Picture of trans pride flag. Text over the image reads Working with Trans Clients: Trans Resilience and Gender Euphoria An interview with Beck Gee-Cohen, MA CADC-II

Working with Trans Clients: Trans Resilience and Gender Euphoria

An interview with Beck Gee-Cohen, MA CADC-II, about how therapists can be better clinicians for trans people. Curt and Katie talk to Beck about gender identity (and why every therapist should do their own work around gender), historical perspectives on masculinity and femininity, the concepts of trans resilience and gender euphoria, the real problems with the DSM diagnosis of gender dysphoria and considerations for providing therapy to trans clients.

Transcript

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Interview with Beck Gee-Cohen MA CADC-II Director of LGBTQ+ Programming

Picture of Beck Gee-Cohen MA CADC-II Director of LGBTQ+ ProgrammingBeck is a master’s level clinician with an undergraduate degree in Sociology with an emphasis on Gender & Sexuality and a master’s degree in Addiction Counseling. Beck has worked in the mental health & substance use field for over 10 years in various capacities. The main focus of his work has been invested in the LGBTQ+ community, adolescents, and families. Over this decade, Beck has trained numerous facilities on LGBTQ+ best practices, has been a keynote and presenter at many conferences, and has facilitated workshops about LGBTQ+, trauma, adolescents, gender and sexuality. Beck is the Director of LGBTQ+ Programming at Visions Adolescent Treatment Center. This program is for young people at Visions who identify in the community, those who are questioning, and their families. It includes process groups, psychoeducation, and family programming with professionals specifically trained and experienced in the LGBTQ+ population and best practices. Alongside the already dynamic team at Visions Adolescent Treatment Center in Los Angeles, young LGBTQ+ people and their families will find a space that serves their specific needs in regards to healing and thriving.

In this podcast episode we talk about trans mental health

We invited Beck Gee-Cohen, MA CADC-II to come talk with us about providing therapy for trans individuals.

Modern therapists need to keep learning when working with trans clients

  • Getting pronouns correct is a basic expectation at this point
  • Finding the balance between focusing on a client’s trans identity and other elements of their identity and experience
  • Understanding trans identity 101 is a basic level of knowledge that all therapists should have
  • What you do need to learn from your trans clients
  • Therapists need to do their own work around gender

The work that therapists must do around gender

“Sexuality and gender should be discussed across the board for everyone” – Beck Gee-Cohen, MA CADC-II

  • The role that society plays in defining gender and the binary
  • The privilege cis folks have in not being asked to assess/address their gender
  • “Women’s” and “men’s” issues
  • Societal expectations related to gender
  • The history of gender expression and how what is acceptable has shifted
  • Cultural and generational differences related to gender

The Concept of Trans Resilience

“I came out as an act of survival” – Beck Gee-Cohen, MA CADC-II

  • The tendency to focus on the pain of being trans
  • The bias and hate that trans folks face, and how they continue to show up
  • The importance of celebrating who you are as a trans person
  • “You’re so brave” doesn’t see the full picture
  • How hard it is to show up – and what it means that trans folks continue to do so
  • Moving away from just focusing on gender dysphoria versus looking at gender euphoria

Gender Dysphoria versus Gender Euphoria and the problems with the DSM

“You don’t have to hate yourself to be trans. That’s actually a false narrative given to us by the DSM… I’m not dysphoric about my gender. Everyone else is dysphoric about my gender… so the gender dysphoria is actually internalized.” – Beck Gee-Cohen, MA CADC-II

  • How the DSM is used for the medical needs of trans folks
  • The problem with assigning the diagnosis of Gender Dysphoria to an individual
  • Internalized gender dysphoria (it is not my dysphoria, it is the dysphoria of the people around me about my gender)
  • Playing around with gender shouldn’t be a diagnosis, it is so culturally bound
  • Trans individuals have to know what to report so they can get hormones (i.e., they may have to lie about being dysphoric in order to “check the boxes”)
  • The problem with gatekeeping and the hope that trans folks being in work groups to help shift these guidelines

Better Therapy for Trans Clients

  • Therapeutic alliance is the most important
  • How therapists can appropriately use vulnerability when a client comes out as trans
  • The likelihood of someone coming out initially versus after trust is built and how to handle it
  • Sharing the therapeutic process and how you will learn and educate yourself
  • The problem of signaling that you are capable of working with LGBTQ+ people when you are not trained
  • Awareness of how being trans impacts the client in front of you
  • When the client is coming into therapy due to their gender identity
  • Understanding the back story and how someone identified that “something is different”
  • Looking at what they want to do next (which may be very little or a full plan on how they handle being trans).

