Gender: A Wider Lens

Are stereotypes always harmful? Should we use stereotypes to predict and impose behaviors and preferences onto others? Some people believe transgender identities defy stereotypes while others believe they reify them. And where does stereotyping come from? This is a mental shortcut with complex roots and crucial implications for the gender debates.

Links:

Carole Hooven: Testosterone: The Story of the Hormone that dominates and Divides Us  

Noam Shpancer: Stereotype Accuracy: A displeasing truth 

Extended Notes

• There are so many stereotypes in this space. What’s the right definition of gender dysphoria? The DMS is just riddled with stereotypes.
• Stella reads out the DMS description of gender dysphoria.
• The first six descriptors of gender dysphoria in the DMS are very stereotypical. It’s fixed with what a boy should play vs. what a girl should play.
• Why are pink colors “girlish” and why are blue colors “boyish”?
• What are some common stereotypes about women? Or even Irish people?
• What frustrates Stella the most about stereotypes?
• Stereotypes are always framed as harmful in this community, yet they also use them extensively. It’s a bit of a contradiction.
• These stereotypes really do come from somewhere. There’s a reason why these exist.
• Stella and Sasha compare their culture and differences.
• Our brains use stereotypes to keep us safe.
• Both sides are claiming they’re breaking the stereotypes down, but are they?
• There are girls who are wearing makeup and are in girls’ clothing, but they are saying they identify as trans guys. What’s going on? It’s a huge mind pretzel.
• It’s confusing, they say “treat me like a man,” but what does that mean if it’s outside of a stereotype?
• There’s a mix between medical and rebellion language and, when it comes to gender, this is very scary.
• If you call a phone a duck and still call a duck a duck, what the heck are we actually talking about?
• Free speech is everything and trying to control or change speech, even in its respect to gender, is dangerous.
• Stereotypes have a certain level of efficiency towards understanding what another person means.
• Kids are resident stereotypes all the time, but they also seek out edgy and cool ones to be a part of. Their own tribe, if you will.
• When they feel like a stereotype is “off-limits,” Sasha wonders how that can impact the development stages of a child if they feel like they can’t be whole or have to shun parts of their identity to fit in.
• There’s a subcategory of feminists who feel driven to be sexually liberated and proud to sleep with multiple, multiple people, but Stella and Sasha ask questions on why that is.

This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:

Rethinkime.org

Learn more about our show: Linktr.ee/WiderLensPod

Heather Brunskell-Evans is a philosopher and sociologist who studies the intersection of medicine and culture. She joins us today to trace the ways in which queer theory evolved in academia and moved into the broader culture, including the Gender Identity Development Service (GIDS) in the UK. Explaining how a social justice angle is key to the ‘affirmative model’ of care for gender dysphoria, Heather recounts a few key moments when she realized there were authoritarian elements at play in silencing thought and conversation around the topic of transgender, even for parents trying to protect their children.

Links:

Heather’s Website  

http://www.heather-brunskell-evans.co.uk/ 

Transgender Children and Young People: Born in Your Own Body 

https://www.cambridgescholars.com/product/978-1-5275-0398-4 

Inventing Transgender Children and Young People  

https://www.cambridgescholars.com/product/978-1-5275-3638-8 

Transgender Body Politics  

http://www.heather-brunskell-evans.co.uk/thoughts/transgender-body-politics/ 

Heather on Twitter 

https://twitter.com/brunskellevans 

The History of Sexuality 

https://www.amazon.com/History-Sexuality-Vol-Introduction/dp/0679724699 

Janice Raymond, The Transsexual Empire 

https://janiceraymond.com/the-transsexual-empire/ 

Vanity Fair Cover 

https://www.vanityfair.com/hollywood/2015/06/caitlyn-jenner-bruce-cover-annie-leibovitz 

Moral Maze 

http://www.heather-brunskell-evans.co.uk/tag/moral-maze/ 

Heather Brunskell Evans opinion piece for Leicester University   

https://www2.le.ac.uk/offices/press/think-leicester/arts-and-culture/2015/neo-liberalism-masculinity-and-femininity-caitlyn-jenner-and-the-politics-of-transgender   

Extended Notes

• Heather has been working in this field since the very beginning --Since the early 1990s. 
• Heather shares a bit about her background and how she got started. 
• The moment Heather discovered medical intervention for transgender children in 2016, her work has not been the same since. 
• Why did Heather decide to do her PhD in child sexual abuse? 
• Technically, we don’t actually have any human or social rights. 
• What research did Heather discover when she was doing her PhD in queer theory? 
• Heather describes what post-structuralism is. 
• We are a byproduct of the culture we live in,
  
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Sasha and Stella answer listener questions… again! They start by highlighting recent episodes inspired by listener feedback. Next, they discuss the financial implications and complexities involved in adult children using their parents’ medical insurance. They reflect on the different roles that can emerge between mothers and fathers of gender dysphoric youth. Other questions address the similarities between body dysmorphia, gender dysphoria, OCD, and other ruminative anxieties.

