Physical Sex vs. Gender Identity

Even before birth most everyone wonders if the baby will be a boy or a girl. “What are you having?” is a commonly heard refrain. Knowing someone’s gender seems like a basic, simple way to begin understanding that person; or is it? While gender has predominantly been thought of as an either/or, boy or girl phenomenon, the world is evolving and inviting scientific and lay people to re-think their understanding of what gender means. The sex of a person is based on physical characteristics present at birth. A person’s gender is considered to be based on that person’s perceived or felt identity.

Gender Non-Conformity & Transgender

Gender Non-Conformity (GNC) or Gender Variance refers to a person’s desire to express their gender in ways that do not fit the typical male/female understanding. Sometimes the expression is through clothing, sometimes through name and pronoun desires or through hair-cuts and the like.

Transgender refers to a process by which the person changes their gender identity, and perhaps expression, to be other than that with which they were born. Some people accomplish this through all of the means described above. Some may accomplish this through hormones to prevent puberty, or in adults, they may take testosterone or estrogen to begin developing physical characteristics of the gender with which they identify. Some people, a minority in fact, have sexual reassignment surgery. These procedures, augmented by hormones, voice therapy and the like, help the person’s body and overall presentation match their felt identity.

Gender Identity Therapy

Since being Gender Non-Conforming or Transgender is not a mental illness or a condition requiring treatment, there are no therapies to cure gender identities. However, since being different in these ways can result in rejection, bullying, violence and general misunderstanding by others, depression, suicidal thinking, anxiety and traumatic stress are all too commonly present. Depression therapy, anxiety therapy and trauma therapies can all be of help.

Letter Writing

While not required by law, some physicians require that an evaluation and letter from a licensed therapist accompany a person for whom they are going to administer hormones or for whom they will perform sexual reassignment surgery. The letter writing process typically involves a single appointment with a gender specialist who will check for understanding about the procedures and provide further information when requested. A letter is then crafted. The gender specialist is available to speak with the physician whenever it is deemed to be helpful.

Support for Gender Identity Transitions

Being with others who understand and who have similar experiences is invaluable. Group therapies designed to provide support as well as to assist people in working through the complexities of a gender non-conforming life can dramatically decrease feelings of isolation, depression and anxiety.

Parent Support Around Gender Identity Concerns

Most parents are unprepared to know how to help their child navigate gender non-conformity or becoming transgender. Parents need to work through their own shock, loss, shame, etc. so that they can best help their children. Parent support through individual, couple, family or group therapy can reduce the parents feelings of isolation and shame and can equip them with tools to meet their child’s and their family’s needs.