OFFERS OF YESTERDAY • IN ORDER TO GET IN ALLIANCE WITH ANY CLIENT ANY POSSIBLE NEW FRIEND OUTSIDE THE BINARY, THE SYSTEM MUST CONVEY KNOWLEDGE AND BE POSITIVE TO GENDER DIVERSITY BEYOND BINARY THINKING.

THE GENDER NON- BINARIES • ALSO INCLUDE THOSE WHO DISMISS GENDER • AND A NUMBER OF SELF-PERCEIVED GENDERS • WHERE HAVE THEY BEEN BEFORE? • MANY HAVE LIED SAYING THEY «WANT IT ALL» , UNTIL THEY GOT WHAT REALLY THEY WANTED AND PULLED OUT. • MANY RECEIVED HORMONAL TREATMENT, SOME MINOR SURGERIES (UP TO BREAST REMOVAL) SOME MAJOR SURGERY, MEANING GENDER AFFIRMING GENITAL ADJUSTMENTS. • IT IS OF COURCE OPTIONAL TO «TAKE IT ALL» BUT STILL DEFINE YOURSELV OUT OF THE BINARY

OPTIONS OF GENDER BELONING FOR GENDER NON-BINARIES • SWEDEN HAD FORMALIZED A GENDER NEUTRAL AND/OR A GENDER DIVERSE PRONOUNI. T IS TO BE FOUND IN SWEDISH DICTIONARIES: HEN • COUNTRIES LIKE INDIA, PAKISTAN, NEPAL, BENGLADESH, AUSTRALIA, NEW ZEALAND HAS ACKNOWLEDGED A THIRD (GENDER). MORE COUNTRIES ARE ON THEIR WAY • MANY CLINICS INCLUDE GENDER NON-BINARIES IN THEIR PROGRAMS AS DOES THEWORLD PROFESSIONAL ASSOCIATION FOR TRANSGENDER HEALTH (WPATH) IN THE «STANDARDS OF CARE» . • THERE ARE, HOWEVER, MANY SOCIETIES THAT DO NOT ACKNOWLEDGE MORE THAN TWO GENDERS, INCLUDING SOME ORGANIZATIONS FOR INDIVIDUALS WHO HAVE BEEN GRANTED THE DIAGNOSE F 64. 0 – TRANSSEXUALISM.

STANDARDS OF CARE. (SOC) FROM WPATH. 7. VERSION 2011 • THE SOC ARE BASED ON THE BEST AVAILABLE SCIENCE AND EXPERT PROFESSIONAL CONSENSUS. • THE GOAL IS TO ACHIEVE LASTING PERSONAL COMFORT WITH THEIR GENDERED SELVES, IN ORDER TO MAXIMIZE THEIR OVERALL HEALTH, PSYCHOLOGICAL WELL-BEING, AND SELFFULFILLMENT. • BEING TRANSSEXUAL, TRANSGENDER, OR GENDER NONCONFORMING IS A MATTER OF DIVERSITY, NOT PATHOLOGY • WHILE TRANSSEXUAL, TRANSGENDER, AND GENDER NONCONFORMING PEOPLE MAY EXPERIENCE GENDER DYSPHORIA AT SOME POINT IN THEIR LIVES, MANY…. . WILL FIND A GENDER ROLE AND EXPRESSION THAT IS COMFORTABLE FOR THEM, EVEN IF THESE DIFFER FROM THOSE ASSOCIATED WITH THEIR SEX ASSIGNED AT BIRTHOR , PREVAILING GENDER NORMS AND EXPECTATIONS. FROM

IS BIOLOGY REFLECTING THE GENDER BINARY? • NO!

“Gendered” brains (White matter) Ft. M F Mt. F Ft. M M

EXAMPLES • THE INDIAN FATHER OF FOUR • THE AUSTRLIAN MOTHER OF THREE.

THE CHALLENGE FOR THOSE WHO EXPERIENCE THEMSELVES AS NON-BINARY • LITTLE OR NO SOCIETAL AFFIRMATIONS NEITHER IN LANGUAGE OR INSTITUTION • INCREASED EXPERIENCE OF MINORITY STRESS DUE TO THE ABOVE MENTIONED • MUST TO A LARGER DEGREE LIVE WITHOUT A TEMPLATE.

THANK YOU From one who do not abide by the binary

SOME REFERENCES • •