Links:

Activist Perspective on Body Dysmorphia & Gender Dysphoria 

Austenhartke.com/blog/2015/5/19/o08szlrrhc8jaasya9s285qenydpy6

Homosexual OCD: 

Centerforanxietydisorders.com/treatment-programs/obsessive-compulsive-disorder/hocd/

Trans OCD: 

Treatmyocd.com/blog/transgender-ocd-symptoms-and-treatment

Aaron Kimberly on Benjamin Boyce: 

https://www.youtube.com/watch?v=vcjBDi-ZRLA

Bryony Gordon, Mad Girl, book about OCD 

Amazon.co.uk/Mad-Girl-Bryony-Gordon/dp/1472232089

Suicidality in Body Dysmorphic Disorder 

Ncbi.nlm.nih.gov/pmc/articles/PMC2361388/

Extended Notes

• A little update on what topics Stella and Sasha have in the pipeline!
• This is the second episode where Stella and Sasha answer listener questions!
• How do you manage the costs of gender? This listener asked her daughter to pay for her own gender medical expenses.
• When does it make sense for parents to accept where their child is in life?
• This parent wants to support her child through her journey, but she also doesn’t want to pay for something she disagrees with.
• If the parent is paying for it, then she should be able to look at the bills she’s paying for. If her child does not want her to see the medical procedures, then she must take ownership of those costs.
• This parent needs to remind her daughter about all the ways she is happy to support her necessities. Basic food, shelter, and safety. How she has done so since she was a child. Sometimes children need the reminder. She also has three other children to consider and it makes sense why she might be hesitant to spend large resources on one when an emergency could happen to another one.
• When do you know you’re enabling your child?
• The fact insurance covers so many of these medical procedures is very shocking. They have an allure that they’re safe to do. They’re not!
• Next listener question! How does a man, who works in a blue-collared field, tell his friends that his son wants to be a girl?
• Stella has noticed that those who attend support groups for their transitioning children, 95% of them are mothers. Where are the men?
• No matter what happens to your child, look after your marriage. You are stronger together.
• Men are often suffering in their own private way. They express themselves differently than women do.
• At the end of the day, the body is real, you’re born with it, and it’s here to stay.
• What is homosexual OCD or transgender OCD?
• This is a bit of a chicken/egg question. Can spending a lot of time on the...
  
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Jungian Analyst Bob Withers joins us to discuss the differences between gay conversion therapy and gender identity conversion therapy.  We examine the possibility of misinformed therapists “transing the gay away” and suggest that perhaps the dark history of conversion therapy may not be over. Bob delves into his view of psychosomatic symptoms and draws on his background in philosophy and medical history to understand our current fixation with one’s subjective sense of identity. Bob also defines what he calls “detrans-phobic” responses to the experiences of detransitioners.

Links:

Winnicott: http://web-facstaff.sas.upenn.edu/~cavitch/pdf-library/Winnicott_PsycheSoma.pdf 

Dr Az Hakeem: 

http://www.drazhakeem.com/publications/

Vsauce Video: The Power of Suggestion: 

https://www.youtube.com/watch?v=QDCcuCHOIyY&feature=emb_title

Safeguard evidence-based therapy for children struggling with gender dysphoria:  

https://petition.parliament.uk/petitions/582083?fbclid=IwAR39py7JJnyxPe_cqQZAIUPBRt5E3wZ4MjvoryWBOdyGjuXVp2qRq0o3YVk 

Transgender Medicalization and the attempt to evade psych distress: 

https://onlinelibrary.wiley.com/doi/10.1111/1468-5922.12641  

The Seventh Penis: towards effective psychoanalytic work with pre-surgical transexuals  

https://www.thesap.org.uk/wordpress/wp-content/uploads/2017/10/Withers-2015-Journal_of_Analytical_Psychology.pdf 

Cambridge Books:  

