In accordance with the American Counseling Association and Counseling Awareness Month (April), I wanted to share with you a little bit about why I do the work that I do, and more specifically, why I choose to devote much of my practice to transgender and gender variant people. I alluded to a conversation I had with a dear friend from graduate school (on our way to see Justin Timberlake!!!) about my “Whys”. She and I met in our first year of our counseling graduate program, and we’ve been friends ever since. She is not practicing now due to different priorities and obligations, but she has a gift in working with substance abuse clients, which is how she likened my being drawn to working with the trans population.
You see, I identify as a cisgender, straight female. This means that my gender identity (how I view myself as a gender) aligns with the anatomy/parts I was born with and how I was assigned at birth. I realize this feels a bit complex with all the words, but now that we have labels for how people choose to identify themselves, we should better identify ourselves so that others can understand who we are and the potential needs we may have. I have never questioned my being female, and have never “walked in the moccasins” of those who may have questioned their gender identity. My friend, luckily, has never struggled with substance abuse, yet felt drawn to assist those who have struggled achieve sobriety and a better, more healthy way of living to suit their dreams, families, and careers. So, my memory of the conversation went a bit like this:
“So, Angela, what made you decide to work with the trans population?”
“Um, that’s a great question, and one that I get a lot. So much so that I should probably have a better response than the one you’ll get…I just feel compelled to work with them!”
*Mind you, I’m on a treacherous part of 95/395N, going into DC proper, trying not to kill us both and her unborn child*
“I’ve been doing reading and research into LGBTQ populations and their mental health needs since grad school, and I feel that I can connect with them, almost like I’m meant to work with that population. I have family members in the community, close friends, and much respect for those who have faced adversity and still choose to fight the good fight for equality, justice, and fairness. Should I be in the middle lane or left lane here?”
“Ugh, I haven’t been paying attention because I’ve been listening to you. Where are we meeting for dinner?”
“I don’t really care. I’m trying not to plan anything else for this trip. So, I’m intrigued by the notion that people can feel that their body’s appearance and how they feel inside are different, and that this dissonance produces a lot of stress and upheaval in a person’s life, and as a counselor, that’s what I like to work on; finding ways to better incorporate someone’s dreams with their current reality, and to provide support to them to fulfill those desires. Can you text the group to find out about dinner plans?”
“Sure…I can’t say that I know much about the population, other than what I’ve seen in the media. I don’t know if I know what language/words to use, or how to make them comfortable.”
I tell her about various people who are trans-identified that have ties either to Hawaii (Janet Mock; friend recently PCSd with husband and child from Hawaii to Virginia) or the military (Kristen Beck, among others) who are more well-known and trans. She had great questions to ask, and seemed genuinely interested in wanting to know more, so she can be better prepared as a parent and citizen of the world. As a counselor, I aim to educate anyone who seems to have a genuine interest in wanting to know more about something I might know about. My friend has a daughter, and is about to have another child in a few months, so I know firsthand that she can enact change in her household, and in her community.
As a counselor, not only am I tasked with providing ethical, clinical, and supportive mental health counseling to improve client’s ability to take care of their emotional, physical, work, and spiritual lives, but I am also tasked with fighting for social justice for those who are disadvantaged or discriminated against due to a part of their identity. Being trans or LGBQ-identified comes with risks…risk of violence, death, discrimination, mistreatment/abuse, suicide, abandonment, etc. I can’t think of any other population or community that is more at risk of mental health needs than this population. I referenced it before, but take a gander at the most recent US Trans Survey (2015) for more information and statistics on the issues plaguing the trans population.