Our Generous Sponsor for this episode of the Modern Therapist’s Survival Guide:

Buying Time logo

Buying Time LLC

Buying Time is a full team of Virtual Assistants, with a wide variety of skill sets to support your business. From basic admin support, customer service, and email management to marketing and bookkeeping. They’ve got you covered. Don’t know where to start? Check out the systems inventory checklist which helps business owners figure out what they don’t want to do anymore and get those delegated asap. You can find that checklist at http://buyingtimellc.com/systems-checklist/

Buying Time’s VA’s support businesses by managing email communications, CRM or automation systems, website admin and hosting, email marketing, social media, bookkeeping and much more. Their sole purpose is to create the opportunity for you to focus on supporting those you serve while ensuring that your back office runs smoothly. With a full team of VA’s it gives the opportunity to hire for one role and get multiple areas of support. There’s no reason to be overwhelmed with running your business with this solution available. Book a consultation to see where and how you can get started getting the support you need – https://buyingtimellc.com/book-consultation/

Resources for Modern Therapists mentioned in this Podcast Episode:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

Bgcbridge.com

beck@bgcbridge.com

Tiktok: transandtrying

Tiktok: visionsteen

WPATH – Standards of Care guidelines

Alex Iantaffi: Gender Trauma and Life Isn’t Binary

My New Gender Workbook: A Step-by-Step Guide to Achieving World Peace Through Gender Anarchy and Sex Positivity by Kate Bornstein

Dara Hoffman-Fox: You and Your Gender Identity: A Guide Book

Two Spirits, One Heart: A Mother, Her Transgender Son, and Their Journey to Love and Acceptance by Marsha Aizumi and Aiden Aizumi

Relevant Episodes of MTSG Podcast:

Interview with Dr. Abigail Weissman: Vulnerability, The News, and You

When is it Discrimination?

Work Harder Than Your Clients

Who we are:

Picture of Curt Widhalm, LMFT, co-host of the Modern Therapist's Survival Guide podcast; a nice young man with a glorious beard.Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Picture of Katie Vernoy, LMFT, co-host of the Modern Therapist's Survival Guide podcastKatie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

http://www.mtsgpodcast.com

http://www.therapyreimagined.com

https://www.facebook.com/therapyreimagined/

https://twitter.com/therapymovement

https://www.instagram.com/therapyreimagined/

Consultation services with Curt Widhalm or Katie Vernoy:

The Fifty-Minute Hour

Connect with the Modern Therapist Community:

Our Facebook Group – The Modern Therapists Group

 

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano http://www.crystalmangano.com/

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Curt Widhalm  00:00

This episode of the modern therapist Survival Guide is sponsored by Buying Time.

Katie Vernoy  00:04

Buying time has a full team of virtual assistants with a wide variety of skill sets to support your business. From basic admin support customer service and email management to marketing and bookkeeping, they’ve got you covered. Don’t know where to start, check out the system’s inventory checklist, which helps business owners figure out what they don’t want to do anymore and get those delegated ASAP. You can find that checklist at buying time llc.com forward slash systems stash checklist.

Curt Widhalm  00:31

Listen at the end of the episode for more information.

Announcer  00:34

You’re listening to the modern therapist survival guide where therapists live, breathe and practice as human beings to support you as a whole person and a therapist. Here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm  00:49

Welcome back monitor therapists. This is the button therapist Survival Guide. I’m Curt Widhalm with Katie Vernoy. And this is the podcast that talks about things that therapists do things that come into our offices, things that we should be aware about. And we are coming to a topic that we haven’t visited here for a couple of years. And we are joined by one of our former therapy reimagined speakers, Beck Gee-Cohen, Director of LGBT programming at visions, and we’re just so glad to have you good people. Thanks for joining us.

Beck Gee-Cohen  01:27

Awesome. Thanks for having me. I’m super grateful to be here.

Katie Vernoy  01:30

We’re so excited to have you. It’s so good to see you again. And I had a wonderful  consultation with you recently. So I just am excited to share this conversation with our audience. Such a good resource, everyone. So anyway, I’ll stop gushing. The first question we ask everyone is who are you? And what are you putting out to the world?

Beck Gee-Cohen  01:53

Which is like the deepest question you could ask. Right from the start? Who am I? What am I putting out to the world. Hope for my community, the trans community to get the things that they need, you know, from therapists to to be heard, to be seen, to be valued. And it started by trying to give a voice to myself, and now you know, to help teenagers to help families.