Transgender Children and Young People: Born in Your Own Body:  

https://www.cambridgescholars.com/product/978-1-5275-0398-4 

Inventing Transgender Children:  

https://cambridgescholars.com/product/978-1-5275-3638-8 

One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria 

https://link.springer.com/article/10.1007/s10508-020-01844-2 

Extended Notes

• A little bit about Bob and his work. 
• Bob met a biological man, now a woman, who wanted to detransition. He realized that becoming a woman did not solve his psychological problems. This was in 1990. 
• Bob’s work would later spark a new set of clients and now Bob sees parents and gender dysphoria teens. 
• How were the narrates about gender different back then? 
• Bob’s first detransition client was attacked and vilivided by the community. He tried to write books about it, but the only way to get the bullying to stop was to say he made up the whole thing. 
• This was the first time Bob saw de-trans phorbia. 
• We know the mind through introspection, but we actually know the body
  
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As they wrap up their initial Behind the Curtain series , Sasha and Stella discuss important issues surrounding the termination of therapy. How do we know when the therapeutic process should end? Does a resolution of gender dysphoria mean it’s time to end the therapeutic relationship? Does the start of a medical transition indicate a good time to end? And how can therapists leave the door open for a client who may want to return at a later date?  

Extended Notes

• ● When a long-term client leaves. It can be a bittersweet moment.
• ● If the therapy process is working well, the client should be proactive in how they’re building new connections.
• ● Therapy is a lot like riding a bike. You are a little wobbling and then, next thing you know, your training wheels are off!
• ● What do you do when you have a client who has resolved their issues around gender identity, yet other issues are cropping up?
• ● Upon the discovery of certain deeper issues, some clients realize that they cannot trust themselves.
• ● Sasha has seen her clients feeling ashamed for their prior thinking.
• ● Some of Stella’s clients wished the whole event didn’t happen. Well, it did. Let’s forgive ourselves a little.
• ● Sometimes what feels like progress and going forward can also sidetrack you and you find yourself going completely sideways. Life gets us like that, but therapy helps us process these changes in a healthy way.
• ● The goal in therapy is not to just help them de-transition. The goal is to help them find the right answers for themselves.
• ● When is it time for a client to leave?
• ● What do you do when you, as a therapist, make a mistake?
• ● Sasha has a lot of her thoughts and opinions online. There have been times clients have read that and disagreed with her, and if the relationship hasn’t been built, this can really hurt progress.
• ● Stella knows it’s ended badly when the client is always on her mind and she’s rethinking of ways to better handle the situation.
• ● Stella is curious to know if people “relapse” with gender the same way people might with food disorders.
• ● Stella has noticed people talking about their feelings of transitioning as if it were a drug.
• ● It can be so frustrating to see a patient not make progress, yet they still keep coming. There must be something there.
• ● Stella also worries for younger patients who use therapy as a crutch. She doesn’t want to create chronic patients.
• ● What do you do when you feel it’s time to terminate the client relationship, but the client still wants to keep going?
• 
  
• This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:
• Rethinkime.org
• 
  
• Learn more about our show: Linktr.ee/WiderLensPod

Marcus and Sue Evans both worked as clinicians in the Tavistock Centre in London for many years. Noticing red flags since the early 2000s, Sue was the first whistle-blower in the Tavistock Centre and Marcus resigned as its governor because the concerns raised by therapists, parents, and managers were systematically dismissed. Marcus and Sue have recently released their book Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults. They join us to discuss the tasks of adolescents, family dynamics, and how important it is to explore questions about gender dysphoria as part of a more holistic approach to clinical care because nobody yet has all the final answers.

Links:

Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults

Authors: Susan Evans and Marcus Evans

Firingthemind.com/product/9781912691784/

“Freedom to Think: the need for thorough assessment and treatment of gender dysphoric children” by Marcus Evans 

Cambridge.org/core/journals/bjpsych-bulletin/article/freedom-to-think-the-need-for-thorough-assessment-and-treatment-of-gender-dysphoric-children/F4B7F5CAFC0D0BE9FF3C7886BA6E904B

“First do no harm: A new model for treating trans-identified children”

Quillette.com/author/susan-evans/

Interview with Marcus Evans:  

Quillette.com/2020/01/17/why-i-resigned-from-tavistock-trans-identified-children-need-therapy-not-just-affirmation-and-drugs/

Sue Quoted in the Guardian:  

Theguardian.com/society/2020/mar/01/families-divided-tavistock-nhs-gender-clinic-judicial-review-goes-ahead

