Blog posts that focus on issues relevant to LGBT issues.

March 2024

Raising the Alarm on Gender Identity Change Efforts Disguised as Talk Therapy

2024-03-12T21:34:50-04:00March 12th, 2024|Advocacy, Gender identity, LGBT, Thoughts From A Psychotherapist|

Below is a petition that some concerned California clinicians wrote to both educate providers and consumers and to use to send to mental health professional organizations to urge them to speak out against these practices.

I want to recognize that the American Psychological Association(APA) issued a very thorough statement February 2024 called APA Policy Statement on Affirming Evidence-Based Inclusive Care for Transgender, Gender Diverse, and Nonbinary Individuals, Addressing Misinformation, and the Role of Psychological Practice and Science. It was a great statement and occurred while this petition was being devleoped. You can find the entire statement here. I will quote below two statements that are especially relevant to the petition ask.

WHEREAS such misinformation is widely disseminated through formal and informal networks, yet credible scientific evidence has not been widely disseminated and is not readily accessible to the public, having the potential to further stigmatize and marginalize all transgender, gender-diverse, and nonbinary individuals, hindering their access to indicated and necessary healthcare, worsening existing geographic disparities in healthcare access, and fostering an environment that may lead to discrimination (DuBois et al., 2023; Goldenberg et al., 2020; Weixel & Wildman, 2022);

THEREFORE, BE IT RESOLVED that the APA supports efforts to address and rectify the dissemination of false information to ensure the well-being and dignity of transgender, gender-diverse, and nonbinary individuals

The below petition can be viewed and signed here. I am encouraging everyone to both sign it and share it. It is important to the well being of the trans community that we get information such as this out there to counter all of the false information that exists. It is also important the reputable organizations like make strong statements like that of the one from the APA to fight the narrative that supporters of gender affirming care are extremists when the reality is that there is wide support of such care.

Thank you to all the therapists that took the time to engage in this work which is critically important right now.



We are a group of concerned therapists, psychologists, and psychiatrists writing to ask your associations to put out a statement regarding the rise in Gender Identity Change Efforts (GICE) disguised as psychoanalytic or talk therapy. The effort to delegitimize and provide an “alternative” to gender-affirming therapy and the World Professional Association for Transgender Health (WPATH) Standards of Care (Coleman et al., 2022) is being led by a small group of clinicians who start many organizations that attempt to wield power through promoting debunked research. The main organizations involved in this effort are Wider Lens Consulting, Therapy First (formally the Gender Exploratory Therapy Association), Thoughtful Therapists, Genspect and SEGM. We are asking your association to put out statements warning against these organizations for their dishonest and fraudulent advertising, as well as naming them as organizations promoting GICE.

1. Dishonesty, Fraud, and Deception:

All of these organizations are careful to sound like they promote reasonable, well-informed, evidence-based treatment for those with gender dysphoria – “a neutral ground between the ‘radical’ gender-affirmative model and ‘unethical’ conversion practices” (Ashley, 2022). The byline for Therapy First reads: “Therapy First exists because we see a great need arising from the current oversimplification and politicization of gender dysphoria in the field of mental health.” Therapy First represents itself as apolitical. However, multiple clinicians on the advisory board and clinical team have participated in political activity aimed at anti-trans legislation and related to many of the trans health bans that we are seeing today. Stephen Levine, one of the clinicians who authored the Therapy First clinical guidelines, was the sole “expert” witness for the state of Arkansas’s ban on gender-affirming care for minors. It was struck down in June of 2023 (Levine, 2020). SEGM has been the central subject of subpoenas by the state of Alabama to the American Academy of Pediatrics, WPATH and the Endocrine Society in the trans youth care ban case Boe v. Marshall (Lannin declaration).

The clinicians involved in founding these organizations are part of a large web of anti-trans organizations aimed at attacking trans rights (Anti-Trans Conversion Therapy Map of Influence), including the American College of Pediatricians, which has been labeled an anti-LGBTQ hate group by the Southern Poverty Law Center (American College of Pediatricians | Southern Poverty Law Center).

Stella O’Malley, who founded SEGM and Wider Lens Consulting, has stated that her mission is to make sure that children are stopped from medical transition (Leveille, 2022). In emails leaked in March of 2023, Lisa Marchiano, LCSW, another board member of Therapy First, SEGM, and Wider Lens Consulting, was caught trying to obtain private information about a transgender journalist with the intent of leaking information to Fox News. When the private information was leaked, it resulted in online harassment of the journalist (Doyle, 2023).

The claim that Therapy First, Thoughtful Therapists, Wider Lens Consulting, SEGM, and all affiliated organizations have no political agenda is completely dishonest and deceptive. We need reputable clinical organizations to make this known to both consumers and therapists.

2. Gender Identity Change Efforts (GICE) by these organizations:

Even though Therapy First claims to not promote so-called “conversion therapy,” further investigation into the organization and client experiences points to GICE. The Therapy First clinical guidelines promote a “psychotherapeutic approach” to gender dysphoria, stating:

“Psychotherapeutic inquiry does not simply accept that a person has the wrong body or gender, it explores why and how a young person came to have negative feelings about their sexed body or that their body or gender is “wrong.” This involves exploring relational and developmental history, the quality of relationships with parents, any traumas or losses that have affected the family, the presence of marital dysfunction, domestic violence, sexual abuse or other detrimental interpersonal dynamics. It also involves exploring social relationships with friends and peers (Ayad et al., 2022, p. 41).”

