How the process of change in therapy mirrors the process of transgender people’s journeys.
The further I’ve progressed in my journey as a trans woman, the more uncomfortable I’ve become with some of the language around this process. Reflecting on it I realise that a lot of it is because much of the language around being a transgender person does not align with my own experience of the process, beginning with the word transition itself.
A transition implies a change or a shift from one state to another. In the case of transgender people, this is often framed as a shift from one gender to another as the now outdated but still regularly used terms ‘male-to-female’ and ‘female-to-male’ suggest. But the suggestion that trangsender people ‘used to be’ one gender and are now (or are now becoming) another doesn’t resonate with many trans people I speak to, and certainly doesn’t resonate with me. Now that I know what it is like to actually feel and experience myself as being a woman it’s blindingly obvious that I was never a man in any meaningful sense of the term. I certainly never felt like a man, never experienced myself as a man. I could say any number of other things though. I could say that people perceived me as a man, that my body looked like a man, that I was pretending to be a man, that I got very very good at tricking people into thinking I was a man, even myself at times. But I never was one – not to myself, only ever to others. So what then does it mean to transition?
That’s a question I had to grapple with when friends and loved ones expressed to me a sense of loss, a need to mourn for the person they had known by a different name, or questions about what they should do with the memories they had of times when I appeared to be a man. At first I didn’t really know how to answer. I was grappling myself with how to reconcile the fact that I knew I hadn’t changed, that the person I was now was the person I always was. And yet that person was claiming a different name, a different identity. What was I to make of the past, of that person I appeared to be? Was that person dead as the phrase ‘deadname’ implies? Did they ever exist at all or were they just a total fabrication, a mask I wore to conceal my real self?
With time to think about it the more the process of coming out as transgender resembles to me the process that clients go through every day in therapy. A process that is sometimes also framed as a transition of sorts – that someone comes to therapy with something ‘wrong’ with them and transitions from being unwell to well, mentally ill to mentally healthy. But what I see in therapy over and over again and what I see in my transition is something much more akin to a shedding of things that were never part of the self. A process of becoming oneself, and an embracing of something more authentic and genuine in the self. Not a transition from one state to another.
The issues that so often bring people to therapy are regularly framed in terms of illness or dysfunction: depression, anxiety, addiction, ‘anger’ issues, personality disorders and so on. And yet – with the exception of certain conditions that we know have a largely neurological or biological basis – most commonly these issues arise because of a person having developed coping strategies or defence mechanisms that they believed were protecting their core self. A self that they have experienced as unlovable, wrong, inadequate or fundamentally flawed in some way. Those coping strategies often take such a toll on us that they lead us to developing the problems that may bring us to therapy.
For example if we believe ourselves unlovable, flawed, broken, or inadequate then it follows that we don’t want that seen by others, because then we would be rejected entirely. And so we find ways of making ourselves acceptable based on what we believe others want us to be. Happy, helpful, patient, hard-working, high-achieving, uncomplaining, un-needy, selfless. Or maybe a man, or a woman. We might all choose a slightly different flavour of this but we’re all likely to latch on to certain ideas about what we need to do, how we need to behave, and how we’re supposed to appear in order to be acceptable in the world. Not acceptable as a person, but acceptable for the functions or the roles we can fulfil.
And as we make ourselves ‘acceptable’ by behaving in the right way and doing the right things we get approval, praise and validation from others. People who appreciate us for what we do. But never for who we are. Often we don’t even allow ourselves the possibility of being accepted for who we are because we never allow anyone to know us that deeply out of fear that we will be rejected. No matter how much acceptance, validation and confirmation we get, we never develop a stable sense of being acceptable or lovable because we’ve built up an expectation in ourselves that our acceptability is based on action and performance. Not based on our just existing as a person. It’s a conditional sense of worth, not an unconditional one.
So often the cost of this is that we develop the symptoms that bring people to therapy. We snap and lash out when we can’t keep up the sacrifice of ourselves for others or we turn to distraction, or addiction. We experience anxiety because we live in constant fear that if we stop doing, stop getting it right, our acceptance by others can be withdrawn at any time. We develop depression because we spend our whole life trying to make things look right because we don’t believe we can ever be right, and so we create lives that bring us no joy. We strive for a point of comfort or stability or happiness or acceptance that can never come because the structure itself is based on conditions we can never fully satisfy. Which means that we can never rest, never be at peace in ourselves because to stop would be to risk losing the conditional acceptance that we’ve achieved.
In the course of the therapy with a woman who wants to overcome alcoholism we might discover that a deep sense of feeling inadequate leads to trying to overperform at work in the belief that achievement and success will finally give her a sense of worth. The burnout from this causes her to drink as a way to deal with the stress or to escape from the hyper-critical parts of her mind. The process of therapy then becomes not so much focused on ‘fixing’ the problem of ‘alcoholism’, but on enabling her to understand and accept herself as being lovable as a person, regardless of her levels of achievement or success. It becomes a process of helping her to connect to her authentic self, to what she truly believes and values separate from the patterns that have ruled her life and which have been driven by an underlying belief that she will only be acceptable for what she can do or what she can achieve.
A man who comes to therapy experiencing deep shame around his sexuality from growing up in a deeply religious household might come to understand that the fear of his sexuality being known stems from a deeper fear that he would somehow be exposed as being unlovable as a person. That his pattern of hiding his true self out of a belief that it will keep him safe has actually sustained the belief that he is unlovable because it has prevented him from ever having someone truly accept or love him. Again, if the therapy is successful we see a shedding, a letting go of patterns of behaviour that were believed to be helpful but which in reality kept him imprisoned.
My ‘transition’ feels much the same. In many senses I am not changing from one gender to another, I am not transitioning from one person to another. I am simply letting go of internal systems and ways of thinking, feeling and acting that I used to see as necessary for survival but which I realise now do not benefit me at all. The person I used to be, that went by a different name – that’s still who I am, just now without the layers of masking, pretense, repression and denial. Those memories that I was a part of – I was still there, still the person I am now, just not quite so present as I am these days. I was doing my best to be there but the internal systems that told me what I needed to do be acceptable – how I had to act, to appear, to behave – got in the way of being able to just live my life.
The change that others see in a person who is becoming more themselves can cause discomfort for those around them. The woman who no longer feels she needs to work 110% to be acceptable gets pushback at work if she stops doing so much overtime. The child who no longer ‘keeps the peace’ at family gatherings because they had felt their worth was tied to that role gets criticised for rocking the boat. The father who stops masking his unhappiness by pretending to be cheerful for the sake of the family has people around him assume he is falling apart or isn’t coping, even though the feeling was there all along. And the trans person who decides to start living as themselves has people lamenting that this ‘change’ is painful or a loss for the people around them. But none of these changes are someone becoming something new, someone they were not – they are simply the process of someone becoming more themselves, more the person they have always been.
The pain and discomfort that this can cause for others is real and understandable. For those witnessing what seems like a change there may absolutely be a sense of loss and a need to mourn and adjust. Those feelings are valid, and they are okay – so long as they’re not used to try and prevent someone from becoming who they need to be. If a person needs help adjusting to a loved one’s ‘transition’, they should absolutely seek it – just not too much from the person making the transition.
The word transition makes sense for people outside the process because it can appear as if someone has changed from who they were before to who they are now, but it does not sit well for me because I am not becoming something different: I am simply, finally, being me. It only looks like a transition because I never allowed myself to be who I am in the first place.
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