An overview of the Judicial Review and court decision about puberty blockers 

Transparencyproject.org.uk/bell-v-tavistock-in-the-high-court-an-explainer/

Extended Notes

• How did Sue get into gender dysphoria?
• Being involved in this work for many years now, Sue was concerned that children were being medicalized too quickly.
• It is clear that there needs to be more research in this area and the subject needs to be understood more before we prescribe children with puberty blockers.
• How did Marcus get into gender dysphoria?
• In 2006, Sue and Marcus were raising clinical concerns about the effects of puberty blockers. It was tough. Their opinions were unpopular.
• Marcus retired in 2018 and became a staff governor. He received a letter from 10 parents that were concerned that their children weren’t psychologically examined properly for their gender dysphoria. They felt the whole process was too rushed.
• After digging deeper into the issues, Marcus felt he had to resign because he disagreed with how his organization was handling the issue. He was terrified his career
  
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Sasha and Stella continue their series which peers behind the curtain of depth work with gender-questioning clients. Today, they weave in philosophy and psychology to discuss the importance of authenticity, happiness, and connectedness. They also explore the value of art in the slow evolving process of an emergent Self.

Links:

The Catcher in the Rye: https://www.goodreads.com/book/show/5107.The_Catcher_in_the_Rye  

The Bell Jar : https://www.goodreads.com/book/show/6514.The_Bell_Jar  

Taxi Driver: https://en.wikipedia.org/wiki/Taxi_Driver  

The Scream: https://en.wikipedia.org/wiki/The_Scream  

Raised by the Village (with Stella O’Malley): https://www.rte.ie/tv/programmes/1076971-raised-by-the-village/ 

External Locus of Control: https://link.springer.com/referenceworkentry/10.1007%2F978-1-4419-1005-9_250#:~:text=Definition,luck%2C%20chance%2C%20or%20randomness.  

Extended Notes

• How do you “break the ice,” as it were, with a gender-questioning teen? 
• Sasha and Stella noticed that a lot of these children don’t have “joy” in their lives.
• What does it mean to be authentic?
• So many teens feel different from others and they feel like no one else understands the feelings they’re going through.
• A lot of gender-questioning teens are asking very common existential questions. It often shows up everywhere, really.
• Sasha often likes to ask what are some of the common triggers to her client’s gender dysphoria. The answers are very interesting and insightful.
• Going from a child body to an adult body is very jarring.
• If a child is experiencing same-sex attraction, therapists really need to slow down in this process and explore.
• Everybody says they’re pro-LGBTQ, but they just don’t want it for themselves.
• There is a lot of bullying going on in schools when someone is gay or a lesbian — a lot of bullying.
• It’s one thing to say you’re okay with it, but it’s quite another to be experiencing same-sex attraction physically.
• Sasha works a lot with helping her clients find their own voice that’s not a reaction towards their parent’s wishes.
• When parents are so adamant about what the “right thing” is for their children, the children end up doubling down even further.
• Sasha loves to do these “gender timelines” to help the child see how their views change over time.
• Stella really likes to go “behind the label.” Yes, they’re calling themselves certain things, but let’s dig deeper as to why.
• Some children also have a hard time accepting their very “ordinary” selves.
• Let’s explore internal vs. external locus of control.
• Young people have been sold this idea that they can control how other people perceive them.
• Stella likes to encourage her clients to develop their own sense of style. Not develop a style based on “what they think it means to be trans.” What her clients come up with is often very freeing.
• Stella is also curious to understand whether medications are suppressing libidos and this means young teens feel like they have to...
  
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After the therapist has laid the foundations of therapy and established a trusting relationship, the process moves into the middle stage. This is the meat of the therapy! In this episode, Sasha and Stella explore the dynamics that can elicit change in the individual. They consider the curious vs. fixed client, self-esteem issues, broadening the client’s focus, and how to speak meaningfully about gender in therapy.

Links:

The Importance of an Unhappy Adolescence: Youtube.com/watch?v=zcUI1Hk0GRU&feature=emb_title