In practice, what this often looks like is searching for any possible reason for a youth or young adult being transgender, rather than simply being transgender (Santoro, 2023). Marchiano spoke out against the executive order against conversion therapy signed by Joe Biden in June of 2022, telling The Economist that it would have a “chilling effect” on the practices promoted by these organizations. She acknowledges the goal of gender exploratory therapy, which is for trans children and teens to resolve their dysphoria through finding the root psychological cause of their dysphoria (“The Biden administration’s confused embrace of trans rights,” 2022). Furthermore, the Therapy First Clinical Guidelines contain detailed assessment questions including intrusive inquiries about the client’s masturbation habits and sexual fantasies (Ayad et al., 2022, p.26). This type of pathologizing, gaslighting, and delaying any gender-affirming care until a talk therapist rules out every possible cause for the gender dysphoria, besides being transgender, is highly problematic and psychologically damaging (Matouk & Wald, 2022; Boerner, 2022; Bhatt et al., 2022; Tordoff et al., 2022).

Everything put forth by members of these organizations points to their belief that being transgender is undesirable and therapy should seek to explain and resolve the transgender identity so that the patient “accepts themself” as the gender they were assigned at birth. The case studies presented in the Therapy First’s clinical guidelines highlight these beliefs and intentions (see Therapy First clinical guidelines pages 57-102 for case studies) (Ayad et al, 2022).

These organizations have been able to wield extensive power in a short amount of time and are attempting to replace the WPATH Standards of Care. Gender Exploratory Therapy/Therapy First has been recommended as the treatment in many of the trans health care bans gaining traction across the country (Reed, 2023b). It has also gained notoriety in prominent problematic articles in The New York Times (Paul, 2024), which greatly inflate the statistics regarding “detransitioning” and conversion therapy (Reed, 2024; Urquhart, 2024; Urquhart, 2023).

Research continues to confirm that gender-affirming care is not only evidence-based but life-saving (American Psychological Association, 2024). The results from the national trans survey have found that 94% of people who pursued a form of medical transition report greater life satisfaction (U.S. Trans Survey, 2024).

The NASW, AAMFT, and the two APAs are signatory associations of the United States Joint Statement Against Conversion Efforts (United States Joint Statement, 2023), a statement by 28 professional associations clearly asserting that so-called “conversion therapy” is unethical and potentially harmful.

We ask that the NASW, AAMFT, and the two APAs (both psychological and psychiatric) also make a clear statement about Therapy First, Genspect, SEGM, Wider Lens Consulting, and other affiliated organizations, warning potential clients about their false and deceptive advertising.

We also want it made clear that social workers associated with these organizations are violating the NASW code of ethics, and potentially their local state laws, as they pertain to Gender Identity Change Efforts and conversion therapy.


American College of Pediatricians. Southern Poverty Law Center. (n.d.).

American Psychological Association. (2024, February 17). APA policy statement on affirming evidence-based inclusive care for transgender, gender diverse, and nonbinary individuals, addressing misinformation, and the role of psychological practice and science.

Anti-Trans Conversion Therapy Map of Influence.

Ashley, F. (2022, September 6). Interrogating gender-exploratory therapy. Sage Journals.

Ayad, S., D’Angelo, R., Kenney, D., Levine, S., Marchiano, L., & O’Malley, S. (2022). A clinical guide for therapists working with gender-questioning youth, Version 1. Clinical Advisory Network on Sex and Gender.

Bhatt, N., Cannella, J., & Gentile, J. P. (2022, Apr-Jun). Gender-affirming care for transgender patients. Innovations in Clinical Neuroscience.

The Biden administration’s confused embrace of trans rights. The Economist (2022, June 23).

Boerner, H. (2023, March 30). What the science on gender-affirming care for transgender kids really shows. Scientific American.

Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., Ettner, R., Fraser, L., Goodman, M., Green, J., Hancock, A. B., Johnson, T. W., Karasic, D. H., Knudson, G. A., Leibowitz, S. F., Meyer-Bahlburg, H. F. L., Monstrey, S. J., Motmans, J., Nahata, L., Nieder, T. O., … Arcelus, J. (2022). Standards of care for the health of transgender and gender diverse people, Version 8. International Journal of Transgender Health, 23(Suppl 1), S1–S259.

Doyle, J. E. S. (2023, March 23). Inside the Terf Harassment Machine. Medium.

Gender Exploratory Therapy Association.

James, S.E.,Herman, J. L, Durso, L. E. and Heng-Lehtinen, R. (2024, February 8). Early Insights: A Report of the 2022 U.S. Transgender Survey.

Leveille, L. (2022, April 3). Leaked audio confirms Genspect director as anti-trans conversion therapist targeting youth. Health Liberation Now!

Levine, S. B. (2020, March 12). Expert Submission of Dr. Stephen B. Levine, MD – PA General Assembly.

Matouk, K. M., & Wald, M. (2022, December 8). Gender-affirming care saves lives. Columbia University Department of Psychiatry.

Paul, P. (2024, Feb. 2). As kids, they thought they were trans. They no longer do. The New York Times.

Reed, E. (2023a, January 13). Unpacking ‘gender exploratory therapy,’ a new form of conversion therapy. Xtra Magazine.

Reed, E. (2023b, May 29). Ohio rep. pushes conversion therapy; Bill mandates it for trans kids. Los Angeles Blade.

