I listened to Allison Puryear’s podcast episode with a gender therapist, and I needed to ask follow up questions.

Jeff Guenther on Jul 21, 2019

In the episode titled “Supporting Non-binary Folx in Session and in Life” of her fantastic podcast The Abundant Practice Podcast, Allison Puryear sits down with Dara Hoffman-Fox, LPC. Allison and Dara talk about some really important information that every therapist (and human) should know. They discuss what it takes to be truly proficient when working with trans and non-binary people. They discuss how a therapist can get more training and competently treat transgender people. They address what one should do when they make mistakes and how to fix them. The info is incredibly relevant right now and therapists have a duty to educate themselves. Allison’s podcast episode with Dara is a fantastic jumping off point. But I wanted to know more.

So I called up Dara and asked her to be on my podcast. Dara was happy to oblige. In this article, I’m pulling out some of the most interesting parts of our conversation. For more, listen to our conversation on my podcast, Say More About That, by clicking play below or check it out on Apple Podcasts or Spotify.

Is there a specific thing that makes a therapist competent at treating transgender and non-binary people?

Dara and I cover what truly makes a therapist competent when treating transgender and non-binary people and I try to figure out if there is a specific thing that makes a therapist transgender competent verses just transgender friendly. Most people agree that the dividing line is whether or not a therapist is willing and able to write a letter on behalf of their transgender client in support of their medical transition to another gender. There is more nuance to it than that, but whether or not a therapist feels competent enough to write a letter on behalf of their client is a solid starting place for evaluating competency.

Is there an age that is too young to start transitioning?

There is no definitive answer to this question. It is very much a case by case basis. Dara and I have a great discussion about how young is too young to start puberty blockers, hormone therapy or reassignment surgery. I give her a hypothetical case of a 10 year old realizing they have been misgendered and wanting to start the transition process. Are there legal limits as to when you can medically transition? Is it important to first socially transition? Socially transitioning is often the first thing that should be tried. Which could mean wearing different clothes, getting a different haircut, going by a different name and/or changing pronouns. Dara and I talk about how if a child socially transitions you’ll get a ton of good info and data about possibly taking medical steps in the future. Dara has more to say about it in the interview.

Can trauma cause someone to feel misgendered?

Dara points out that before someone goes through a traumatic experience, they are often already in touch with whether or not they have been misgendered. And that it can be really dismissive and harmful to tell someone that the reason they identify as a different gender is because of trauma experienced in the past. Dara expands on this topic and makes some really good points.

What goes into a letter that is written on behalf of a transgender client that want’s to start medically transitioning?

The answer: a lot. I have heard about these letters for as long as I have been a therapist, but I have no idea what goes into them. I asked Dara to tell me about what the letters are filled with when they write one. I think this is the most important part of the podcast episode. Dara goes into detail about what she puts in the letter and it’s incredibly comprehensive. Even if you never plan to write a letter, you should listen and find out what’s included.

How to support transgender clients even if you don’t treat them

Not sure if you’ve heard about TherapyDen, this really amazing progressive and all-inclusive therapist directory but if you haven’t, you should sign up for it. Even if you don’t treat the transgender community it’s important to create a profile with TherapyDen so that the directory can grow and grow and grow and compete with larger directories that don’t fight transphobia. Just click here to create a profile. You’ll get your first six months free and you’ll be supporting causes that will help move the mental health industry forward.

Jeff Guenther, LPC, is a therapist in Portland, OR. He has been in private practice since 2005. Jeff is the creator and owner of Portland Therapy Center, a highly ranked therapist directory. Jeff, and his team, have launched a new progressive therapist directory, TherapyDen.

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