Curt Widhalm  02:22

We normally start a lot of our episodes asking for learning purposes, what therapists get wrong in working with trans clients. And we say this in a way of helping us catch up to where the world is today and responding to the clients in our offices. And a lot of things end up being out-dated, and especially for those of us who were educated A while ago, things have changed since maybe we have had some basic learning steps. So what a therapist normally get wrong, or what are some old habits that you see,

Beck Gee-Cohen  02:57

The worst thing that we could do is this is the way we’ve always done it. Right. This is how it’s always been. And that’s what I love about the modern therapist, Psych podcast and the you know, that the, you know, the, the essence of the modern therapist is we’re tired of this, right? We’re tired of doing the way it’s always been done, you know, the foundations of therapy were built, you know, on white cisgender men, you know, and and we’re not, that’s not who we are, that’s not who we serve. And so I think what we what therapists get wrong is is just stopping learning, not being open to new ideas, I think, and I mean, I can go, you know, I could go down the line of like, okay, great, like use the right pronouns. Okay, so like, everyone should be doing that by now. Right? Like, that’s, that’s like 10 years ago, I don’t mean to sound snarky in that way. Because that is, that is something that is like a huge, like thing to do, right. But don’t always look at like a person by their pronouns, either. Right? Like, don’t, it’s, it’s like, we’re missing out on like, the people in front of us and more, either overly looking at the trans piece, or we’re like, minimizing it. So it’s like, it’s finding that balance. So sometimes I run into therapists who, like, everything that has to do with them is about them being trans, right? And it’s like, no, like, we also have depression and anxiety and have relationship issues. And we have, you know, all the struggles that, that all of humanity goes through. And, and then also, there’s the other side of the kind of pendulum that says, Well, I work with all people and then being trans doesn’t matter, you know, and it’s like, okay, but you’re not understanding that some of these things that are struggles that they’re having, absolutely has to do with their gender identity and absolutely have to do with their transition or you know who they are in the world. So, I run into therapists that are like kind of one or the other Right, and so like my job and what I like to do, and the conversations that I like to have is like, let’s bring us into the kind of the center, and talk about how we can Yeah, invest our time into their gender and understand it and understand, but not have to learn about gender and sexuality from them, but learn about their gender and sexuality, their personal gender and sexuality from them understanding trans identity, a 101, that is a therapist job, right to learn outside of their client, the nuances of gender, the nuances of, of what’s happening in their lives, we do learn from our clients, going in with curiosity, and conversation and humility is really important. I see a lot of therapists run away from working with trans people, because they just don’t know, while I believe in referring out, there’s not enough like clinicians out there that are working with trans people, I always like to say, part of my story is saying that the woman that saved my life, when I came out to her was a therapist who was really versed in trauma, and really versed in understanding the LGBT community, but she was not part of that community. And she saved my life. And so, you know, so I think that what therapists are getting wrong, just not not doing their own work. And I also like, like to challenge therapists to do their own work around their gender and sexuality. Because if we’re not doing that work, then how are we supposed to even understand some of the things that we struggle with, with masculinity with femininity, and many trans people struggle with that stuff as well, non binary people struggle with that as well. I hate to say that you’re getting it wrong, but what can you do better, right? Curt? No, I’m just kidding. I told you, I was gonna come from a place of positivity today, I’m going going into 2022, with a little positive skepticism.

Katie Vernoy  07:09

So you started talking about this, and I want to get a little bit more specific with one of the things that you had talked about, you know, kind of all clinicians need to be better for trans clients, because trans clients are going to show up on our practice at some point, most likely. And so I think, to me, when you’re talking about therapists not doing their own work on gender, let’s let’s start with that one. I think that society doesn’t necessarily ask that of us. You know, there’s, there’s a binary, you know, there’s pink and blue, there’s these things that I think society really puts on us. And I think this idea of really exploring our own gender identity and sexuality and all those things, especially I’m, I’m old, you know, so, you know, when I grew up, it was pink and blue, you know, and all of that. And so I think it’s something where, to me? What do you mean, when you’re talking about that therapists need to work on their own gender and those issues?

Beck Gee-Cohen  08:15

I love that question. Because I think you’re right, like, right, it’s a privilege to not have to think about gender.

Katie Vernoy  08:21

Absolutely.

Beck Gee-Cohen  08:22

Right. So when you’re walking in the world, and you don’t have to think about it, it’s, you know, that’s a privilege that you have. And I think we actually think about it more than we think we do. And I see, it’s in our face, constantly. And I but I also do think like, once you’re aware of it, right? I think there’s an old parable about the goldfish, right in the water. They go, you know, the goldfish swims out and says, Hey, how’s the water? And they’re like, what’s water? You know, like, they don’t know that they’re, you don’t know you’re in it until you know that you’re in it, right. So I don’t know how that parable goes. But something like that. Y’all can look it up. But I’m not aware until I’m aware is basically what it is. And so, so that’s why I also, like give a lot of leeway to a lot of therapists and people that I work with, where I’m not like, you should know this, because sometimes you just have no awareness. But once you know, then it’s your job to kind of start working on it. So like, I had a therapist come up to me a year after I did a talk. And he was like, you know, you really messed me up. And I was like, Oh, great, you know, what did I do? And he said, Now everywhere I go, I see male and female sides. You know, I see male female girls, boys, you know, pink and blue. Like it was just, I was unaware. And I was like, great. Now you know how I live and many other people live every single day. But we talk about like women’s issues and men’s issues a lot. Right? And, and sometimes even then we’re not even actually aware of that. that actually affects us, right? So when I’m working with like a cisgender, man, so for those, you know, when I say cisgender, it’s someone who is assigned, let’s say, male at birth, and identifies their gender identity as male sis means to be on the same side of so most people are cisgender. But when I talked to cisgender men, I asked them about masculinity, and being a man, and what is that like for you? And if we actually start having the conversation and dialogue about what it is to be a man in the world, you’re going to get a whole lot of different conversations, right? You’re gonna have a different opinions, different, you know, boxes, you know, men are put in a specific box to attain, you know, like, I have to be this way or that way, right. Same thing with women. And so that’s the work that I ask of therapists to do is like, let’s, let’s, what is what does femininity mean to you? What does being a woman mean to you in the world? What is how has that affected you growing up? What did you learn about? You know, you just said, like, you know, I’m old and I grew up with pink and blue, right?

