Acceptance is Not Affirming Therapy
The other day, in a Facebook Therapist group, another therapist posted asking for a referral for a “transgender”. Before I got there, there were several posts responding to the referral request, but no one called out the language. Which, to my mind, means that not one of those referrals would actually be affirming because none of them called out the dehumanizing language. Four people quietly liked my post, and 5 people responded. More disappointing to me than the language is that no one else called it out.
In my opinion, if you cannot stand up to the dehumanization of transgender people, you absolutely should not be working with them. I often see posts in therapist Facebook groups that make me shudder. I have worked with clients experiencing the consequences of harmful therapy experiences.
Acceptance is tolerance. It is a bare minimum. It means that you are accepting that trans people exist. Hopefully, it means you even believe they deserve the same rights as everyone else. However, that alone does not mean you are providing affirming care.
Affirming means you understand how the current socio-political environment affects trans people every day. You understand minority stress and how it affects trans people. There is no not being political in therapy with a trans person. You may or may not be talking about how political events affect the client each session, but you need to be holding that they are. You need to know the resources in your community and be competent and supportive of a person and where they are in their journey. You need to be able to write letters when clients need them. Most importantly, you need to call out injustice when you see it. It is not the job of TGD therapists to carry this labor.
If you have not had specific training on working with transgender and gender diverse people given by someone with lived experience or done consultation, reading, etc you probably have some blind spots. And those blind spots jeopardize your work with your trans and gender diverse clients.
If your response to this is to get defensive, I get it. No one likes being told they have work to do. However, I ask that you sit with it, absorb it, and then decide whether you need to take any action. Because transgender people deserve good mental health care from genuinely affirming therapists.