‘I wonder what your position is on gender and trans issues?’ I’m sitting nervously on a couch during an initial meeting with a potential training therapist. They listed working with gender as one of their specialisms on their website, and I’m hopeful that they might have experience of working with people who, like me, identify outside of the gender binary. ‘Well, I’ve worked with trans clients in the past,’ they reply, ‘and, you know, initially when I saw how you spell your name, I assumed you would be trans. So I was actually a little surprised when you arrived, to see that you’re obviously not.’

My heart sinks. Whereas I’d started the hour nervous and hopeful, I now see that I am invisible in this space. Silently, I try to gauge whether it’s worth pursuing my question any further, but based on the number of assumptions that we’d need to unpack, and the familiarity of this conversation, I decide that I will pick my battles and this won’t be one of them. It’s one thing to be met with assumptions – hurtful as these can sometimes be – but, as most people don’t have a concept of non-binary gender, I can hardly expect others to recognise me as such. As far as I personally am concerned, people can interpret my gender expression as they like. When it comes to gender identity, though, being told who I am is always a painful experience, and I’ve come to find that most conversations that start off with another person wanting or trying to define my gender, often also end that way.

In trans communities there has often been a strong emphasis on ‘passing’ – that is, being read by others as the gender you’re presenting as. This has been and continues to be important for many, both for individuals’ experience of being validated in their gender identity and expression, and also plainly in terms of safety and risk. For non-binary, genderqueer and gender non-conforming people, as well as for binary-identified people without access to resources such as clothing, make-up, electrolysis, hormones, surgery etc, which facilitate people being read as the gender they are presenting as, passing is less straightforward. As a middle-class, white European, genderqueer person, who is straight- and cis-passing (ie read by others as heterosexual and as identifying with the gender I was assigned at birth), I occupy a privileged position in that I can generally afford, in terms of my personal safety, to hold a more playful perspective on passing. This is because the default assumption people make about me, is that I fit into society’s norms – and the flipside of invisibility is that within these norms, slim, white, heterosexual women generally get a fair amount of leeway in terms of their gender expression.

Monitoring evidences that, within trans communities, it’s predominantly transfeminine people – people who were assigned the male sex, and concomitantly gender, at birth, and who identify predominantly with femininity – who face violence and murder.1 At every annual Trans Day of Remembrance, when vigils are held across the world for those who have lost their lives to transphobic hate crimes in the previous year, it’s unmistakeably transfeminine people, especially transfeminine people of BAME backgrounds, whose numbers stand out among those lost.1

As such, I’m aware that I can only speak from my own experience, and that I by no means represent the broad experiences of the various trans communities, nor of the individuals who constitute these diverse communities. However, what I do hope to bring to the dialogue is another perspective: one that sits outside the norms of gender identity in our society; another data point, if you will, so that we can begin to broaden our understanding of trans identities. Mainstream portrayals of trans narratives offer a disappointingly narrow perspective. The media brings us stories of hate crimes and murder. We are represented in television and film as struggling with poor mental health, as detached from reality, as victims of attack – always struggling against something, never simply being. We hear of struggles in finding loved ones and friends who will accept us. While trans people do face rejection, discrimination and violence, this does not define us as people.

It’s time we questioned where we get our understanding of trans identities. If we are to support and understand trans clients, we need to be able to see them as truly three-dimensional, as embodying joy, love and satisfaction as candidly as their sadness, loss and disappointment. To be trans isn’t necessarily to experience a loss of a part of oneself, nor need it be based in an experience of pain within one’s assigned gender. This is true both for people who identify within and outside of the gender binary. Many of us have happy, healthy relationships, loving families and strong support networks, and rewarding and successful careers. Our role in working therapeutically with trans people must involve an understanding of the breadth of trans experiences, and must reach beyond the binary, physically focused and assimilationist accounts provided by the mainstream media. In holding on to the medicalised and stigmatised understanding of what it means to be trans, we risk not only misunderstanding clients’ experiences in the here and now, but also reinforcing to ourselves and to them, the idea that they are other, that they will continue to hurt far beyond this conversation, and that they will struggle to be understood and accepted in this world.

As part of my role at METRO Charity, I’m fortunate enough to run sessions for professionals, looking at how to improve the experiences of LGBTQ+ young people. The sessions are open to anyone who works with young people, and as a result I run workshops for audiences including teachers, youth workers, CAMHS teams, counsellors and therapists, GPs, Drug and Alcohol services, and third sector organisations. While these groups of professionals have varied roles and face different challenges in terms of casework, there are nonetheless specific themes whichemerge, and which bear consideration in the context of working therapeutically with trans clients.

Language as a tool

When opening up conversations around gender, a common barrier is language. The vocabulary we have to describe the experiences of LGBTQ+ communities is rapidly expanding, with new words being coined to describe experiences not yet named. It can feel difficult to keep up with, especially as many of these conversations are happening online, via social media, rather than being spoken about directly in our day-to-day life. Often people will talk about language and labels as being negative. They will describe a situation of there being too many words, too many choices, and of labels playing a divisive role in naming difference as opposed to shared humanity. In these conversations, I often think about emotion. I wonder about the different words we have to describe happiness – joy, euphoria, pleasure, glee, delight... and the role they play in conveying to another, through a shared vocabulary and meaning, an aspect of subjective and intersubjective experience. At these times, I’m struck by the beauty of the nuance infused into our language, which allows us to share our experience with others.