Katie Vernoy  11:09

Sure. Yeah.

Beck Gee-Cohen  11:10

You know, but if you were older, even older, and grew up in the, you know, 1700s, you know, 1800s, you know, Pink and Blue were different. Pink was more masculine, Blue was more feminine.

Katie Vernoy  11:22

Oh, interesting

Beck Gee-Cohen  11:23

Men wore wigs and heels and makeup. And that was a sign of class, right. And so, and the ideas of like, boys clothes and girls clothes for children really came from a marketing ploy where people were having less children. Because if you actually look at like pictures of like, Franklin, Franklin Roosevelt, they were wearing all white, all kids were white, and dresses until they were a certain age, right? So it was a money saver for families who had giant families of 16 kids. Now, you know, in the early 1900s, you know, the history of it, is that people are having less kids. And so then they started being like, Oh, girls, clothes, boys clothes, you know. So if we start to learn the history of that, and we start to learn that, like, clothing doesn’t have a gender makeup doesn’t have a gender. And we start to learn how I was raised to see what femininity looks like, and what masculinity looks like. Because in a lot of different cultures, too, it looks differently. So that’s the work if I look internally, and then if I can look internally and at myself, it’s just like, you know, every therapist should have a therapist, right?

Katie Vernoy  12:33

Yeah!

Beck Gee-Cohen  12:33

.. is that if I start with, note that everyone, you can start to empathize with how difficult these things might be, for a client that is in is it was questioning their gender or transitioning. And you may not know, someone is trans when they come in your office, and you build a rapport with them, and you build a therapeutic alliance, and then they come out to you. Right, and they feel that they trust you. You know, that is your job to continue to work with that. And you can work with them. As long as you you know, maybe you need to seek supervision or whatever. But I think therapists can really do a lot of work on themselves around gender, even if they they’re not trans. Right. I think it’s funny because we only talk about like sexuality and gender when it comes to the LGBT community. We’re actually like, sexuality and gender should be talked about across the board for everyone. I think we would we’d serve us as as therapists and as the world as a whole,

Curt Widhalm  13:34

when we sent over the what should we talk about questionnaire to you, you dropped in this term trans resilience? Can you tell us what that is? And how that plays out? With our clients.

Beck Gee-Cohen  13:47

Sometimes we focus in on the pain of transition a lot. Right? As therapists we concentrate on anxiety and depression, all the hard things, right?

Katie Vernoy  14:02

Yeah.

Beck Gee-Cohen  14:03

Why do people go to therapy? Do people go therapy when they’re super happy, you know, but, but at the same time, I think when I when I talk about trans resilience, and they talk about how we can celebrate identity in the therapeutic space, I think this is a really important piece to helping our clients celebrate themselves and empowering themselves and trans resilience to me means that, you know, we walk through the world, and we walk through all of this stuff that we do, and we we, you know, we get misgendered and we walk through all the messages that say we shouldn’t be here, but we still show up every day. And we still are present in our lives or we try to be and we still show up to therapy, we still show up. And we and I keep saying show up because it’s sometimes it’s so hard to show up. And so To foster that, and to like, empower my clients who are trans is like really like celebrating them and celebrating who they are, and, and walking in their truth and walking in their authenticity. A lot of times people will say, Oh, you’re so brave for doing this. I don’t Thank you. Right? Like, I think, no, thank you. Right. And I know where that comes from. And I also know that like, I came out, because it was like an act of survival. Like, I run out of a burning building, like I was running out of a burning building. Is that brave? No, that’s like, I’m trying to survive.

