Trying to think psycho-dynamically about a service for transgender people

Trying to think psycho-dynamically about a service for transgender people

2012-01-01 00:00:00

Gender is a core aspect of human experience and crosses biological, psychological, social, cultural, and religious categories. It is difficult to convey the depth of feeling of bodily wrongness that many trans people live with. Mental health professionals may be perceived as gate keepers who hold the key to their salvation or who are denying them their only chance of rescue. Feelings are intense and there is often an urgent desire for action that will bring relief. In such circumstances, maintaining a rational frame-work for thinking can become very difficult.

This paper describes practices and structures in the working of a gender identity clinic that are founded on psychoanalytic work. We aim to understand the subjective experience of patients with gender problems, and how this pain is transmitted and experienced by others, rather than attempting to look for the aetiology of the clinical phenomena. The clinic aims to offer the containing environment that may have been absent developmentally, in an attempt to reflect, contain and modulate anxiety and to assist patients towards a reasoned decision about their future. I will address two main issues, the importance of the assessment process in fostering thought and reflection, and transference and counter-transference issues that are commonly encountered. This will be prefaced by brief consideration of the role of a psychoanalytically-informed mental health professional in a gender identity clinic and will conclude by considering the implications for the development and provision of services.

Conference: WAS Glasgow 2011
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