Reed, E. (2024, February 2). Debunked: Misleading NYT Anti-Trans article by Pamela Paul relies on pseudoscience.

Santoro, H. (2023, May 2). How therapists are trying to convince children that they’re not actually trans. Slate Magazine.

Tordoff, D. M., Wanta, J. W., & Collin, A. (2022, February 25). Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Network Open.

United States Joint Statement (2023, October 11).

Urquhart, E. (2024, February 6). Pamela Paul shows NYT Opinion’s lack of accountability to the truth. Assigned Media.

Urquhart, E. (2023, December 1). What it actually means to listen to detransitioners. Slate Magazine.

April 2023

Have I Become a Gay Elder?

2023-04-04T16:58:17-04:00April 4th, 2023|Gender identity, LGBT|

Yesterday I saw a post on social media where a 38-year-old person talked about how they had become an elder in the community. As someone a bit older than that I immediately thought then what am I?

I was asked last week by a younger person if the current environment towards LGBTQ+ people was the worst I had ever experienced. My answer was yes. As I reflected more I feel like the time before I came of age was most likely worse since clubs and even homes were raided and people’s lives were ruined by being outed. But in my Gen X lifetime, this is the unsafest I have ever felt.

Why now? Back in the late ’80s and early 90’s there was a lot of being closeted. You were not out if you had any job working with youth. My first job out of graduate school was at a residential program for youth and you better believe I was deeply closeted. On the other side of the equation, though there was so much community. Yes, much of it was at bars but when you felt like it was all too much, there was always a place to go and just be with people that looked like you and had similar experiences. When I moved to San Francisco in the early 90’s it was right before AIDS medication became what it was today. The local gay paper had pages and pages of obituaries every week. Until the week they did not and that was a celebration. Living in the Castro, I felt safe. We may have been invisible to the general population but we were okay in our safe space (for those of us lucky enough to find them-other people’s experiences were different). We looked out for each other. I know many straight people do Friendsgiving now but back in the day it was survival. If you were celebrating you made sure your people had a place to go or you invited them over. Even people that you may not have known that well. When you left your safe space you were alert. You watched out for yourself and stayed closeted in most spaces. But since media attention was not on us, people were not paying attention so it felt safer.

Social media and its use by anti-gay and anti-trans groups has made most of us feel unsafe. Now we are a political pawn everywhere. Yesterday in a Facebook group the admin twice deleted posts asking for LGBTQ book referrals because the hate crowd could not skim by and instead had to post hateful remarks. IT WAS a group about BOOKS. But the people with the hate feel emboldened now they feel like they can post their hate anywhere and not have repercussions. And for the most part, they are correct. Now it feels like there is no safe place. Social media and news are in most of our homes, even if we try and restrict it. There are very few if any gay bars or gay spaces anymore. People have said to me well isn’t that better? You can go anywhere now. Yea but if I do and it is full of straight people it is a different experience. And sometimes I just want to be with people like me or at minimum people that really get me.

Before this time there weren’t laws allowing us to marry and transition (in some states) and have employment protection. We never got a full victory on those things. And now the victories we did get are slowly being torn to pieces. We are constantly being bombarded wtih messages that we are sick and that our existence is an issue. We can’t talk about our families or have our kids read books that represent what we look like. I do not know an LGBTQ+ person right now that is not totally freaking exhausted. We want to live our lives and it’s very very hard to do that right now.

I worry about all of this a lot. When I look back on those pictures from my days in SF in the 90s many of those men are no longer with us. I fear with the culture that is being created now those in their 20s and 30s are going to be facing the same thing when looking at their photos in the future. Except more of those people will die at their own hands when they just can’t take it anymore.

This is my personal experience from a place of white and economic privilege. Others may feel differently. However, I doubt anyone would say it’s not very very hard. And the answer to my original question is yes I am now an elder and a grumpy one at that.


December 2022

Why I Am Not Excited About the Gay Marriage Bill

2023-04-08T23:41:12-04:00December 13th, 2022|LGBT, Thoughts From A Psychotherapist|

I will admit, I am tired of hearing about how this gay marriage bill is such a great thing. I will start by saying it was a necessary law. Because whenever I have feelings about it I keep getting told it’s something. And indeed, it is something. If Obergefell is overturned this will allow those that are married to have their marriages recognized in whatever state they live. It also means that if they live in one of the 35 states that will likely make gay marriage illegal, they can go to another state to be married and their state will have to honor that marriage. As someone who had one marriage overturned by the courts and a second (same person!) one that stuck us in limbo for years, I get the importance of this protection. After marrying in CA in 2008, the state passed Proposition 8 which made gay marriage illegal in CA. Our marriage was still valid in Ca but not valid federally. It was a tax nightmare. Our tax guy had to do dummy single-person CA tax forms for the feds along with our real married tax forms for CA. It was gross.

That being said the law that passed is a loss of rights for gay couples. It only is necessary if Obergefell is overturned. But it doesn’t give us the same rights as we currently have now. Imagine being told that you could no longer get married in your state. You had to go to another one. Kinda like what is happening to women and abortion right now. It is making LGBT marriages second-class marriages. And as we know there is no separate but equal. As a gay person, I have spent years having rights doled out to me. With the Obergefell case, we were almost there. We had marriage. Still, didn’t (and don’t) have employment, housing, and other protections in many states. My new home state of PA literally just passed some of those rights, it was one of 21 states without it. The LGBTQ+ community never had equal footing but we were getting there. Now it is a step back. So tell me again why I should celebrate?