Katie Vernoy  15:41

Yeah,

Beck Gee-Cohen  15:41

you know, I think bravery is really like going back in and getting people and pulling them out. Right? Bravery is like, you know, showing up again, every day and helping others and all those things. So that mean, I think therapists are brave, right? But for me, it was an act of survival. And so when I talk about resilience is really talking to my clients about, like, you know, you show up every day, you know, as hard as it is you keep showing up and with suicidality, and suicide rates so high in the trans community, you know, for those who are able to survive, I think it’s, I think it’s really important. And I think it’s also really important to like, celebrate, and, like, enjoy being trans, you know, I mean, I’m constantly like, asking them, you know, we’re talking about dysphoria all the time. And I’m like, where’s your euphoria? You know, when you feel good this week? When did someone like make you feel like, you know, when did you like, go put that dress on? Or, or, or get gendered correctly? Or like, like, hold on to those moments, too, because that feels good. When did you look in the mirror? And we’re like, damn, I look good today. You know, like, I feel good in my body. I think therapists you know, sometimes will so hyper focus on like, oh, you you have to hate yourself to be trans. Like you actually don’t. Yeah, actually don’t like that’s that’s a that’s a false narrative that has been given to you by the DSM.

Katie Vernoy  17:09

Yeah, I think I want to actually like there’s so many things I want to go into here. But I think one of the the pieces that feels really compelling to me is this idea of this notion, and you’re calling it gender dysphoria, then gender, euphoria, we’ve heard that as well before, but I think there’s this notion of hating yourself feels like it is already coming from a cis place, a cisgender place, that the self is defined by whatever gender you were assigned at birth. And so talk a little bit more about your feelings about the DSM, because you started to go there.

Beck Gee-Cohen  17:52

I went there,

Katie Vernoy  17:53

I just am curious about how you look at it, because I think most of what we do is based on what society deems normal, and it’s so culturally bound, I loved when you were talking earlier about how gender has been perceived through the years, because I think we feel like well, this is just what it is. And it’s like, well, no, actually, it’s completely culturally defined if we really look at it. But anyway, it’s early, where I’m going all over the place. So let me get to the question. How do you think the DSM harms our efforts toward treatment? Because it seems like it’s framed improperly.

Beck Gee-Cohen  18:28

Yeah. Well, so if I look at like, so again, this is just my opinion, not the opinion of all trans therapists, we’re looking at two things here, right? That the, the DSM in and of itself helps people like having dysphoria as like a, as a diagnosis can help us get hormones and all those things, which is like, you know, if you’re not in an informed state, right, like, you can at least go to the doctor and get your medical needs met. So dysphoria, and you actually actually said it, in what you what you were just talking about is that dysphoria is actually not mine. If I actually look at the myself, like, I am not dysphoric around my gender, everyone else is dysphoric around my gender, right, like, so it the gender dysphoria is actually internalized. And if I look at like, you know, gender dysphoria from the DSM, it actually says the stressors from the outside in, right? And so it’s like, So, am I really dysphoric um, I’m in my internalizing the gender dysphoria that people have placed on my gender, you know, and so, it can be a hard concept to talk to teens about to talk to even adults about because they, like it gets so set on like, No, I’m dysphoric and I have dysphoria, and I chew you know, I struggle with that. But the more I I have this conversation, the more I even dive internally, it’s like, actually, I’m Just internalizing that dysphoria. And so then I feel depressed and anxious because I can’t get a job because I’m seeing in the world is a freak. And you know all the things, right? I’m told that I shouldn’t, you know, play sports, or legislation against me says I can’t play sports, things like that, right? So I’m internalizing everyone else’s stuff. Like when I talk about dysphoria, it’s like, well, what, what are you actually dysphoric about? Right? Yeah, what’s, what do you actually dysphoric about? Well, I want to change my body. Well, a lot of people want to change their body, and they’re not diagnosed with gender dysphoria. Like, you can go to a plastic surgeon and get whatever you want done. But you’re not diagnosed with dysphoria, or any diagnosis, really, I’m not depressed, because I’m trans I’m, I can also just be depressed. I can have depression, if you actually look at the DSM dysphoria in children and adolescents, right? We’re already talking about boys and girls toys, there’s already like this, like, thing around like, you know, gendered toys in they’re already like, these societal cultural stereotypes that are put into the DSM. And so it’s like, children should be allowed to play with gender, and play, everyone should be allowed to play with gender and, and be who they are. It shouldn’t be like a diagnosis. What we see here is that we also see, I talked to a lot of parents, and they say, Well, my kid wasn’t playing with dolls when they were younger. So there’s no way that they could be a girl. Right? Right. And so it attaches, again, like, this gender roles is, you know, stereotypes on to a child, and then it’s like, you know, do I have to like dresses and all these things in order to be a girl? Or do I have to play with trucks to be a boy? It’s like, well, no, not necessarily. Right? So it just, I think we get so honed in on, like, the diagnosis, that we forget the person. And I think that happens a lot in the DSM, we’re just so hyper focused, and in order to get insurance to cover it, or whatever. So yeah, we’re like, Okay, do you do check all the boxes? And if you don’t, right, then maybe you’re not. And so what I’ve run into with a lot of like, even young people, I mean, it’s amazing what you can find out there on the internet, young people know exactly what they need to come in with to share what they need, you know, and, and people know, like, so if I’m not depressed around my gender, so then I have to go into a therapist, and I have to lie, to get hormones, right. And I have to say, Well, I’m depressed, but I’m not depressed. I’m not. I’m not too depressed. Because if I’m too depressed, then you’re not going to give me my hormones. If you’re too if I’m too anxious, or if I’m feeling you know, I’m having suicidal ideations, then, you know, maybe I need medication, I don’t need hormones, right? So I’m gonna lie to you about actually, like, how bad I’m feeling or how good I’m feeling because I need to hit that middle ground. And so you’re already starting off the therapeutic relationship in a lie?

