my experience working with transgender clients

8/12/2019 My Experience Working With Transgender Clients

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Gay & Lesbian Issues and Psychology Review, Vol. 4, No. 2, 2008

ISSN 1833-4512 2008 Author/Gay & Lesbian Issues & Psychology Interest Group of the Australian Psychological Society

MY EXPERIENCE WORKING WITH TRANSGENDER CLIENTS

PAUL MARTIN

In over 15 years of private practice specialis-ing in working with GLBT clients, Ive workedwith a number of transgender clients. Whatfollows is a personal account of some of theissues Ive encountered working with thispopulation.

For each person Ive worked with, Ive realisedI need to expect the unexpected. Ive beenamazed at the strength, fortitude and resil-ience of some of these clients, and workedwith others who Ive felt have struggled some-what due to personality disorders and otherissues, rather than issues related to their non-normative genderper se. There do, however,appear to be some experiences that areshared by all of the clients I have workedwith. I will now summarise these similarities in

the remainder of this commentary.

Working with several older transgender clientswho are now in their late 50s, I have oftennoticed a sense that they have been pioneerswith no real reference points or role modelsand that they had to almost make it up asthey went along. Some of their stories havetaken them across the globe in search oftransgender surgery and many have encoun-tered all sorts of horrendous physical and psy-chological distress as a result. The clients I

have worked with seemed to gained muchfrom these experiences. I have found thoughthat for some there is enduring psychologicaldamage in response to years of relentless andsignificant hurt, rejection and social isolation.

Some of the female clients I have seen haveworked very hard at altering the many nu-ances required to be perceived as a straight orlesbian woman and have been quite success-ful in this identity. However, for some of

these women I have witnessed an underlyingsadness, which in part appears to be con-nected to not having had children whilstknowing they would have made a wonderfulmother. Many of the heterosexual women Ihave worked with have also experienced theinevitable conflicts and rejections around

coming out as transgender when formingrelationships with straight males. I have alsonoticed a significant amount of violence thatsome of these clients have endured in theirlives.

Dealing with misunderstanding and rejection isoften a daily challenge for some of my clients,particularly those who are transgender. Un-fortunately, this has not solely been caused byheterosexual people, but has also occurred

within GLBT communities. For some reason,many gay men and lesbians dont seem toconnect with my transgender clients. Thismay perhaps be a combination of an uncon-scious belief that there must be something

disordered about a tranny, and that theytherefore do not deserve to be taken seri-ously. There is also a sense that transgenderpeople are incorrectly perceived as dragqueens. As a result, some of my transgenderclients have not felt that they belong to GLBTcommunities, believing they would be auto-

matically rejected. Furthermore, some of myclients who identify as straight females haveseen being part of the GLBT communities asbeing irrelevant. However, for some theyalso dont feel they fit into the straight com-munity either, and have struggled to gain het-erosexual or homosexual friendships or socialconnections. Some of my clients felt theywould find their tribe in the transgender com-munity, but expressed a disappointment withsome of their experiences in that community.


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MARTIN: WORKING WITH TRANSGENDER CLIENTS

So whilst some of my clients would be morethan able to be a wonderful potential friend,through their own issues and others percep-tions can end up isolated and unhappy.

Dealing with employment challenges has alsobeen a significant issue for some of my cli-ents. Some of my older clients found that theonly options open to them were in the enter-tainment, prostitution and other undergroundareas. These environments for some seemedto include dealing with exploitation and vio-lence. However, some of my younger clientshave experienced some employers who genu-inely care about inclusion and diversity andmake a genuine effort. One of the lesbian psy-chologists in our practices has worked withtransgender people regarding issues in theworkplace. This has often involved identifyingand modifying specific behaviours that areperceived by colleagues in the workplace asaggressive. This opens the door for manyinteresting discussions on the unconscious andconscious difference in gender expectationsand behaviour.

For the female to male clients I have workedwith there are just as many complexities. Acouple of my preoperative clients have experi-enced difficulties with wanting to becomepregnant. They have had to deal with themany challenges that have resulted from otherpeoples negative reactions to this concept.This has included their doctors, potential do-nors who believe the child would be too con-fused and pull out at the last minute, and thechallenges with having to cease hormonal

treatment to aid the pregnancy and risk agingas a male.

The clients I have worked with who startedhormonal treatment at a young age have agedin a way consistent with their chosen gender.The clients who have done so at a later stagein life have the aging characteristics of theiroriginal gender which they have found to bedistressing as for these people it is often moredifficult to seem like a straight woman or man,rather than being perceived as a tranny, aterm often used in pejorative ways.

When I first started working with transgenderclients I found myself having to identify myown internal irrational beliefs about these cli-ents and found supervision to be very useful.In the early days, it took me some time toadapt to some of the complexities and confu-sions I had. For example, when doing somereprocessing work using schema therapy witha woman, I had to be careful to not confusethe both of us when going back to her child-hood memories as a boy. I particularly had tobe careful of not confusing genders when us-ing past and present tense to demonstrate myown level of comfort in dealing with trans-gender issues. As such, I found that beingopen and aware of all of my emotional andunderlying beliefs and challenging these con-stantly was essential.

Overall, Im often left with a slight feeling ofsadness after working with a transgender cli-ent, knowing they have made wonderful pro-gress and will no doubt experience a higherself esteem, greater confidence and happi-ness, but at the end of the day Im always

aware of the other people out there who, nomatter what, seem to have a real blockaround developing meaningful connectionswith transgender people. So many of mytransgender clients, however, have shown mepersonally what can be achieved in life, nomatter what the seemingly unsurmountablechallenges.

Author Note

Paul is Principal Psychologist for Centre for

Human Potential, a Brisbane based GLBT spe-cialist psychology practice combining counsel-ling, coaching, seminars and workshops. Heis the mental health columnist for QNews(B r i s bane GLBT magaz i ne ) andwww.samesame.com.au a GLBT internetmagazine. He also integrates organisationalpsychology into the practice including leader-ship development and coaching in governmentand corporate settings.

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my experience working with transgender clients

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