Any marginalized group will tell you we are constantly told we should be grateful for what we have. We should be happy with the pace of progress. Easy for people whose lives are never affected by these laws to say this. I am personally tired of having to accept crumbs of acceptance and be told tolerance is important. I do not want to be tolerated I want to be left alone to live my life with the same rights as a cisgender straight person. I truly do not think that is too much to ask for.

October 2022

Leaving the Bay Area Bubble for Pennsylvania

2022-10-07T19:20:16-04:00October 7th, 2022|LGBT, Thoughts From A Psychotherapist|

I was born and raised in NJ. In the 90’s I moved to San Francisco. In the 90’s it was a very different time for LGBTQ+ people. On the East Coast, you needed to be closeted in most places. The word transgender was never spoken and non-binary was not a word most people identified with. You were closeted and butch or femme. Moving to San Francisco was a move for freedom. Freedom to be who you were without being constantly judged or scared. Not to say there was no discrimination there but there is power and safety in numbers. You were careful but not constantly afraid.

Times changed. We got the right to marriage. We began to acknowledge transgender people and non-binary people and accept them into the community. Not without pain. And wrongs committed. The overall umbrella got larger and as legal rights came more and more people came out. For a quick minute after Federal Marriage Equality, it felt almost safe. At least for white LGBTQ+ people. Then the culture wars increased in force. LGBTQ+ people again became an open target. Books about us were (and are) banned. LGBTQ+ people, especially Trans people, are getting accused of grooming children. Doctors and therapists that help the community are getting death threats.

In the bubble, it still felt safe enough. I always knew the community I lived in would step up to anti-LGBTQ+ bullying.

At the end of 2021, I decided to return to the East Coast. That was a huge transition. One of the factors in thinking about where to land was will the place I land be safe for me? PA is not the Bay Area but would it be accepting of my gender non-conformity and Gay identity? 

When I arrived I was pleasantly surprised at how little an issue being Gay was for our neighbors. It was a huge relief. Then this happened.

A local church had some inclusive signs that were torn down. Then they posted a rainbow flag. That was also torn down and feces was put on it. This event was shared in the local Facebook groups. People were upset for sure. The disconnect for me was that although people were upset no one has done anything (the exception being the church which put up a new flag and published the event). It appears that people think their moral outrage will make the neighborhood safer for the LGBTQ+ community. A nearby community had a similar thing happen. Every store owner promptly put out a pride flag in solidarity. That shows that people care. Right now it is always important to send the message that people care. 

What frustrates me the most about straight people is that many of them just don’t get it. I have some great friends that do. They make an effort to get it. But most people don’t understand the effects of the constant aggressions that we are coping with. Every day there is a case where an LGBTQ+ book is banned or teachers are told they can’t put up a pride flag or a person is fired for being who they are. Yes in 18 states and 5 territories you can be fired for being gay. The question I want to ask straight people is “Has your marriage ever been legally overturned?” Because mine has. And given current conditions in this country, it could be again. In the Bay Area, it felt like a safe bubble. Here I drive through the county and see signs for Republican candidate for Governor that I believe is truly dangerous. I cannot even imagine what laws he would pass in PA if elected that would harm LGBTQ+ people. It is hard for sure. 

For me, the solution is always action-oriented. I volunteer for the local Democratic Committee, I have started escorting at a local Planned Parenthood, and I got a job to help with election preparation by delivering supplies the weekend before the election. I will volunteer outside the polls on election day. I am happy to do my part to fight for the rights of LGBTQ+ people, POC, women’s rights, and overall democracy. It feels good to be in a place where the work I am doing can make a difference. At the same time, it is challenging to be in a place that is so different. With people that seem so well-intentioned but are still oblivious.

I have been writing this post for a week now. I have walked away and returned several times struggling with what was I trying to say. What I want is for people to understand how hard these times are for marginalized people. I want the people that are struggling to know that many of us are struggling and you are not alone. I want others to pay more attention and when things happen in your community to speak up. Don’t wait for someone else to do it for you. I understand feelings of overwhelm or that whatever you do is not enough. And, indeed, what you do is not enough. But what you do along with what I do along with what others are doing matters. It helps people. And change only happens when we are engaged and fighting.



June 2022

What I Want Non-LGBTQ+ People to Know

2022-08-29T18:50:20-04:00June 29th, 2022|LGBT, Thoughts From A Psychotherapist|


I am writing this post from my deeply personal place and the opinions expressed here are my own. I speak as a white person with many privileges.

What do I want Non-LGBTQ+ people to know and to do.

Pay Attention to LGBTQ+ issues

You don’t need to know or understand everything. But have a basic understanding of what rights LGBTQ+ people have and which they don’t. Be aware of what rights are being attacked and removed. The Supreme Court has stated (Thomas) that they are going after gay marriage, the privacy of sex, and birth control (Obergfell, Lawrence, and Griswold). You know who has known this for years. LGBTQ+ people. We have been saying it. But many Non-LGBTQ+ people have not been listening. I don’t have the time or the energy to be educating people on this. In my mind, if you cared we would already know what was happening. I have plenty of people in my life that do.

