You might end up with trans or gender variant clients

Some might be there voluntarily

Some might not

I'm going to call that involuntary therapy

Let's go back to one basic point

Therapeutic practices should only be provided with the full, free and informed consent of the individual

That's not the case when your signature is a requirement to update legal documents and access hormones

Your care might lead to these things but is not these things and that's a notable distiction

Imagine if you were made to see a therapist for 4 months in order to update your last name on your driver's license

You can see how someone going through that would draw a distinction between the therapy and the document change

More to the point you can see how the opinion of the therapist might not matter to the client so much as appeasing them

We're dealing with the same thing here with trans and gender variant clients

The services you provide might not be what's valued by the client

But rather accessing something else which may have a significant bearing on their quality of life

To which you are a potential blocker in achieving

You are now a gatekeeper

Things are different when you're a gatekeeper

Clients undergoing involuntary therapy might not be truthful

They might tell you what they know works

The trans narrative

Knowing from young age

Gender roles

Surgery

Let's go with an example

Let's say you're a man who has been out for years and wants to medically transition

You first spend months with a therapist to get a referral where you have to prove you're trans enough

In an absurd twist of fate, you or your peers might have trained the very therapist who is assessing you on what being trans looks like

And you're aware of how flawed their understanding could be

Many months pass and you now have a doctor

You now have to prove you're trans all over again and spend months doing that

Now you fill out forms and write a long document proving you're trans again, this time to CAMH

( Centre for Addiction and Mental Health )

Then you have to wait two to three years

Then you have to go before a panel to prove you're trans all over again

Only then would you have received all the care you deemed necessary to medically transition

At any one of these steps, are you really going to risk jeopardizing your care by telling them your story

Or will you play it safe and tell them what you know works?

With endless stories of trans people educating their own care providers

There's a real skepticism in terms of the value of the opinions provided

I've never heard someone say "gee I'm glad I had to prove I was trans enough to receive basic care!"

Keeping in mind that none of the care providers would have seen themselves as making their clients prove that they were trans

The other consequence of gatekeeping is that a portion of trans and gender variant people won't receive care

And they will seek alternatives

25%

Have acquired hormones from non-medical source

6.4%

Currently taking non-prescribed hormones

http://transpulseproject.ca/research/nonprescribed-hormone-use-and-self-performed-surgeries/

What we need is informed consent for hormone replacement therapy

...and being able to update gender markers as easily as we update other information

Until then I need you to pay attention and ask yourself whether the client is there for your care or because they're forced there by a set of attitudes that doesn't want to believe them

And if you recognize that they are there involuntarily, then spare them of having to share that trans narrative

There's a long history of gatekeeping with trans and gender variant people

Please do what you can to not contribute to it further

Pretend like it's informed consent already and ask yourself how would you act under those circumstances

The

Trans Narrative

&

Involuntary Therapy