In naming difference and building shared meaning, as we do each time we learn a new word, we paradoxically create an opportunity to truly be present with another. Difference isn’t as formidable as we are encouraged to believe. Just as we cannot address racism from the perspective of ‘not seeing colour’, it’s only when we open ourselves up to recognising the difference our LGBTQ+ clients bring, that we can truly hope to meet them. As such, our use of language and vocabulary are powerful tools. While it would indeed be wonderful to live in a world in which gender-based discrimination as a whole did not exist, this is sadly not the world we live in. Further, in such a world, difference would still exist, even if not with such pejorative undertones. I wonder where the danger might lie in recognising this difference.

Pressure to ‘get it right’

In my opinion, perhaps the most valuable aspect of these sessions is the opportunity for people to open and engage with conversations that wouldn’t otherwise have a platform. Going into these sessions, I often find that participants are holding a lot of questions, but simply don’t have a space in which to address them. They may be seeking greater fluency around identities and labels, holding in mind a particular service user and the specific challenges arising in their work together, or noticing curiosity regarding others’ subjective experience, which may on the surface seem quite foreign. The anxiety associated with these questions often manifests as concern around saying the ‘wrong thing’. When this pressure is removed, we can start to look at the underlying questions.

Often there can be such pressure to express things the ‘right’ way that it closes down a conversation before it has begun. Participants tend toward self-censorship. Here, I would like to distinguish between censoring a comment of knowingly transphobic, hurtful or voyeuristic intent, versus censoring a question or comment that is genuinely fuelled by trying empathically to understand an experience. The former type of comment is in no way constructive, whereas the latter is an important part of learning. In our society, trans vocabulary isn’t yet a part of our general lexicon: trans people ourselves aren’t exempt from the process of having to learn, and indeed of making mistakes along the way. As such, we have an understanding of what it’s like to grapple with these new words. In conversations about gender, which will be familiar to us, common questions often fit into a pattern: as with homophobic comments, such as ‘sexual orientation should be a private matter’, it is generally quite easy to tell where the root of a statement might be leading, and whether this is a constructive or destructive place.

My concern is that a fear of getting things wrong can leave people in a catch 22. Without recognising and exploring the gaps in our knowledge, we’ll be locked in a stalemate. And while concern for others and a desire to be respectful is of great value, when used as a defence, it becomes a part of the problem. No amount of kindheartedness on the part of a therapist will compensate for their resistance toward frankly and honestly examining with me my experience of gender, if that is where my work is to be done. Instead, I will receive a reiteration of a familiar and lonely message: ‘You do not exist.’ In truth, however, the value in these conversations is substantial. There’s always more to learn, and indeed as facilitator, I grow alongside the groups I work with. This is something I treasure greatly.

Stigmatisation of trans experiences

It is only three years since the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published, in which gender dysphoria replaced gender identity disorder, thus recognising that trans identities are not in and of themselves a mental illness. The stigma that follows trans identities remains patent. This is perhaps most usefully illustrated in the not uncommon question of how one might differentiate between a service user’s presentation as a trans person, versus the presentation of someone with a dissociative disorder, or PTSD/C-PTSD. We all have a gender identity: a personal relationship to our own understanding of masculinity, femininity, and other ways of experiencing gender. Whereas we regularly tease trauma apart from a person’s gender identity in working with cisgender clients (people whose gender identity matches the gender they were assigned at birth), these questions illustrate the basing of our understanding of trans identities solely in negative experiences of gender dysphoria and disidentification. Not all trans people experience dysphoria. Further, fundamental to trans identities is not an experience of disidentification, but rather a positive identification with a specific and integrated experience of oneself. This is qualitatively no different to cisgender people’s experiences of their own gender. The way it is labelled and understood in our society, in the context of gender norms and cisnormativity, is where difference in experiences come to the fore.

When transgender and cisgender clients are seen as separate species, their experiences viewed as qualitatively disparate, this indicates an underlying assumption that bears examination. When professionals ask me how to determine whether a transgender man’s gender identity is the result of childhood abuse, turning the question around and considering whether this same assumption would be reached in the case of a cisgender client, provides a useful prompt for reflection upon personal process. When we’re able to see that trans clients have an equally rich experience of, and relationship with, their gender, we can start to consider how we might work with them, including examining symptoms that may be held as a result of trauma, without undermining our client’s self-identification.