Understand and Validate Our Feelings

My primary current emotion is rage. There can also be depression and sadness and anxiety mixed in. I deserve space for all of that. Let me have my feelings with you listening or validating them. Don’t try and make me feel better. You can’t except by  listening. Most Non-LGBTQ+ people don’t know what it is like to have a right given or taken away by the courts (unless you are of color and then you know for sure). I got married in 2004 in San Francisco. It was an amazing experience. Something I never expected in my lifetime. It got overturned by the courts. Not unexpected but still devastating. More devastating was 2008. I got married in the time frame between when CA legalized marriage and Prop 8 overturned it. From 2008 until 2015 when Obergfell was ruled on I was married in CA but not in the eyes of the federal government. Try filing those taxes. It was devastating. For weeks after the election, I looked at everyone I passed on the street and wondered did you vote against my civil rights? At the time, straight people in the Bay Area were shocked it passed. Gay people were not. We know.

Also, I love when I hear my Non-LGBTQ+ friends and family express rage at the attacks. Sometimes it feels like we are all alone in this.

Do Something to Support Us

Give money to causes, challenge transphobia or homophobia when you hear it, put your pronouns everywhere you can, vote like our lives depend on it, post supportive things on social media, tell us you love us and that you have our backs, and mean it. But do something. 

Understand Our Trauma and How it Affects Us

Every LGBTQ+ person has trauma from being part of a marginalized community. That is in addition to the normal life traumas they have. I am a white privileged person who lived for many years in the Bay Area. I have faced being called derogatory names, told I was in the wrong bathroom or glared at in the bathroom, had a negative word scratched into my car, had a house where the deed said I was unmarried when I was married, had friends and families not validate my relationship and marriage, had one marriage overturned and one that was in an in-between state for 7 years (married in CA but not federally). This is what I can come up with off the top of my head. Imagine being in an unsafe area of the country or being trans-identified or being Black or of color. It is never-ending. For those of us that are older, we remember having to be in the closet. We were scared of having any job that involved working with children because we could be accused of being abusive. We all have many stories. Those traumatic stories affect how we move through the world. Understand that. Never invalidate us by saying it’s not that bad or things won’t really happen. Because they are happening. As we predicted. 

This is a really tough time for LGBTQ+ people. The overturning of Roe is devastating to this country and we also see what is coming next. We are often not okay. We need Non-LGBTQ+ people to step up their game if they haven’t already. We cannot fix this on our own.

May 2022

Filled with Rage Today

2022-08-29T19:04:23-04:00May 4th, 2022|feminism, Gender identity, LGBT, Thoughts From A Psychotherapist|

I had a list of topics to write this month’s blog. Then yesterday happened. There is one topic. The attacks on marginalized people. Right now, it is women. This means that it will affect women of color and women without resources the most. We also see attacks on LGB people, massive attacks on transgender people, and ongoing attacks on people of color. If Roe V Wade is overturned we know the next issues on the agenda are birth control, gay marriage, interracial marriage, and medical privacy. There will be no such thing as an established court precedent anymore.

Many of us have seen this coming for years. We have been gaslighted and told we were overreacting. Roe V Wade was a settled law. It would never be overturned. The right has been laser-focused on this issue since Roe in 1973 and have finally begun to reach its goal. Many of us have been feeling this rage for a long time, it gets amplified every time we face another loss. I am rageful at everyone who denied this was happening, who chose not to vote because it didn’t matter anyway, and to politicians who have failed on their promises. I am less rageful at people who support the overturn because they have been honest about their intentions for years. This should not be a surprise.

Why am I as a therapist being so vocal about this issue? Shouldn’t I be a blank slate for a client to work through their pain? No. That is not what I as a social worker believe. I believe in social justice. I am part of marginalized communities as are my clients. For me to be silent in the face of this is to be complicit in it. I don’t raise the issue in therapy but if/when my client does I am there with them validating their rage and the parts underneath the rage that are filled with sadness and feelings of powerless and everything else that is there. My clients need to be safe with me and part of that is knowing that I understand how marginalized people are treated in this country. My experiences are different from theirs but I get how painful it can be.

In an online therapist group, the question was asked Would you tell your client your feelings about this issue if they asked? And some of us said our clients do not need to ask. They already know where I stand. Especially, since 2016 when politics became a constant topic in therapy. Then COVID when therapists were experiencing the same trauma as clients. One of the most effective interventions I had during the shutdown was to say it’s not just you to my clients. At the time many of us felt like our feelings were just ours as a result of not being exposed to many other people to check in about this.

I have to be honest with my clients about my parts that are activated with what is going on in this country. I don’t ask them to take care of me. I don’t tell them how I deal with it because that is mine to manage. I do model that I am activated also. That is who I am as a therapist and as a person. I am angry. I am sad. I am scared. I am figuring out how I will move forward and what actions I need and must take. Probably a combination of self-care and activism. A combination that may shift back and forth over these next months until the next election. What I won’t do as a therapist or as a person is be silent. I will scream and yell with every bit of energy I have. And I will tell my clients that when they ask.


October 2019

Traveling while trans

2024-06-10T20:10:17-04:00October 31st, 2019|Gender identity, LGBT, Thoughts From A Psychotherapist|

The other day this article caught my eye. CNN was covering the trauma of TSA for transgender people. Essentially the problems boil down to two main issues.