Katie Vernoy  23:18

Yeah.

Beck Gee-Cohen  23:18

How do you build something from there? So if I take myself out of a gatekeeping role, right, if I tell a client, like, I’m not here to tell you who you are, you know who you are, right? I’m not here to tell you who you are. I’m here to like walk you walk through, you know, because I believe in therapy. Don’t get me wrong. Like, I believe in the power of therapy. I don’t believe in it to to gate keep for certain things for telling someone who they are. Right. But I definitely believe in walking through with someone through the changes and shifts that they’re gonna happen through their transition. That’s a big deal. But if you’re starting off, like, with a client just having to lie to you, because they just want a letter from you. It’s like, well, that’s, that’s not okay. You know, that’s,

Katie Vernoy  24:07

it’s not therapy

Beck Gee-Cohen  24:08

person. It’s not therapy. It’s it’s not at all, and it’s actually super harmful. And I’ve seen it harm a lot of people in that way.

Curt Widhalm  24:17

Speaking of letters and organizations, that gate keep, I know that one of the resources out there that people point to in working with trans clients and especially maybe the first times that they’re working on transplants, is Wpath. And there’s some guidelines there that I understand that you’re part of some some groups working on some making some changes over there, too.

Beck Gee-Cohen  24:43

Yeah, so there’s some work groups that are changing some of the Wpath guidelines for teens and so there’s like working groups of actual trans identified providers, which you know, Wpath has, over the years been primarily cisgender people kind of, again, implementing certain guidelines, which, in effect have been helpful, you know, over the years, but I think as we just as, like, we get to understand gender, and as it works in the world, right, we have to shift and move things. And, and, and just as it’s been over the years, you have these really great, amazing people who are allies and who are trying their best. And like, you also have to now have people at the table who are actually, you know, part of this community, and now that there are more providers, more doctors, that are trans identified nurses, therapists, you know, they’re actually bringing more of us on into the conversation. And so, you know, I told Curt before this, I don’t want to, you know, I had some, like, really strong, you know, like opinions, but now like, it’s like, okay, well, yes, of course, right? Like, no, I mean, all this any kind of legislation, any kind of like licensure stuff, like trans people were never at the table. So now that we are kind of stepping up into these spaces, I think we’re going to start to see some great changes happening, hopefully, you know, fingers crossed some changes in how care is given to trans clients, across the board medically, because, you know, Wpath is like mental health, medical, you know, treatment, all of these things. And, and people do go to it, and it’s almost like, you know, well, this is, and it’s taken, I think people who are like, well, this is not, this isn’t still isn’t right, right, this still isn’t right, there still needs to be some changes happening. And so bringing in trans people with experience, I think, is really, really important and valuable. So still go to WPATH still go to, you know, get those guidelines, that should be like, kind of foundational, and if it doesn’t feel right, it probably isn’t, you know, like, if it does, it’s like, this feels a little gatekeeping, right, this sounds a little bit like, you know, like, these kind of hard lines, like, Oh, you have to, you know, you know, it used to be like you have to live as, you know, the opposite gender for a year, you know, in order to get hormones, and you’re just like, what, what is that? You know, what is that about? Like, those kind of guidelines, now, we’ve kind of stepped away from it, but I will still hear that I will still hear therapists using those old antiquated kind of markers of like, being trans, like, you know, because there’s not one way to be trans, there’s not one way to like, walk in the world, right? Not all trans people want surgery, not all trans people want hormones, you know, that’s not all people want to live, like, like as like the opposite. Right? Like, you know, we all lie somewhere somewhere in the middle, some of us so.

Katie Vernoy  27:52

So stepping out a little bit, because I think there’s some nuance to what you’re talking about. But I do know that there are some folks that this may be one of the first stepping stones for them learning about how to work with trans clients. And so maybe just to a very brief because I think people need full on training, and will definitely give you a chance to talk about the trainings that you do, because I think that would be a really good start. And there’s, you know, lots of great resources for letters and all the things but if someone is a general therapist, and they they don’t spend specialized and trans clients, and they have a trans client walk into their office, first off, get supervision, get training, all that stuff. But is there anything because you know, you’re not going to necessarily know tell? You know? And so, what are some advice that you have for for, for clinicians, whose clients who they’ve been working with for quite some time, come out,

