The Mainstream Approach
Many therapists do not recognize the many variations of gender identity, and want to place people in limiting categories. They have been trained to believe that anyone who exhibits mixed feelings about their gender identity is either transsexual - in which case they are directed towards gender reassignment surgery - or transvestite, and that these two types of "disorders" never overlap. These categories are over-simplified and do not reflect the reality of the transgender world today.
Even worse, mainstream therapists have been trained to see transgender people as "mentally ill". This is clearly a problem because therapists are the "gatekeepers" to medical intervention. If the practicioner has rigid definitions of Gender Identity Disorder that have not kept up with the times, and views the "mentally ill" transgender client as incapable of self-determination, he or she may deny medical help simply by refusing a recommendation letter.
That's why picking the wrong therapist can derail your journey in major ways. In general, a gender variant person is "safer" with a gay-affirmative therapist who has extensive experience working within the LGBT community. HINT: if your therapist talks only of "transsexuals" and "transvestites" and never uses the word "transgender" - you may want to get a second opinion.
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As an IPG therapist, one of the greatest things has been to work with transgender youth. They are so awesome and courageous, it's an honor and a delight to be involved in their journey.
Our work with gender variant people is guided by the concept of the "transgender continuum" or "transgender spectrum". Simply put, this means that we believe that gender identity, like sexual orientation, varies widely and normally in humans as in other animals, and that it is "hard-wired". Many people squeeze themselves into a two-gender system easily and unconsciously. But others are gender variant, meaning that this binary, biology-driven system is too limiting for them.
The mainstream view is that gender variant people are either transsexuals - i.e, headed towards full medical treatment including gender reassignment surgery - or transvestites - i.e., cross-dressers with no interest in full-time "transitioning". We recognize that as our culture offers an increasing number of gender options, transgender pioneers are developing a multitude of identities and that some people are more gender-fluid than we realized.
The mainstream theory does not leave room, for example, for the genetic female who wants to dress and live as a male without medical intervention, or the life-long cross-dresser who eventually decides to transition surgically in middle age, or the genetic male who decides to take hormones and live with both a female identity and a penis, or for the many variations on these above themes. Some people have experienced gender conflicts from an early age and have a very stable internal sense of gender identity; for others gender identity is fluid, and may change over time.
At IPG we recognize the variety of transgender identities and the evolving nature of the community - because we work within that community every day. We will accept you where you are in your life, and we'll help you figure out where you want to go. Our therapists can assist you in your self-determination along the way. We can direct you to books, Internet resources and medical referrals if necessary. For clients who do want to transition, we work within the World Professional Association for Transgender Health (WPATH) ethical guidelines, providing the support you need in order to move forward in your journey. For clients who are unsure or don't want medical intervention, we help you figure out your unique path.
In recent years we have become one of the few groups of therapists willing to work with gender variant children and teens. We are able to help families assess whether their child is among the small number of gender variant children who are potentially transgender. When that is clearly true we help with "social transitions", and refer to special pediatric endocrinologists who are able to prescribe hormone-blocking treatments for young adolescents and cross-hormone therapy for older teens. We provide a completely supportive environment for all members of the family and, when needed, we are not afraid to advocate for our clients with social institutions like schools.
We've put together a comprehensive Resource Guide for transgender people and their allies. Click here to read it and also get a Word version of the Guide. Feel free to print it out and share it.