TRANS 101 FOR MENTAL HEALTH PROFESSIONALS Elizabeth Kent

TRANS* 101 FOR MENTAL HEALTH PROFESSIONALS Elizabeth Kent GRST 13

SAFE SPACE All questions accepted This is a space for learning You will not be judged In turn, do not make judgments

POSITIONALITY Who has a voice in discussing trans* identities and issues? Julia Serano argues that cisgender people have taken control of the discourse; this is problematic On the other hand, there are many disagreements within the trans* community My own positionality Activity: Participants should state name, gender pronoun, reason for attending

SEX VS. GENDER Frequently Sex conflated as biological Gender Most as mental of society views them as binary

SEX, GENDER, &PRESENTATION Sex: Female—Intersex—Male Gender Identity: Woman—Genderqueer—Man Gender Presentation: Feminine—Androgynous—Masculine

SEXUALITY Sexual orientation and gender identity are separate parts of one’s identity You can be a gay trans*man, lesbian trans*woman, etc. Homosexual—Bisexual—Heterosexual

UMBRELLA TERMS

TERMS & DEFINITIONS Gender Non-Conforming & Gender Variant Trans* Transgender Binary & Non-Binary Transsexual Cisgender Intersex MTF & FTM Trans*man & Trans*woman FAAB & MAAB Transvestite Cross-dresser Drag Queen & King Genderqueer Bigender Agender, Neutrois, & Genderless Two-Spirit Third Gender Butch A. G. (Aggressive) Androgynous Gender-Neutral Pronouns Gender dysphoria

TRANSITION PROCESS Children & adolescents vs. adults World Professional Association for Transgender Health – “Standards of Care” Step 1: Therapy Step 2: Social Transition Step 3: Hormones Step 4: Name Change Step 5: Surgery Step 6: Legal Transition

ROLE-PLAY: INITIAL ENCOUNTER Scenario 1: A new patient, Jess, arrives at your office. Jess is FAAB and seeking help with gender dysphoria she has been experiencing, especially in regard to her breasts. Jess is uncertain about her gender identity because she presents as masculine and is attracted to men. Scenario 2: A new patient, Elliot/Ellie, arrives at your office. Elliot/Ellie is MAAB and has begun to cross-dress in women’s clothes, go by “Ellie, ” and use female pronouns part-time. Elliot/Ellie is uncertain about their gender identity because they still enjoy using their penis during sex with women. Scenario 3: Two parents have come to your office with their 10 -year-old child, Avery is MAAB and has been interested in stereotypical “girl” activities since a young age, including playing house and wearing princess costumes. The parents are concerned because they recently saw a special on Oprah about transgender children.

DISCRIMINATION Statistics from the National Transgender Discrimination Survey � Low income � High rates of suicide, unemployment, HIV, homelessness, and physical & sexual assault � Harassment in schools, workplace, housing, public spaces, and by police force � Work in the underground economy � Problems with legal documents � Rejection by family

NON-BINARY VS. BINARY What is binary privilege? What is conditional cisgender privilege? Supplement to the NTDS: “A Gender Not Listed Here” �Results proved their hypothesis wrong �Rates of discrimination were higher, equal, or only slightly lower than that of the overall survey, depending on the category

INTERSECTIONALITY Race multiplies rates of discrimination Correlation to socioeconomic class Transgender Day of Remembrance

TRANSMISOGYNY VS. MALE PRIVILEGE Trans*men who are read as male gain male privilege Study by Kristen Schilt � 2/3 of trans*men received “male” benefits in workplace � White trans*men more likely to benefit than trans*men of color � Trans*men more likely than trans*women to gain conditional cisgender privilege Hormones Wendy Mc. Kenna & Suzanne Kessler research � Masculine cues vs. feminine cues � The penis is the only “cultural genital” What is transmisogyny?

ROLE-PLAY: DEALING WITH DISCRIMINATION Scenario 1: Avery, the gender non-conforming child from Scenario 3 in the previous role-play, has been attending school as a girl and is facing bullying from other students. Her parents are very concerned and are considering either home schooling, private school, or forcing Avery to go back to living as a boy. Scenario 2: One of your trans* patients, Ashley (MAAB trans*woman, 25 years old, has just started hormones), is a sex worker. Last night, a client assaulted her. She does not want to go to the police both because her work is illegal and because the client was a white, upper-class, cisgender man, and she is a working-class Latina trans*woman. Scenario 3: One of your trans* patients, Parker (FAAB, genderqueer, 16 years old) has been kicked out of their parents’ house after coming out to them. They are suicidal and will not be able to afford therapy without their parents’ support.

HISTORY IN THE MENTAL HEALTH SYSTEM Harry Benjamin �Focused on gender binary & heteronormativity �Excerpts from The Transsexual Phenomenon Sandy Stone argues that this leads to the need for “constructing a plausible history” Mental system has improved greatly

ACCESS TO THE MENTAL HEALTH SYSTEM Trans* people are very connected to the mental health system Generally need letter from psychologist/psychiatrist to access hormones & surgery This is slowly changing

GENDER IDENTITY DISORDER Criteria very focused on social norms of binary gender Excerpts Change from the DSM to gender dysphoria

NON-BINARY INDIVIDUALS & THE MENTAL HEALTH SYSTEM Dean Spade critiques the medical institution for permitting only “gender-normative altered bodies” Non-binary people generally cannot access hormones or surgery This also means they cannot change their legal gender marker Some binary-identified trans* people also do not want to or cannot medically transition Kay Siebler argues that the further marginalization of non-binary identities is harmful to trans* youth

TENSIONS IN THE TRANS* COMMUNITY Jay Prosser argues that legible identities are paramount to trans* survival GID allows for legible identities GID also creates the possibility for insurance coverage Is GID ultimately harmful or hurtful?

CIRCUMSTANCES & OPPRESSION Psychiatry does not take into account life circumstances or systems of oppression Trans* people face much discrimination Discrimination leads to psychological stress Therapists should not just be gatekeepers to medical care

CISGENDER PRIVILEGE Cisgender privilege checklist: http: //takesupspace. wordpress. com/cis-privilegechecklist/ Activity: Discuss the cisgender privilege checklist in small groups of 3 -5. Have you ever experienced any of these situations, even if you are cisgender? Do you disagree with any of the items on the list? Would you add anything to the list? Bring discussion back to big group: How do these situations specifically impact trans* people? How can you be aware of your cis privilege when interacting with patients?

BEING A GOOD ALLY Respect trans* patients identities Question your assumptions Understand Educate Speak Adopt Look cisgender privilege yourself and others out against transphobia a non-binary view of gender at all circumstances of patient’s life

ROLE-PLAY: BEING A GOOD ALLY Scenario 1: You have just finished a session with Ashley, the trans*woman from the previous role-play. As you walk into your waiting room, your next patient makes a transphobic remark to Ashley. How do you handle the situation? Scenario 2: One of your trans* patients, Judith (MAAB, butch trans*woman, on hormones, seeking bottom surgery), was just kicked out of a female bathroom in your office building. What are some steps you can take to make the building more trans* inclusive? Scenario 3: Parker, the genderqueer FAAB adolescent from the previous role-play, has reconciled with their parents. However, Parker’s parents refused to use their chosen name and pronouns. Parker and their parents have arrived at your office for a family therapy session.

RESOURCES See handout for list of websites and books You can search You. Tube for channels run by trans* people, many document individual transitions Blogs are a fantastic resource; on some platforms such as Tumblr you can track tags (ex. “transgender, ” “genderqueer, ” “trans”) Simply placing search terms into Google can yield great results; however, remember to read critically