I was visiting with a client I’ve seen pretty regularly for about 3 months or so, who is working his way through an incredibly tough time. He came in after a rough week, and said that his anxiety has been through the roof that week, especially at work. I asked him if he could pick one character trait, or feeling to be filled with in the coming days, what would he choose. He thought for a minute and he said “Peace, I want to be filled with peace.”
Because I know this client so well, I know that one of his daily routines is to drink a full glass of water right when he wakes up every single morning, so I asked him this question:
“If that morning water you drink tomorrow were somehow infused with peace, how might you notice?”
And off he went, describing a day in which he was filled with peace. When I saw him again two weeks later, he was feeling a whole lot better, and when I asked him what was different; he said “The water! Every time I drink my water I can feel the peace it’s infused with as it goes down my throat and into my stomach, and now that peace stays with me.”
What would you want your water or coffee be filled with, and what difference might it make?
I am participating in Trans*forming the Dialogue, Simmons College’s
Online MSW Program’s campaign to promote an educational conversation about the transgender community. By participating in this campaign, I will be offering my perspective on what TO ask and what NOT to ask trans*people.
I offer the answers to these questions from the perspective of a mental health professional who works with this community. Though I will preface these answers with the ‘warning’ that I am not a typical ‘therapist’. I do not work as the expert in the room, rather I allow each and every client that I see to be the expert of their lives. I only take on an expert role when I am simply conducting an assessment to write a letter for a trans client, and need some black and white information from them in order to be comfortable with the writing of that letter.
What are the do’s and don’ts when asking a trans*person about their experiences?
What are some questions that one should NOT be asking a transgender person?
1. Will you have/Have you had surgery?
• Or anything about surgery, unless someone explicitly invites you to ask them, or unless you need to know this answer for a specific and clearly articulated professional reason.
2. What’s your real name?
• Sometimes, for professionals we need to know a legal name, and so it’s okay to seek that info, respectfully, by using the term ‘legal’ rather than ‘real’ and if the client as already legally changed their name to their preferred name, I never ever ask them their birth name, as it is just not ever relevant.
3. Are you trans?
• If a client wants you to know this and believes this information to be relevant to their hopes from your services to them, they’ll tell you. I don’t believe that even as a counselor who works with this community, asking this question is ever a necessity. I have had clients in my office who came to me as heterosexual individuals, and I never knew them to be trans until they revealed that information halfway into the first session or even later than that. And had they not told me, I would not have asked, even if I suspected that to be the case.
4. What bathroom do you use?
5. Anything that is JUST based on your curiosity.
• I think that too often professionals get morbidly curious about their client’s lives, and with this community more so than usual. I think we should be incredibly disciplined to never let that curiosity guide us, or the questions we ask.
What are 2 – 3 questions that one SHOULD be asking a transgender person?
1. What are your very best hopes from our work together?
2. What are your preferred pronouns?
3. If you only know their legal/birth name, “what is your preferred name?” (This is a question on my intake form, and once I know a client’s preferred name, I solely use it.)
4. Is there anything I/we can do to help you feel more comfortable here?
5. What would you like me to know about you or your life?
6. I’ve asked you some questions; do you have any questions for me?
Just a few of the current injustices the trans and gender variant community faces at the moment followed by simple ways that we can help to grab the wheel and turn things around:
• There are attempts being made to pass laws that would disallow trans people to use the bathroom that matches their gender. Meaning, if Caitlyn lived in a state or country where that law passed, she would be legally pressured to use the men’s room.
• There are talented student athletes who are forced to either drop sports altogether or hold off transitioning so they can play the sport they love.
• There are teachers and school administrators who refuse to accept a student’s transition, calling them their birth name in class, and mis-gendering them in front of their classmates.
• Often, students who are in transition don’t have a safe bathroom to use at school, feeling alienated or unsafe in either the boys or the girls.
• When a trans-male (someone identified female at birth) gets their name and gender marker legally changed, and then gets ovarian cancer, or needs gynecological care for some other health issue, their health insurance can (and likely will) refuse to cover treatment, because ‘men don’t have those problems.’ The same is true for trans-women if they get issues related to typically male health.
• There are still licensed counselors who support the idea that identifying as transgender is something that can and should be changed.
