Coming out trans: questions of identity for therapists working with transgendered individuals: (trans identity from the queer perspective).

Author:Henkin, William A.

[An earlier version of this paper was originally delivered as a presentation at the In the Family conference "Fostering Therapies of Resilience," San Francisco, CA, June 2001. At that time I was a member of the Ethics Committee of the Harry Benjamin International Gender Dysphoria Association (now the World Professional Association for Transgender Health), past-president of the San Francisco Chapter of the Society for the Scientific Study of Sexuality, a member of the International Foundation for Gender Education, FTM International, and TGSF (Transgender San Francisco), and had been, since 1989, a participant in Bay Area Gender Associates (BAGA), the longest-running therapists' peer consultation group in the world devoted exclusively to transgender identity issues. I thank my BAGA colleagues--Rebecca Auge, Ph.D.; Koen Baum, MFT; Lin Fraser, Ed.D.; Kim Hraca, MFT; Dan Karasic, M.D.; Luanna Rodgers, MFT; and Anne Vitale, Ph.D.--for their thoughtful readings of and responses to this paper in its penultimate draft.]

What is gender? I believe it is becoming increasingly clear ... that ... gender is considerably less fixed than we have been led to believe and that one's sex has less to do with one's wholeness than one's individuation. So simple is this idea that I think it is easy to underestimate the momentous implications such a view has for civilization as we know it.... Ours is a culture in which the gender dichotomy has been made so central to the definition of what it means to be human that any change reverberates deeply and terrifyingly in the souls of even those who ardently wish for movement.

--Robert Hopcke, Persona: Where Sacred Meets Profane


    A gym-toned, bearded man and a voluptuous, large-breasted woman were walking down Castro Street a few years ago, in the heart of San Francisco's gay mecca, and as they passed a local coffee place they were hissed for being breeders. The man had once been an extremely well-known member of San Francisco's leatherdyke community, and the woman had been a recognizable gay male resident of this very neighborhood for years. At such a moment that altogether transcended degrees of queerness, what could they do but laugh? At that moment, what could they have said about the ways gender identity, gender roles, and sexual orientation intersect? How can we talk about identity in this context? What is a trans identity from the queer perspective?

    The premise of this paper is that, at least in the absence of a known transgendered therapist or specialist, you and you and you and I--therapists known to be LGB--are often the referrals of choice among straight doctors and therapists for their transgendered clients, simply because straight people often presume similarities between "transgressive" gender identities and "transgressive" sexual orientations.

    We and our transgendered clients may make the same assumptions, and in fact there are many reasons to include "T" along with GL and B in the headlines, banners, parades, and events that more and more bind a very broad coalition into a single community of people. What makes our sometimes disparate groups one community can be understood most simply by the need every individual in those groups has to take at least one look at his or her own identity, exactly terms of sex and gender, that the main body of straight, heterosexual, vanilla, non-queer folk do not have to do. Even though some straights most certainly do make such an examination, they don't have to: they can get along in their lives, in their relationships, and in society without ever attending to that aspect of themselves; and so I use that necessity to define the concept of queer, and it is what, for me, lumps T in together with LGB and a few other fellow travelers, such as people in the leather, or BDSM, communities.

    But being transgendered and being G, L, or B are also not alike in many ways, and in those ways the experience of coming out with a variant gender identity, including coming to terms with a gender-variant life, is not like the experience of other comings out.

    Certainly the finest psycho-political rhetoric says each person is unique, and certainly we shrinks not only believe it, but also have laboratory evidence that it is true, though admittedly our samples are small, non-random, uncontrolled, and skewed. Yet--considering the way our culture views human identity altogether--if we go beyond our presumptions, then in those areas where we truly do stand apart from the mainstream by reason of who and what we are, queer therapists have a unique opportunity to serve queer others who are in the process of coming to terms with their own identities. In order to do that with gender-variant people it helps to learn what the trans experience is like, in some measure, so we can learn what our trans clients need, and respond with genuine empathy to them and to all people working their gender identities.