Gender Care Consumer Advocacy Network: Gccan.org

Extended Notes

• What’s the true job of a therapist when a parent brings their gender-questioning teen in for counseling?
• Timing is important when approaching therapy. Both Stella and Sasha keep phrases and viewpoints their teen is saying in their back pocket to bring up for exploration at another time.
• If you’re not careful, it can turn into a “gotcha” moment for your client. You want to avoid that.
• Teens have very harsh inner voices and, as therapists, it’s important to look into this in a gentle way.
• A lot of adolescents understand the importance of their mental health, which is why they’re so critical of themselves when they don’t have happiness. It’s a vicious cycle.
• Whenever there’s an outburst, people might be dismissive and say, “Oh you should talk to your therapist about that.” Although true, there are better ways to reassure a child that their emotions are perfectly normal.
• Parents don’t like to reveal some of the bad things that happened to them throughout their life, but sharing some of these experiences with their children really humanizes them.
• When you don’t divulge information, you make your relationship colder. By sharing information and life experiences, you create a deeper friendship.
• People love to throw out diagnoses left and right, but sometimes these are just children going through normal teenage things.
• Stella shares an interesting pattern that happens with her clients when they go from gender distress to seemingly being fine, and then back to gender distress.
• As a therapist, it’s important to position yourself as someone who explores unknown questions together with your client.
• It’s important to think big picture and dive into what else is going on in their life and not just focus on the teen’s specific gender issue.
• Teens have reported that social media causes a lot of distress and time wasted. Too much time on these platforms causes them a lot of mental health issues.
• As therapists, it’s also important to show the client how they can find their strong voice and say no to things that aren’t serving them or causing them distress.
• What is the sexual self? How do you define it?
• Therapists need to not hurry this process. A strong relationship can develop over years and so there’s time to explore challenging subjects pieces at a time.
• The political narrative around puberty blockers is not matching what Stella and Sasha are seeing in their clinic, is it because they have a more biased cohort?

This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:

Rethinkime.org

Learn more about our show: Linktr.ee/WiderLensPod

This is the first episode in a short series which takes listeners behind the scenes of a gender exploratory therapy process. Although there has been plenty written about Gender Affirmative Therapy, very little has been written about a concept often described as Gender Exploratory Therapy. Sasha and Stella discuss the specifics of establishing a therapeutic alliance when a person is questioning their gender identity. They describe different strategies involving issues such as names, pronouns, clothes and hairstyles and reflect on the different stages of therapy, which they’ll discuss in subsequent series episodes.  

• Anastassis Spiliadis: ‘Taking the lid off the box’: The value of extended clinical assessment for adolescents presenting with gender identity difficulties 

 https://journals.sagepub.com/doi/abs/10.1177/1359104518825288  

• Sasha Ayad: How do I work with gender questioning teens: https://gdworkinggroup.org/2018/11/12/how-i-work-with-rogd-teens/  

• Sasha Ayad, Stella O’Malley and Lisa Marchiano: ‘Effective Relationships and Clinical Relationships’ https://youtu.be/Sy1VuuN6V2g  

In today’s episode, we begin to answer some of the many questions sent to us by listeners.

Can we be born in the wrong body? Do parental role models influence children to reject or seek transition? What is the impact of a trans partner on a teenagers’ sexuality? How do siblings of trans people experience these changes in the family?

Listen in to see if your question was answered and how Sasha and Stella plan to explore these topics in future episodes.

Links:

TED Talks — “Own Your Face” Happiness isn’t found in your appearance:

Youtube.com/watch?v=QbxinUJcLGg&feature=emb_logo

“My Philosophy for a Happy Life”:

Youtube.com/watch?v=36m1o-tM05g&t=1s

My Left Foot Film: Imdb.com/title/tt0097937/

The Crying Game: Imdb.com/title/tt0104036/

Dr. Lisa Diamond: Youtube.com/watch?v=m2rTHDOuUBw&t=5s

Extended Notes

• Thank you so much for sending your questions! Let’s talk!
• Born in the wrong body? How is that different from those with disabilities?
• What does it mean to be in the “wrong body”? Stella and Sasha discuss.
• You cannot let yourself be defined by your disability or your abnormal face.
• Stella asks some interesting questions about people who undergo drastic cosmetic surgery.
• Is it the new normal to just drastically change your appearance?
• Sasha shares interesting cosmetic surgery trends that we’re now seeing in our society.
• How do you really know you’re born in the wrong body vs. just being unhappy with your body?
• Next question! This listener’s teenage daughter is dating a girl that identifies as a boy. This mother has some questions on what this all means.
• This listener is curious if her parenting style has had an impact on her daughter’s rebellious tendencies to reject her own gender identity.
• It’s normal for a daughter to not be a carbon copy of the mother.
• Don’t blame yourself for your daughter’s gender identity.
• Parents often put their own needs on the backburner when they have a child.
• Next question: How do you talk to siblings about their gender dysphoria?
• Birth order is important. Was the child who is transitioning older or younger? This can affect siblings differently.
• Parents are trying so hard to give their resources to their trans child, but siblings are sitting on the sidelines keeping their questions to themselves because they see how much conflict this is giving everyone.
• Listeners share some of their favorite episodes, and even ones they’ve shared with their children.
• Sasha and Stella share some upcoming episodes that they have in the works right now!

This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:

Rethinkime.org

Learn more about our show: Linktr.ee/WiderLensPod