Both gender and sexuality are more multidimensional than people generally realize.
Sex refers to one’s biological status as male or female. Sexual orientation is the nature of one’s physical and emotional attraction to another. Gender identity is the deeply felt sense of oneself as male or female, neither or other. Gender expression is the set of external behaviors and characteristics that one displays that are “generally” considered to be masculine or feminine. Transgender is an umbrella term used to describe people whose gender identity or gender expression differs from that usually associated with their birth sex.
Gender and sexual orientation each exist along a continuum with many shades of gray. Therapy that addresses issues of gender and sexuality needs to acknowledge the wide spectrum of possible life paths, and combinations of sexual orientations, gender identities and expressions.
In therapy my priority is to provide a safe environment for clients to consider and explore their sexuality, gender identity and expression. They can also explore the possibilities available to them for changing how they relate, behave or present – while they discover inner and outer resources for managing any changes they might make. In therapy we address sexuality, gender and intimacy and I help clients, their significant others, family and social network deal with the challenges that gender and sexuality can raise.
The theme – as in all of the therapy I do – is to discover what is essential in us, and to discover when, where and how to express that in our outer lives. There is no one storyline or narrative that is the best, other than the one that works for you. Naturally, I also work with gender-variant individuals in therapy on issues that have nothing to do directly with gender – such as dealing with stress, career, relationship or transpersonal concerns.
For transgender clients seeking hormonal therapy or surgery (e.g., mastectomy, genital reassignment), that assessment occurs within the context of ongoing therapy. As appropriate, I provide letters and referrals during the transition process. In doing so, I follow the Standards of Care and typically meet with someone for a minimum of three to six months before writing a letter of support and referral for hormone therapy.
Some Introductory Readings
- Notes on Sex, Sexuality, and Gender – A very brief overview of the topics of sex, sexuality, gender, and transgender persons.
- Answers to Your Questions About Transgender People, Gender Identity, and Gender Expression – Article on transgender topics from the American Psychological Association.