Beck Gee-Cohen  28:47

I still believe in that therapeutic alliance is the number one thing for any relationship, if you do that, so there’s there’s two different there’s two different like, I think, scenarios here, there’s the one where the transplant just comes in, right from first time to like, one that you’ve been working with for a long time. So we’ll start a long time one, and that you start, like having this conversation and I think that there’s a really valuable tool called vulnerability that therapists can use in the space where they say, I haven’t had a whole lot of experience working with trans clients before or around gender and, you know, I, you know, and thanking them for, like, coming out, you know, to you, right, because ultimately, you have built that trust because people don’t just, like, come in and be like, I’m trans, you know, like, first I mean, maybe that’s a like, I did that, but I knew that she had worked with transplants before so, but I just needed to say it out loud, but I think like, it’s pretty rare. Um, I think people like wanna, like feel it out a little bit, right and kind of see how they’re, how you’re gonna respond. And and so obviously you’d become that trusted person, so even thanking them, you know, in some way, and then, and then doing the work around it and kind of saying, like, you know, I, I don’t have a whole lot of experience, but I’m, I’m so willing to learn, and I’ll learn outside of here. And I will ask questions. And if you don’t want to answer them, like, I will find out other ways, you know, and just sharing like your process, I think it’s a big, I think, if I were a client, and someone said that, to me, as a trans person, I would feel more connected to my therapist, than someone just assuming that they knew everything, and then being like, you actually don’t know, right, or walking into a therapy room for the first time, and someone has like a rainbow flag up, and has no idea how to work in the LGBT space, right, because they got a rainbow sticker that they said that they should have on their wall to show that they work with diverse clients, you know, like, I mean, like, you know, we see that a lot. And I think that that is that can be dangerous, because like I let my walls down, because I’m looking for safety. So I may let my walls down, and then then find out like, oh, you actually have never worked with a transplant before. And you actually have no training. And so, so if you, like were a therapist, and you had a client just walk in the door and say that they were trans, you know, that’s a conversation that either you’re gonna have to have with a supervisors, and also, again, being honest from the start and saying, I’ve never worked with transplants before, but I have some training. And I Oh, you know, and I’ll, you know, seek that out. And I think a lot of us, for those of us who are trans seek out therapists, like, I’m going to, I don’t automatically seek out trans therapists, like trans identified therapist, probably because I know all of them personally, in some way, shape, or form. So it makes it tough. And I’m in that space right now. Um, but I’m looking for, you know, like, I will, you know, I will ask questions of like, Have you worked with trans clients before? Are you part of the LGBT community if they do choose to disclose or not, they don’t necessarily have to be part of that. But I want to know what kind of, you know, if they’ve ever worked with, with a trans client before, but that’s me, but I also ask if they’ve ever worked with clinicians, as well, because that’s a whole nother

Katie Vernoy  32:27

Yeah, that’s a whole other dynamic. We are getting short on time. So I want to, I want to just comment on something and get a couple more thoughts from you, I think there’s this element of, you may have a client come in either in the process with you either come out for the first time, or kind of identify that for themselves for the first time, I feel like there’s so much to talk about there. And then there are also clients who are trans and that’s not what their issue is. And I think there’s so there’s different elements of what we would need to know, when someone comes in and they are trans and the issue isn’t about their gender identity, it sounds like this awareness is important and being able to understand the impact that it may have on what’s going on. And I think that’s, that’s fairly well in the wheelhouse of the therapists, especially as they are able to get consultation and make sure that they’re, they’re kind of there with them and understanding the person in front of them and that the issues they’re facing when someone comes out or is in the process of identifying for themselves, their gender identity. And that process, I think that can be very confusing for folks, especially with a hard bias against, you know, kind of what we went back going back to life, the gender dysphoria, and even just the angst that can be coming through as the identification or the understanding, I am trans. And so can you talk a little bit about that process of the kind of understanding kind of the introspection, the kind of identifying for the individual, as well as how therapist can support trans clients as they identify and come out and potentially even transition because that seems like that’s very specific to the gender identity whereas other things are informed you know, it’s it’s gender identity informed it’s other issues, but it’s gender identity and form. This is it’s about gender identity,