• Violence towards and suicide within the transgender community are both astronomically high.
• Hormones and surgeries affirming a person’s transgender identity are often not covered by insurance. So the choice for many is to raise thousands and thousands of dollars, find cheap and often unsafe alternatives, or live with their dysphoria and all of the depression and anxiety that creates.
So what can we do about these things?
• If you have kids, you can help make their school safer for their trans and gender variant classmates by advocating for at least 1 gender-neutral bathroom in their school. And educating them about gender and the importance of using preferred names and pronouns of their gender-variant classmates.
• If you donate you can donate to trans friendly causes.
• If you vote, vote for trans-friendly laws, and against non-friendly ones.
• If you see or hear injustice, you can help turn it around by acting on it right then and there.
• If you’re in the field of mental health, you can advocate for and offer trans friendly counseling practices.
- I wish she hadn’t given up…she was so close to adulthood and new possibilities that she had no idea were just around the corner.
- One of the first things I thought about was the truck driver who she jumped in front of. That person’s life was also changed forever that day, and I am heartbroken for what they must be experiencing.
- She was apparently on Prozac, a strong anti depressant that is known for sometimes increasing suicidal thoughts and actions, especially in teens. Sometimes medications can be a lifesaver, but I urge parents and doctors to exhaust all other options before putting youth on such strong medications with such disturbing side effects. Whenever I have a kid in my office on Prozac or other anti-depressants, I see it as my duty to have a very serious talk with their parents about keeping a close eye on their kid and talking with the prescribing physician about any concerning signals.
- Her parents have just lost a child in the worst way imaginable; demonizing them when they are struggling with such an incredible tragedy isn’t fair. It just isn’t. An important lesson can certainly be learned by other parents about things they might want to do differently with their gender-variant kids, and I bet there are many parents who are thinking long and hard about their children’s lives because of this tragedy. That is the most important thing right now, for other parents to see this as a lesson and do things differently. Leelah’s parents cannot reverse time and do things differently; all any of us can do is learn from this and move forward, evolving as we go. I admit that it is disheartening to hear them continue to misgender their kid, but to expect them to do a complete 180 in a matter of days is just not realistic. They might still come around and learn what it is to be transgender and, with time, they might humble themselves in the face of this and become educated advocates. We don’t know where they will end up as a result of this suffering. Let them get wherever they go in peace as they heal. They deserve that, as any parent who loses a child would.
- And finally, in regards to the title of this post, I am angry with my profession right now. It is UNACCEPTABLE for this to go without consequence in this field. I hope the counselor(s) that Leelah reportedly saw get investigated, and if proven at fault here, lose their license. As healthcare providers, our very first rule, is to “first do no harm”, meaning that it may be better not to do something, or even to do nothing, than to risk causing more harm than good. You should not be able to label yourself a “Christian counselor” and, with that as your shield, stand on a pedestal in front of your clients telling them to simply pray more or become a more Godly person. Therapy should never be talking at your client, lecturing them about becoming a better person. Therapy should be a helpful conversation, with the person sitting in front of you as your guide, and only therapists who are educated about the issue at hand should do it. ANY counselor who was properly educated about what it is to be transgender would have spoken with Leelah’s parents in an attempt to educate them and would have helped Leelah to find ways to be her best self in the face of the incredible adversity she was dealing with. The counselors who see trans individuals and kids need to have their feet held to the fire to ensure that they are not doing those clients more harm than good. Our profession needs to do something about holding all of us more accountable to these clients.
Around this time of year, almost every single year, something incredibly irritating happens (and I know that any gender non-conforming person reading this will be able to relate). You see, I’ve been a tomboy my entire life. Ever since I could choose what I wanted to do and how I wanted to dress, it was clear to everyone around me that I was simply not a typical girly girl. Yet what has always happened around this time of year is that well-meaning people in my life will get me a gift that they think I should want because I’m a girl, rather than one that I might actually want based on my style and choices. Let me tell a little story to make my point here.
