Gender Identity Counselling

Gender identity counselling can be beneficial to clients who may refer to themselves as: Transsexual, Transgender, Trans, etc. as well as those who do not feel comfortable with any label.

The majority of people are reasonably content with the gender label – “male” or “female” – which is assigned to them at birth based on their physical characteristics, and with the role which this gives them in their family and in the world at large. This is usually the case even if their sexual orientation is gay, lesbian or bisexual. A significant minority however are not comfortable with their given gender label: they feel, sometimes from a very early age, that they are “in the wrong body”. This condition has been given the medical description of “Gender Dysphoria”, which is to say unhappiness with gender. For those with this condition the only available solution, from a medical perspective, is treatment with hormones and surgery to bring their body into conformity (in so far as it is possible) with their inner psychological reality.

Unfortunately however the situation is often far from straightforward. For one thing if you have been labelled as, say, “male” you will have been brought up and “trained” from birth (some would say that the training begins even before birth) to be a male. No matter how uncomfortable this may have felt it will have had a powerful effect on how you experience and deal with the world, and on how you expect it to treat you. The same is obviously true for someone labelled as female.

Next you will probably have been producing hormones appropriate for the body you were born with, not for the true psychological gender that you alone may know about. These hormones also have a lasting effect on you and the older you are before you start treatment the greater their effect will be.

Cross dressing (transvestism) may be simply a sexual preference, a means of expressing another side of your personality, or it may be an expression of a deep inner need to change gender. In our society however some people feel a sense of shame about cross dressing, and this can cause confusion about why they are doing it.

For others the situation is complicated by sexual orientation issues. Sexual orientation is about how you relate sexually to others whereas gender is about how you identify yourself. These are quite separate issues but they can easily become tangled together for someone who is gender dysphoric. For example if you are living as a heterosexual in your assigned gender what will happen after your gender reassignment treatment? Will you maintain the same sexual preference and would that mean that you would become gay or lesbian? Or would you expect to switch your preference and remain as a heterosexual in your new gender? There are many variations on this theme and endless scope for confusion and suffering. Possibly even more worrying than what you may want from future sexual relationships might be the impact on any current relationship.

Finally, depending on your parents’ attitudes and the schools and social environment you have grown up with, you may well have protected yourself by keeping your feelings about your true gender identity secret. After years of secrecy it can be very difficult indeed to begin to talk about it, and if anything is to change for you this is going to be necessary sometime.

The purpose of gender identity counselling is to provide a safe time and place for you to explore these and any other issues, and to help you to gain clarity about your unique identity and experience. My function as a counsellor is not to give advice (although I may give information if asked and if I have it), but to facilitate this exploration and to give emotional support through what may be a very difficult and painful journey.