    I remember attending a lecture on queer art in about 1990, where the photographer Mark I. Chester started his presentation by lifting his shirt and dropping his pants, displaying his ample tattoos and piercings, among other things, in order to show he had nothing to hide.

    My version of truth in advertising is more academic: I refer you to my own essay on Multiple Personality Order (MPO) (Henkin, 1997), which describes one paradigm for understanding cross-gendered experience. In that essay I assume dissociation to be a continuum that ranges from Dissociative Identity Disorder, or what used to be called Multiple Personality Disorder, to the sort of dissociative process with which we are all familiar--dreaming, daydreaming, becoming so involved with work or with reading a book or watching a film that we "lose" ourselves. In that context I examine the concept of the Inner Child and other alters as personifications of our variable states of mind: as fairly common dissociative states that can, for some people, include cross-gendered experience. As I did in that essay, I am writing this one not only as a clinician, rather than as a scholar or a researcher, but also as someone who has done my own share of gender exploration on the road to concluding that I am not transgendered. In some measure, then, I'm talking from both--or at least from two--sides of my experience.

    In the mid-1980s I was working in a community mental health facility in another city. One morning, on my watch, I received information that two of the residents had slept together in the house the previous night, which was a cardinal infraction in that program whose mandated consequence was immediate discharge. But I knew one of the women, who was so familiar with our facility that some of the staff regarded her more as a pal than a client. I knew she could act out, but I had never seen her behave so, well, so stupidly, without some compelling reason.

    I called both women into the office, ascertained that the accusation was correct, and asked the reason for their behavior. Somewhat sheepishly, both women told me they wanted to know what "it" was like. "It?" I knew the first woman had slept with plenty of other women: she was not a virgin. But the second woman was new to the facility and we had barely met. I asked what "it" was.

    "It" turned out to be that the second woman was a pre-op MTF (male-to-female) transsexual, and actually had her surgery date set for just a few days after her planned discharge from our facility. She had never slept with a woman before, and the first woman had never slept with a transsexual woman. The temptation of the unknown had been too much for them to resist.

    With the ball was in my court I elected to ground both women for the weekend--a gentle slap on the wrist at the time and under the circumstances--rather than toss them from the house. An hour later I had to defend my decision in staff meeting. Several of the women on staff reconciled themselves to my leniency because they were countertransferentially fond of woman number one and therefore felt themselves morally obligated to tolerate woman number two, even though they thought that since she was, well, odd, and since she was a stranger to our house anyway, she had probably been the seductress and should really be dealt with more severely. But once her gender status was made clear, not a single other man on staff could find his way to agreeing to keep woman number two, and several were vehement--"panicked" was the word that came to my mind at the time--about getting her out before their shifts commenced.

    Eventually my chosen punishments prevailed and both women stayed, but only on condition that I become the primary in-house counselor for woman number two; and since I did not seem to have the same highly anxious response to her that the other men on staff felt, there began my education in transgender identity. My client talked to me about her own experience, loaned me what was then the very recent video, What Sex Am I?, provided me with pamphlets about transgender issues, and gave me the name of her therapist in San Francisco, whom I called and who spent a somewhat hectic hour talking to me in his Union Street office.

    Her therapist, the late Paul Walker, was among the founders of the Harry Benjamin International Gender Dysphoria Association (HBIGDA), and was its first president. In addition to seeing clients, he was running the Janus Information Facility when I met him, educating people to the nature of transgender identity issues. I read the Janus pamphlets and much else I found on the topic, and while I cannot say I was remotely "prepared," I was at least not wholly ignorant when a heterosexual couple entered my private practice, the male of whom was a female-to-male (FTM) transsexual.

    Some time thereafter I tried on a pair of the high heeled shoes my partner in process, Sybil Holiday, kept for her cross-dressing clients, and experienced a remarkable transformation in myself. While I...

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