  1. The scanner used by TSA must have someone manually enter a perceived gender of the person entering it. If that person does not have a body that the scanner feels like is in accordance with that gender the person is then subject to a pat-down.
  2.  Many transgender people have then be abused by TSA officers when going through TSA. If you want specific examples read the CNN article.

While the abuse of transgender people is bad enough my experience is that those scanners also hate those of us that are gender non-conforming. I always get pulled aside for a pat-down. Sometimes gently which is my general experience at SFO and some times rather invasively which is my experience at Newark airport. Needless to say after my last trip through Newark airport I was personally pretty traumatized. I have family in NJ so it is not an airport that I can avoid. I cannot even imagine the trauma of trans and non-binary people.

Shannon Minter legal director of the National Center for Lesbian Rights (NCLR) was quoted as saying this in the CNN article

“For many transgender, nonbinary and gender-nonconforming people, going through airport security is a grueling and often humiliating and traumatizing ordeal” “Some of the worst stories we hear are from gender-nonconforming women who are subjected to intentionally assaultive pat-downs from TSA agents. In effect, these women are being asked to accept being sexually assaulted as the price of traveling by air.”

What is the supportive cis person to do? Pay attention to the treatment of transgender, nonbinary and gender-nonconforming people in your community and nationally. Right now there is an epidemic (as identified by the AMA) of violence against transgender women. As of the date of this blog post 18 women, mostly of color, have been murdered this year. These are only the deaths that have been classified as such the real number is much more. Last year 26 women were murdered. While I get that we are in a time where there is so much to fight for it is important that we do not forget these women and that we all do we can to fight against the attack against trans people. And since the majority of these women are of color we need to be aware of the intersection between transphobia and racism in this country.

When you see injustice speak up and help the person. Vote for candidates who include transgender people in their policies. Donate to organizations that support transgender rights. Just be aware of the daily struggle of transgender, nonbinary and gender-nonconforming people. It is easy for any of us to get stuck in our own day to day life and not be paying attention to what is happening to various groups. I get it. I sometimes have to stop watching the news myself. But now more than ever we need to be paying attention. Lives are literally being lost every day to violence and suicide. It may not seem like much to be harassed when you travel but it is having to live with the constant threat of something like that happening in any environment that creates sustained trauma that needs support and treatment and won’t get better until society does.





Photo Copyright: sevenozz / 123RF Stock Photo

Rage and sadness at knowing LGBT rights are once again under serious attack

2021-08-11T00:14:14-04:00October 8th, 2019|Gender identity, LGBT, Thoughts From A Psychotherapist, trauma|

I am filled with rage today. I suspect underneath it all is a deep sadness and grief but right now I am experiencing rage. Full on. I am rageful that I live in a country where the court is going to decide if it is legal to fire LGBT people just for being who they are. I am rageful at all of the straight well-meaning people that just don’t get that in 22 states you can be fired for being LGBT and that winning the federal right to marry did not end the battle for LGBT civil rights. I am rageful at the people that think that their personal or religious beliefs should be more important than the civil rights of an entire group of people.

One of the happiest days of my life was my first wedding on February 13th, 2004 (both weddings are to the same spouse). Gavin Newsom said he thought LGB people should be able to marry on Feb 12. That day my now wife and I talked on the phone and said let’s do it! She had always said we would never get married until it was legal. With no planning, we got up at an obscene time of the morning and were waiting outside of City Hall with many others as it opened. It was beautiful. It was a time of triumph. We saw mostly older couples that first morning. All of us were both excited but also afraid that the marriages could be stopped at any time. The city staff was almost as excited as we were. As each couple came out with their license the entire line erupted in cheers. I am getting goosebumps on my arms as I write this. Then the community started to bring food and other celebratory items to support those in the lines that were now getting longer and longer.

It was a bit bizarre because after we got married, we each went to work. We were in a bit of shock, I think. At the time I worked at an LGBT counseling center. When I got there I told everyone that I got married. People cheered and cried and many raced to their phones to call their partners and propose. It was amazing.

Of course, eventually the courts both stopped and invalidated the 2004 marriages. Court cases continued until in 2008 the CA Supreme Court ruled in favor of marriage equality. Marriage became legal in CA. So, in July 2008 we did it again. Another of my happiest days! This time it was planned and we took a brief weekend honeymoon. There was little time to enjoy being married because shortly Proposition 8 was approved to go on the CA ballot. This meant people got to vote on whether it should be legal for gay people to marry in CA. It passed 52% to 48%. That day and the days to follow were some of the most challenging in my life. For a long time after Prop 8 passed I would look at everyone I saw and wonder how they voted.

Our marriage was then in limbo for years. In hindsight, I am not sure we would have gotten married in 2008 because it led to years of us being married in CA but not being married federally. Taxes were a nightmare.

We had to wait until 2013 when Prop 8 hit the Supreme Court along with the famous Windsor Case. Prop 8 was vacated on a technicality but Windsor case finally gave us the full federal right to marriage. It was an amazing victory.

Post Windsor, it felt like things changed a lot. When we traveled, we didn’t feel the need to be as cautious as before (granted we don’t travel to places like the south where we still wouldn’t feel safe). We told restaurants it was our anniversary and got free cakes. I must admit that on one vacation I told several restaurants that and got a few free desserts. I figured after all the years of not getting anything I could milk it for a bit

Things felt safer for us personally and I imagine for others who are LGB in blue states. I don’t think trans people have ever felt safe nor should they. Then came the 2016 election and it all went to shit. None of us felt safe. Our rights and the rights of other minority groups like Muslims, immigrants, Jewish people, and POC were being assaulted daily. November 6, 2016, was another on the list of very terrible days.