Today, I saw a long-term client whom I’ve assisted through transition who is a retired military veteran. She served her country through Desert Storm, and has received military honors for her career in the military. But SHE wasn’t able to serve as she. Due to Don’t Ask, Don’t Tell, the client wasn’t able to come out unless she risked being discharged from the military. Since she is a retired and now a civilian, she has been able to make many of her dreams come true. This has not come without sacrifice. Her healthcare has been at risk because her gender is listed one way with her insurer, and another way with the various providers she sees. I had to let her know that depending on which insurance will be her primary when she turns 65, I may not be able to provide her with needed mental health counseling services because as an LPC, I can’t accept Medicare. Guess who holds the keys to that door? Congress. I’ve used what opportunities I have to advocate for this client and countless others with Medicare coverage to ensure that they can continue to see providers they are comfortable with, who know their stories, and can provide the affirming care they need and want. But, Congress has to agree that what counselors do is of value, legitimate, and needed to serve the aging population past the age of 65. I was able to provide the client with the documentation necessary to get her birth certificate changed to reflect her name and gender in her home state. That’s what advocacy is, and is a minor blip on the screen of things that counselors do on a regular basis to better serve the folks they work with to help improve their lives, via self or within systems.
Yesterday, I saw a client couple who don’t have any known ties to the LGBTQ community. But yesterday, it came out that they are concerned about their oldest child, who is struggling emotionally, in school, and most recently at home. The mother stated that the child has also said that they desire to be the opposite gender. In not knowing the child, or the context in which this statement was made, I provided some guidance to the family about what I and other affirming colleagues see when a child presents as gender fluid or transgender, and that asking more questions for clarification (at appropriate times) may bring more understanding of what their child means. I felt honored to be able to provide them with knowledge and reassurance that their main goal in helping their child is to provide unconditional love and be interested in what their child has to say.
You may not identify as LGBTQ, or as a parent, or as someone who struggles with mental health issues, but I know you know someone that does. If that person hasn’t experienced counseling but remains struggling, here are some tips to provide that person with support:
- Empathy – empathy is knowing something is difficult for a person, but you might not have experienced it directly. “Gosh, losing your home and precious memories to a housefire must be awful.” Providing empathy for their struggles helps that person to know that they are cared for emotionally.
- Encouragement – After providing empathy, acknowledging that it’s okay to seek out help. Most people would hire an attorney to represent them in a legal matter or a CPA if they have a complicated tax case; it’s encouraged to see a counselor for mental health matters because we’re *kinda* trained in that sort of thing. Many have reservations because of stigma, past experiences, time off from work, finances, etc, but if you can help guide them through those obstacles, do it. You may be saving a life!
- Be genuine – Ask how they are doing! Use eye contact when you’re communicating with them to show you care. Follow up with them if they’ve mentioned something stressful or difficult they are anticipating. Sometimes just being acknowledged or heard can help people see the importance of seeking help for themselves.
- Don’t ask for the nitty gritty. If they trust you enough to share details, they will (or not). But don’t pester, and DON’T GOSSIP. Sharing personal information or medical information is a big NO-NO. Even if you are not a “Covered HIPAA Entity”, you do not want to cause someone who is about to get help to crawl back in their shell because they are afraid their personal business will be aired for all to know. While it is hoped more who have experienced mental health struggles to be open in talking about it to reduce overall stigma, forcing a person or disclosing information yourself is not appropriate.
- If at first you don’t succeed – If this person hasn’t found a good fit in a counselor (we’re people too!), then encourage them to look for a better fit. We all have different styles, approaches, personalities, and some people we are not made to treat. I’m pretty animated, honest, and active during sessions. If that’s not helpful to you, I won’t be offended to refer you to a different clinician based on personality and/or needs. I happen to think I’m pretty cool, though, sooooo….;-)
Counseling is more accessible than it has ever been. More is being done with technology to provide counseling services to those in remote areas, or while they work or travel out of their normal home base. If you’ve thought, “I’d like to talk with someone who doesn’t know me about this situation”, I’d encourage you to find a counselor that will serve you best, with the best means to serve you. Ask your friends, family, neighbors, and those you trust for a recommendation. When I get a new client based on a friend or family member’s recommendation from a current or former client, it means the world to me that the previous client has appreciated the work I have done. And some referrals come from clients whose marriages ended, but they were able to see that it wasn’t because of their counseling experience!
Loréal was on to something when they said “Because you’re worth it”. You are worth improving your mental health and life! #CounselorsHelp, in April, and every month of the year!