When I was in fifth grade, I had a “high school buddy”. What that meant was that a girl from the local high school would come in during the school day and hang out with me for about an hour, once a week. It was for an elective class that she had, and for some reason I was one of the lucky elementary kids who got partnered with one of these high school buddies. I remember loving that time every week. I got to get out of class and hang out with a high school student, walking around the school or on the playground, playing basketball or checkers, while everybody else was in boring old class. It was so much fun for me. I can’t remember my buddy’s name, but I’ll call her Sarah. I really liked Sarah a lot; I thought we were great friends. We hung out once a week for an entire semester in the fall. I remember the last time we hung out quite clearly. We were walking around outside the school, on the playground and basketball courts, and talking about Christmas, which was just around the corner. She had a little gift for me, and I was psyched that she thought to get me something. She said she put a lot of thought into what to get me, and she was convinced she got the perfect gift. I remember wondering if she got me a basketball, because of how much I loved to shoot hoops back then. But when she pulled a little package out of her coat pocket, I knew it couldn’t be that. But I was still quite eager to see what it could be. I opened up the package, and immediately, my little heart sunk.
She got me barrettes for my hair. They came complete with a little speech about how putting my hair up would make me look so pretty. It felt like a judgmental punch to the gut. I remember being on the verge of tears and thinking that my friend Sarah thinks that I’m not pretty enough, I’m not girly enough, what I choose to do with myself isn’t ok enough, so she had to help me be more like she knew I should be.
I never wore them. I don’t know what I did with them, but I never looked back at the time Sarah & I spent together in the same way. I thought we were friends, I thought that she knew me and accepted me for who I was. Clearly I was wrong. She was just like everyone else, telling me that something is wrong with me because I choose to be more tomboyish than girly. I dressed like a boy, walked like a boy, spit like a boy, played soccer and basketball like a boy, and my entire childhood it was made dramatically clear to me that other people were not okay with my self-expression. Whenever I would get makeup, or pink clothes or flowery patterned gifts, I would roll my eyes as the message was received loud and clear; the gift giver either doesn’t know me, or simply doesn’t fully accept me because I’m not a girl who likes what other girls like.
One of the reasons I love SFBT as much as I do is that in a true SF therapist’s office, the client gets to define themselves for themselves, without exception. And nobody knows how incredibly impactful that can be more than someone who has struggled her whole life seeking permission and acceptance just to be herself.
So this being the holiday season, I challenge those reading this to really scrutinize what they give to their loved ones. Are you giving them a gift that you believe they will truly love, or one that you believe that they should love?
Feel free to offer me feedback via twitter, FB or email, and happy holidays!
Rebekka Ouer, LCSW
With the kind of therapy that I do, it isn’t very often that I see clients for months on end, much less a year or more. But it definitely does happen occasionally. This past week I was speaking with one such client, who I’ve seen pretty regularly for about a year and half now, and something occurred to me. This client made a list for 2014 a year ago, about what she wanted to notice happening in her life one year from that date. Her list reached 50, and it had some very small and specific hopes. Things like keeping tidier around the house, writing more like she used to, socializing with friends a few times a month, prioritizing calls to her brother and seeing him more often, and taking care of her health. So now, a year later she has pretty much checked everything off on that list of 50, with a few minor exceptions. She described to me this feeling she has now of being on the edge of something very big, and not really knowing what’s next in her life. I asked her if she thought that a new list would be helpful for her, and if she thinks it would be very different from the last one. She emphatically stated that yes, a new list might be helpful, and it would definitely be different. She pointed out that the last list was full of small busy kinds of things, tasks and such, but this one would feel very different. I wondered if that was a signal of how incredibly far she’s come in the past year, and she seemed to agree that it was, and the work she did to check those things of that list contributed greatly to this better place she was in now.
I think that the small things matter most when you’re in a tough place. Think about it a minute, when life is at it’s most difficult, THAT’S when the small tasks like reaching out to friends and keeping your house clean, and going to the doctor or dentist can be the most beneficial for you. It’s in those tough times that you need to do the easier physical things to keep yourself moving in the right direction, and once you are back at your best, that’s when you can refocus some of that energy on the bigger tasks such as finding fulfillment in life.
So, where are you in life? Could a list of 50 details you hope to notice in 2015 be helpful for you?
If so, I’d love to hear about it, feel free to email me or contact me on my Dallas Rainbow Counseling Facebook or Twitter page to let me know.
Rebekka Ouer, LCSW