Now in 2019, I will say that in some ways there is a greater awareness of the issues. I see straight cis friends advocate some for trans and gay rights online. At the same time, I don’t think most of them get what it feels like today. It feels like shit. I am super privileged. I recognize that. I am white, I am middle class, and I live in CA. So, I have legal and other protections that others do not have. I cannot even imagine how they feel if I feel this bad.

At this point as I write this, I feel sick to my stomach and am so so sad. I knew there was a lot under that rage. I do not know how to cope with this. I also know that I will be holding this for many of my clients. One already brought it up in session. But more in the manner of a minority saying “yup, we are getting screwed again what can you do”. I am not sure what we can do. This decision won’t come down until June 2020. There is nothing we can do to influence the decision. Most legal experts expect the decisions to be against LGBT people (there are three cases two for gay men that were fired and one for a trans woman who was fired).

I can work towards getting legislators in office in 2021 that will finally pass an LGBT employment non-discrimination act. Once again LGBT people will have to just suck it up. We may be allowed a day or two of feeling awful but then what? We will all just move on until June when the decision comes out. And if I feel this bad now, I cannot imagine what I will feel like then.

What I will say is if you are straight and cis reach out to your trans and gay friends and check-in. Let them know you see what is going on and you care. Advocate in the ways you can for legislators and judges that will protect all of our citizens. After Prop 8 I had a friend send me a stuffed animal with rainbow clothes on it. That meant so much to me. It meant she saw the pain I was feeling. At the end of the day really what we need when we are struggling is to be acknowledged and not feel so alone.

August 2019

On feeling unsafe in Trumps World

2021-07-27T17:45:34-04:00August 22nd, 2019|LGBT, Thoughts From A Psychotherapist, trauma|

Last blog post I wrote I got an amazing response. It feels like more people read that post than every other prior post combined! It made me feel good to read all of the comments. It made me feel even better when a friend told me that they learned from it. I don’t often get that personal in a blog post but the posts in which I do get personal obviously resonate a lot more. So I decided to stay with the topic of moving through the world as a GNC person and how that feels right now in our country that feels so dangerous.

Last week I saw a post about an Alabama Mayor who called for killing LGBT people on their Facebook page. In response to a friend talking about a revolution against LGBT people, he said” “The only way to change it would be to kill the problem out. I know it’s bad to say but without killing them out there’s no way to fix it.” When called out on it he first denied, then blamed Facebook, then “apologized” in a manner that said he really just regretted it being shared publicly.

Since gay marriage, it has been less common to hear people publicly call for gay people to be killed. There is a long history of LGBT people of being assaulted and murdered. For LGB people it has improved but for trans people, especially trans women of color, it is still dangerous to be alive. When the AIDS crisis hit it became very clear that many people in this country had no concern at all about gay people dying. They thought it was deserved. Obviously, some people still believe that but it had become pretty unacceptable to say so. Now those filters are gone. And now it is also acceptable to blame black people for getting shot by police and brown immigrants for being assaulted when all they are trying to do is escape death in their own countries.

So within this context, I am flying back East tonight to visit with family. Part of the trip will be an additional bus trip to Niagra Falls. All of which I expect to be fun. At the same time when I was packing my baseball hat for sun protection, I made sure to dig out a pink hat because I thought it might be more easily read as female. Because that is this world pink is feminine and blue is masculine. Sigh. I was also reminded by a friend that I might be with Trump supporters. This really threw me for a loop. I have a few family members that I know voted for him and that I also consider anti-gay. They are not family that I can totally be estranged from. At the same time, the distance between us has grown greater since the 2016 election. We never talk about politics but I know that they think I am going to hell. It does create a distance. I don’t feel unsafe with them just uncomfortable. I do, however, feel unsafe in general with Trump supporters.

I feel like if you support a man who is so blatantly racist, anti-semitic, misogynist, xenophobic, and anti-LGBT that I am not safe with you period. It doesn’t mean I feel like every Trump supporter may physically assault me but I do feel emotionally unsafe with them. And quite frankly depending on their presentation I also feel physically unsafe. A young white man with a MAGA hat would cause me to do anything I could to avoid them. I live in the progressive bay area and I feel pretty safe here. It has been a long time since I have been harassed for my appearance or sexuality. But it has happened in the past even here. I had FAG scratched into my car in San Francisco. When I was leafletting against Prop 8 at the Bart stations in 2008 I was stared at and was obviously being talked about negatively by some. But in recent years since gay marriage was legalized, it has felt a lot better. However, when I leave here it is different. I can never see myself traveling to the midwest or the south. This trip I am going into an unknown environment and I know I will have an air of hypervigilance throughout my travels. I will use the bathrooms quickly. I will scan for signs of danger such as the MAGA hats (and thank you for white supremacists for picking such an obvious sign for us to see). I won’t be expressing my feelings on political topics unless I know I am safe which probably means not at all.

I am still a person with a lot of privilege. I am white. Recently more than one brown person I know has talked about how it is harder for them to leave the house right now. One person named all the documents that they carry with them all of the time (and have done this for years) to prove they are a legal citizen. These are people that feel physically unsafe all of the time. I have also heard this a lot from my Jewish friends. More than one has spoken about their fears of being rounded up. It used to be that you could say that wouldn’t happen but now? Our president has made anti-semitic statements for two days straight.

