Dear Everyone: Letters on Being TGNC

I sit in my office with my client. She tells me she feels fragile. After months of planning, she finally told her family that she is transgender. It was over the phone. They were mostly supportive. They suspected such a conversation might be coming. They also had a lot of questions. Her sister said, “Well, at least you live in San Francisco. We know you will be safe and accepted there.”

She tells me that last part and her voice breaks. I don’t know whether to laugh or cry for her. She leads with tears. “Yes, I live in San Francisco, but I have had three bladder infections this year because I’m terrified of going to the bathroom at work. I’m not sure which to use and I’m scared of what someone might do if I use either one.”

While the rest of the country may imagine it’s easy to be transgender in San Francisco, “easy” is a relative thing. Living as an out transgender person — especially if you do not pass as male or female — does not mean living without fear, harassment, or worry. Sure, it may be better than living in North Carolina, but it’s no picnic to be transgender on the street or in the office, even if you have a supportive community. It can be much worse for people of color or those living with a disability.

Meanwhile, I’m having my own challenges, in the form of administrative headaches. I have written four letters this year. This missive is going to be number five. I tried to complete a member profile on two Bay Area Psychological Association websites and part of the required information for my profile was that I had to choose male or female. I tried not to choose either one but the systems would not let me progress further. There was no “other” (although what could be more “othering” than having to identify one’s self as “other”?). I wondered why I was able to specify that working with transgender and gender non-conforming people was one of my practice specialties, but I wasn’t able to identify myself as anything but male or female? What about clients who might turn to such psychotherapy directories to find a transgender or gender non-conforming clinician? I suppose they can only choose a male or female therapist too.

This experience was replicated when I tried to sign up for a Continuing Education class at a graduate school. In order to take the class, I was forced to identify as male or female. My skin felt prickly and I felt a wave of nausea. They wanted my date of birth too. Why would I need to identify my gender and give up my birth date just to take an ethics class? That wound up being letter number three.

All of these letters were replied to and people did something to make changes. Either the question was no longer made mandatory and one organization added more gender options. But I wonder how many people before me didn’t have the stamina to reach out and complain? How many people picked the wrong gender because they had already paid dues and they just wanted to have the same membership benefits of other members without having to set aside time to choke back anger and write a polite email to the organization? Maybe they were busy with other important things. Writing these letters is fatiguing and upsetting. Of course, the pain of writing these letters pales in comparison to being arrested for using the restroom  or walking down the street fearful of being harassed, raped, or beaten.

My fourth letter was when I had the same issue occur on the American Psychological Association’s website. This is our national organization which spent money to put together a Task Force to develop Guidelines on Working with TGNC people. What a wonderful piece of work! But if you want to be listed in their Psychologist Locator, you can only identify as male or female. Maybe they forgot to read their own Guidelines?

It is wonderful to live in a sanctuary city. It’s great that mental health organizations are taking steps to provide guidelines for treatment and research with gender diverse individuals. But it seems hollow when our organizations support developing competence to treat diverse populations but continue to indicate their belief that no psychologist could also be nonbinary themselves.

I would like this to be my last letter.

One Response to “Dear Everyone: Letters on Being TGNC”

  1. Lily Thompson

    Great post Dr. Kolmes. Transgenders typically have to cope with great anguish. It’s estimated that over 40% transgender people have attempted suicide, a rate that’s 9 times higher than cisgender Americans. The stigma associated with the term has driven people to consider ending their lives. And, the lack of emotional support makes the situation worse.


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