Working with Trans Clients: Trans Resilience and Gender Euphoria

Working with Trans Clients: Trans Resilience and Gender Euphoria

An interview with Beck Gee-Cohen, MA CADC-II, about how therapists can be better clinicians for trans people. Curt and Katie talk to Beck about gender identity (and why every therapist should do their own work around gender), historical perspectives on masculinity and femininity, the concepts of trans resilience and gender euphoria, the real problems with the DSM diagnosis of gender dysphoria and considerations for providing therapy to trans clients. 

Interview with Beck Gee-Cohen MA CADC-II Director of LGBTQ+ Programming

In this podcast episode we talk about trans mental health

We invited Beck Gee-Cohen, MA CADC-II to come talk with us about providing therapy for trans individuals.

Modern therapists need to keep learning when working with trans clients

• Getting pronouns correct is a basic expectation at this point
• Finding the balance between focusing on a client’s trans identity and other elements of their identity and experience
• Understanding trans identity 101 is a basic level of knowledge that all therapists should have
• What you do need to learn from your trans clients
• Therapists need to do their own work around gender

The work that therapists must do around gender

• The role that society plays in defining gender and the binary
• The privilege cis folks have in not being asked to assess/address their gender
• “Women’s” and “men’s” issues
• Societal expectations related to gender
• The history of gender expression and how what is acceptable has shifted
• Cultural and generational differences related to gender

 The Concept of Trans Resilience

• The tendency to focus on the pain of being trans
• The bias and hate that trans folks face, and how they continue to show up
• The importance of celebrating who you are as a trans person
• “You’re so brave” doesn’t see the full picture
• How hard it is to show up – and what it means that trans folks continue to do so
• Moving away from just focusing on gender dysphoria versus looking at gender euphoria

Gender Dysphoria versus Gender Euphoria and the problems with the DSM

• How the DSM is used for the medical needs of trans folks
• The problem with assigning the diagnosis of Gender Dysphoria to an individual
• Internalized gender dysphoria (it is not my dysphoria, it is the dysphoria of the people around me about my gender)
• Playing around with gender shouldn’t be a diagnosis, it is so culturally bound
• Trans individuals have to know what to report so they can get hormones (i.e., they may have to lie about being dysphoric in order to “check the boxes”)
• The problem with gatekeeping and the hope that trans folks being in work groups to help shift these guidelines

Better Therapy for Trans Clients

• Therapeutic alliance is the most important
• How therapists can appropriately use vulnerability when a client comes out as trans
• The likelihood of someone coming out initially versus after trust is built and how to handle it
• Sharing the therapeutic process and how you will learn and educate yourself
• The problem of signaling that you are capable of working with LGBTQ+ people when you are not trained
• Awareness of how being trans impacts the client in front of you
• When the client is coming into therapy due to their gender identity
• Understanding the back story and how someone identified that “something is different”
• Looking at what they want to do next (which may be very little or a full plan on how they handle being trans).