Beck Gee-Cohen  34:25

when a specific client is is coming in specifically around their gender identity like this is this is the the pressing struggle at this point in time that that I’m you know, is is obviously getting the whole story around because, you know, some people are in relationships, right, some people are in, you know, I mean, I come from obviously a wider lens of like the sociological piece of a person like all of these things and, and really diving into their fears, right diving into, like you said, they kind of they’re there, because they’ve already been thinking about it. Like, this has been something that has been brewing for a while someone just doesn’t usually just wake up one day and be like, Yeah, I’m trans, right. Like, I mean, this is something. And I like to get that backstory, I like to ask people when they first kind of knew something was different, right? Like, you know, it could be a year ago, it could be six months ago, it could be 10 years ago, right. And when they first maybe even talked about it to someone, you could be the first person they are talking to about it, right? And so let’s say, you know, they knew when they were five, and now they’re 30, that’s 25 years of kind of unraveling of like, you know, what, you know, what has been going on? For them? I think the first question my therapist asked me when I told her that I was trans, which I, which I, you know, so appreciate. And I go back to, even as a clinician is like, okay, cool. So what do you want to do about that? Sounds like, which sounds it’s so her right? It was like, I was like, what, you know, like, like, what do you know, because you’ve obviously been thinking about this. So like, we’ll deal with all that, that unraveling of the history and all that stuff later. But like, How can I be present for you now? Like, what is it that you are looking for right now? Like, are you looking to get on hormones? Are you looking to get top surgery, you know, like or whatever. Like, for me, it was like, I knew I wanted to get top surgery, I did not know I wanted to go on hormones. That was like, so far, like, it was like a lot for me to think about, but I knew exactly what I wanted one thing. It’s just like, cool. Let’s start there. Right? We don’t have to make it like, I think we also get overwhelmed with like, what if I say the wrong thing, right? Like, what if I, what if I, what if I screw this up? And but it’s just like, it’s almost like goal setting. Like, okay, great. Like, what do you see for yourself, because a lot of trans people don’t even aren’t even, they’re so focused on like, the history and like, the present, like, the fear and the anxiety that, that I couldn’t even see myself in the future. So to be able to, like, be present, and then look forward, was really empowering. Like, oh, I can do this, right? Like, right, yeah, it scares the shit out of me. But excuse my language, but like, I’m also like, but, but I can see that I can see that there might be a future for me here. And so I you know, kind of kind of, in that, in that in that respect, that’s like a celebratory way of thinking and, and then we can get dive into the introspection, we can dive into the struggles of, of what it is to be trans in the world and all those things. But like, if we give it a moment and ask, really just kind of asked, like, what do we want to do here? Like what to do with this information? Do we want to move forward? Or do we want to focus on like, the hows and whys and then giving like, you know, sometimes we give readings, sometimes we give, but most people that come in who are who are talking about their gender, they’ve already been researching, they have already been, like watching YouTube videos, they’ve already been having this conversation internally, they just need to, like, get it out, and like have a place to like, get it out, and they may not have any movement, maybe they just want to talk about it in the room. Maybe they have no idea what they want to do. And it’s like, that’s great, too. But this is a space where you can, we can acknowledge that sometimes it’s the only space where I’m using the name and pronouns that they want to use for the first time. Right? Like, I’ve used that space for helping people come out to their loved ones. Right, I came out to my best friend in my therapy, and with my therapist, actually came into town and I’m like, you’re going to come to therapy with me. And she allowed that space for me to come out, you know, to the person that I love the most, you know? And so, like those are the things that we can do as therapists.

Katie Vernoy  39:12

I love that.

Curt Widhalm  39:14

If people are looking forward to a future with you and your training where can they find out more about you and follow you?

Beck Gee-Cohen  39:26

Oh, I was thought this was a proposal Curt. Um… Oh was like okay. So you can find me at my website BGC bridge calm. I offer consultation and trainings and things like that on that website. You can always email me it’s Beck at BGCbridge comm I’m always open to offering you know, help, consultation, you know, networking. You know, if you have a trans client and you just have a couple questions, I’m always glad to you know, Email. But if you want more of like a sit down, you know, we can talk about that as well.

Katie Vernoy  40:06

And just one quick question around resources. Are there any ideal resources for clinicians who’d like to do some reading or some get some basic information that that would help them? At least have a foundation?

Beck Gee-Cohen  40:19

Yeah, for sure. There’s a lot. But I think the MY GO Tos are Alex II and TAFI has a couple of books on gender trauma. Life isn’t binary for non binary, folks. They’re also a therapist and amazing therapists doing somatic and trauma work in the LGBTQ plus community so you can go to their website. And then my gender workbook by the fabulous Kate Bornstein is always a good tongue in cheek kind of gender workbook. And again, I suggest therapists get it for themselves and you know, start filling it out like workbook style. You know, Dara Hoffmann Fox also has a gender identity workbook. I love workbooks, again, more introspection, I never give out a book that I wouldn’t do myself. So, you know, just get those for yourself and see if they work. And there’s a great book for I know, there’ll be another conversation around families and trans teens and things like that. But it’s called Two Spirits one heart and it’s written by a trans son and his mom and the coming out process and that way, so I gave it to my mom when I came out. So a lot of you might be working with parents of trans teens, a really great resource for them.

Curt Widhalm  41:39

And will include links to all of those in our show notes. You can find those over at MTS g podcast.com. And follow us on our social media, join our Facebook group, the modern therapist group. And until next time, I’m Curt Widhalm with Katie Vernoy and Beck Gee Cohen

Katie Vernoy  41:55

Thanks again to our sponsor, buying time,

Curt Widhalm  41:58

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Katie Vernoy  42:26

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