I think what the thing is is that most of us don’t necessarily recognize the stress that each person that feels scared right now is carrying. I know mine and I can feel the pain of my friends but I can never know what it feels like to have to carry all my papers with me because otherwise I could be rounded up and sent to a camp with no legal representation. As a trauma therapist, I do know how much affect carrying these burdens can have on a person. It is hard to process a trauma that is currently happening. I know all I can do for myself is to allow myself to keep myself safe in the ways that I can. For my friends, I can try and protect them and listen to them. I also can continue to try and advocate for those that need help. I have been very active in a fundraiser to raise money for legal services for unaccompanied minors in the bay area. It helps me to be doing something. I also want those who can walk around without worrying about being round up, jailed, or beaten to recognize that they have some immense privilege that many do not have. I think it is easy for us to stay huddled in our own world and not recognize the suffering others are experiencing. I think it behooves us all to try and have a new awareness and to fight so that everyone can feel safe.

November 2016

Transgender Rights and Resources

2021-08-16T22:52:33-04:00November 17th, 2016|Gender identity, LGBT, Thoughts From A Psychotherapist|

Transgender Rights and Resources

Since the election, a lot of concerns have been coming up for the transgender people. I have put together some resources and information below so that you can have the best possible information when you make any decisions. Obviously right now we do not know anything for sure. I don’t want to perpetuate panic but at the same time, people need information on the best ways to protect themselves. Everyone needs to make the decision that is best for them in their own circumstances.

I am going to focus on the practical concerns of documents and health insurance.

Please feel free to comment or email me if you have anything to add to this post.



In California, the go to for information on legal documents is The Transgender Law Center. Here is the link to their page with detailed information about this topic. Here is their extensive guide.

Here is my quick summary:

California State-Documents

In 2013 Governor Jerry Brown signed AB 1121 which made it easier to get documents changed in CA. Full implementation occurred in July 2014. So with the same Governor in office and statements issued both from him and the Legislature that assert that they will protect Californians, at this time there is no indication that this law will change and you should still be able to change your name and gender in CA fairly easily.

It is important to note that you do not currently need a court ordered gender change to change your California driver’s license, social security card, or U.S. passport. You also no longer need a court order to have a new California birth certificate issued reflecting a change of gender.

You DO need a court order for a change of name.


Documents-Other States

For information on other states and their rules, The National Center For Transgender Equality has an awesome site here. You can click on any state to get additional information including some local advocacy partners.

In states with Republican Governors, there may be a backlash against gains for transgender people and those laws may be at risk so please check in with your local transgender advocacy projects.


Federal Documents

Social security cards and passports are Federal documents and as such may have more risk for change.


Social Security Cards

National Center For Transgender Equality also has a great fact sheet on changing your gender for Social Security. Right now it is considered a relatively easy process but we have no idea at this time if this might change and become more challenging in the future so if this is an important change for you, it should be done as soon as possible.



In 2010 the State Department updated its policy to make it easy for transgender people to obtain a passport that has their correct name and gender identity. This may be an area that is targeted and changed moving forward.

If you believe you may want to leave the country at some point this is a very important process to complete as soon as possible.

Here is information from the National Center for Transgender Equality on passports.


Health Insurance-California

The California Department of Managed Health Care (DMHC) has ordered California’s health plans to remove blanket exclusions of coverage based on gender identity or gender expression. This was done to comply with the California Insurance Gender Nondiscrimination Act, passed in 2005. These rules did not apply to self-insured plans. Many larger businesses have “self-insured” plans governed by ERISA, a federal law that preempts state nondiscrimination protections.

Essentially what this means is that those who got transgender health coverage added because of the Affordable Care Act (ACA) risk losing it if the ACA is repealed.

However, many in California will continue to have transgender health care coverage under private insurance plans.

With Medi-Cal is more complicated. Many people got on Medi-Cal through the Medicaid expansion in the ACA. Many others also got private health insurance because of the ACA subsidies to buy private insurance. Those aspects are at risk if the ACA is repealed. So people will lose their entire health care plans not just transgender-specific aspects.

CA law does still require coverage of transgender health but it could get more challenging if cities lose funding for public health.


Health Insurance-Other States

If the Affordable Care Act is repealed then Rule 1557, which removed trans health exclusions federally, will be gone. If you live in a state that did not protect transgender health care prior to the ACA there is every reason to believe that coverage can be gone by the beginning of 2018. Also, those who got coverage through the Medicaid expansion will also most likely lose their healthcare coverage if/when ACA is repealed. And we know repeal of the ACA is the top of the list of legislative goals for the Republicans. The other scenario I have heard is that Medicaid expansion may stay but become much more restrictive depending on the state. Vice President Elect Pence did do a Medicaid expansion in his state so we just don’t know how this will play out.



Resources for Further information

Transgender Legal Services Network

Transgender Law Center-CA Specific

Southern Poverty Law Center is collecting reports of incidents of violence and intimidation. They advise reporting to local police first but they are tracking the violence. The link to that is here

Trans Lifeline

US: (877) 565-8860 Canada: (877) 330-6366

Trans Lifeline is a non-profit dedicated to the well-being of transgender people. It is a hotline staffed by transgender people for transgender people.

CA Courts Site Reference for further CA legal document questions.

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