Identity and expression

Related to the stigmatisation of trans identities, and the assumption of dysphoria as a predominant experience in trans people’s relationships with their assigned gender, is again the issue of passing. In medical circles especially, both historically and indeed today, trans people are expected to fit into a stereotype that involves dysphoria, pressure to transition medically as well as socially, and a desire to fit as closely as possible some conceived notion of the ‘opposite’ gender. This often all-or-nothing, binary view of trans identities accurately reflects the experience of some members of trans communities; for others, there is less of a desire to fit in with (or personal identification with) societal gender norms. The narrative of being ‘born in the wrong body’, while a true reflection of some people’s experience, is not a universal narrative in trans communities. Thus transition, if desired at all, can take many forms, and originate from diverse motivations. Transgender activists such as Jacob Tobia,2 Julia Serano3 and Kate Bornstein4 have spoken openly about challenges they have faced, during and after coming out, in others pressuring them to fit a stereotype they do not identify with; while peers of mine who have visited gender identity clinics have been questioned due to not presenting as masculine or feminine ‘enough’.

The conflation of gender expression and gender identity places pressure on trans individuals to police themselves according to others’ expectations. In a balancing act between self-expression and external invalidation, it can at times feel like a lose-lose situation. In this balance, the presence and support of people who don’t place expectations upon trans individuals, provide a precious experience of acceptance with no strings attached. Being willing to hear another’s self-identification, without presumption or reactive questioning, provides a space in which a client can feel sufficiently safe and held to speak openly about their experience, without the threat of another’s agenda. Characterisation of trans people as dishonest and deceptive when presenting as the gender they identify as is an ongoing issue in our society, while from another side, there is a pressure to be ‘trans enough’, or the ‘right’ kind of trans. To be invited to assert one’s own identity is, for LGBTQ+ people, not something to be readily taken for granted, but rather an experience that is fought for.

Therapists as allies

An ally is a person who doesn’t belong to a minority group, but who recognises the discrimination faced by this group and actively works to counter it. Thus a therapist who themselves identifies as trans would be a member of the trans communities, as opposed to an ally; whereas a bisexual and cisgender therapist might be an ally to the trans communities, and a member of the broader LGBTQ+ communities.5 Allyship can take various forms, from creating a platform for people to be heard, and amplifying their voice; to actively campaigning for the rights of a marginalised group; to educating themselves and others and challenging discrimination in day-to-day life; to creating a safe space in which people can trust that they will be witnessed. Being an ally is an active label, both personal and political, implying continued dedication, in which small and big acts alike are of immense value.

Through the workshops I run, I’ve met a number of inspirational allies with creative perspectives on how to uplift their clients who face marginalisation and discrimination. I would encourage readers to consider their own relationship with trans identities, and to continue to learn about trans issues. My hope is that this article will provide a cursory introduction, and a point of reference going forward. The topics covered are, as mentioned, common themes that arise in the workshops I run. I’m aware that still other topics bear consideration, including intersectionality (the layering and interaction of different facets of an individual’s identity and experience)6 and issues such as transmisogyny (the intersection between transphobia and sexism) and transmisogynoir (the intersection between transphobia, sexism and racism),8 the distinction, and relationship, between gender and sexual orientation, the difference between gender expression and gender identity, and an exploration of non-binary gender identities. Hopefully you’ll feel moved to continue to learn about trans experiences, and to find your own ways of supporting the rights and wellbeing of trans people. Even small acts can and do make a big difference, both for ourselves and for those we are reaching out to.

Kaete Robinson is the Young Person’s Mental Health Project Worker at METRO Charity, and a student psychotherapist at the Minster Centre. www.metrocentreonline.org

Find out more

Gendered Intelligence
Works predominantly with the trans community and those who impact on trans lives, and specialises in supporting young trans people aged eight to 25. Delivers trans youth programmes, support for parents and carers, professional development and trans awareness training for all sectors, and educational workshops for schools, colleges, universities and other educational settings.

Supports children, young people and their families to achieve a happier life in the face of great adversity, and raises awareness about gender issues among professionals and the general public.

Produced by the Gender Identity Research and Education Society (GIRES), TranzWiki provides a directory of groups campaigning for, supporting or assisting trans and gender non-conforming individuals, including those who are non-binary and non-gender, as well as their families across the UK.


1. Smith GA. International Transgender Day of Remembrance. [Online.] https://tdor.info/ (accessed 27 June 2016).
2. Tobia J. I’m genderqueer – please stop asking me when I’m ‘really’ going to transition. MTV News; 16 November 2015. [Online.] http://www.mtv.com/news/2428003/genderqueer-transition-trans-awareness/ (accessed 23 June 2016).
3. Serano J. Whipping girl: a transsexual woman on sexism and the scapegoating of femininity. Berkeley CA: Seal Press; 2007.
4. Bornstein K. On men, women and the rest of us. [Performance.] Soho Theatre 2016; 24 February.
5. Suffolk University Boston. Social justice terminology. 2016 [Online.] http://www.suffolk.edu/campuslife/27883.php 2016 (accessed 27 June 2016).
6. Crenshaw K. Demarginalizing the intersection of race and sex: a black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. The University of Chicago Legal Forum 1989; 1(8): 139–168.
7. Blaque K. Unfunny transmysogynystic tropes + trans comedy. [Online.] https://www.youtube.com/watch?v=uaGhMyJ4eqU (accessed 27 June 2016).
8. Wodda A, Panfil VR. ‘Don’t talk to me about deception’: the necessary erosion of the trans* panic defense. Albany Law Review 2015; 78(3): 927–971.