Gender identity is a complex interaction of several factors. At its core gender identity is a person’s deeply held sense of their gender, whether that might be male, female, both (e.g. genderfluid) or neither (e.g. non-binary). Gender identity is separate but closely intertwined with biological sex and sexuality.
Everyone expresses their own gender identity in their presentation (clothes, hair style etc.) and behaviours (what they do, how they (inter-)act or interests someone might pursue), within the cultural environment (gender norms) one is in.
You may already notice that this is a truly complex matter to be figured out. Some people may experience confusion in relation to the above, they may experience difficulty feeling authentic and congruent with their sex and gender identity.
When this is the case, an individual may seek therapeutic support and/or a diagnosis of gender dysphoria.
In therapy, I aim to support you (or your child) in gender identity formation and consolidation. (Gender) Identity consolidation is the creation of a strong, stable sense of self, characterised by a positive self-image and a clear sense of oneself and one’s identity. Identity consolidation is a central developmental task of adolescence. This process can at times be a long and certainly not very linear process. Teenagers (whether or not they experience gender dysphoria) often have feelings of dissonance, low self-worth, feel confused or ashamed of who they think they might be or might NOT be. At times these feelings can develop into depression, anxiety or self-harming behaviours.
· 52% of LGBT people said they’ve experienced depression in the last year;
· One in eight LGBT people aged 18–24 said they’ve attempted to take their own life in the last year;
· Almost half of trans people (46%) have thought about taking their own life in the last year and 31% of LGB people who aren’t trans said the same;
· 41% of non-binary people said they harmed themselves in the last year compared to 20% of LGBT women and 12% of GBT men.
Therapy will provide a safe space to work through these feelings, thoughts and questions that you (or your child) might have. If significant mental health difficulties are part of your experience, we will aim to reduce the acute distress and implement coping skills, so that you are feeling well enough in order to tackle the complex question of gender identity.
In this gradual but most important part of therapy (gender identity exploration and formation) we might explore where exactly your discomfort lies (expression, body, pronouns, gender roles). We will also explore how gender dysphoria and the experience of minority stress may be directly linked to depressive and/or anxious symptoms and we might also explore further aspects of your identity (religion, family background, values, character etc.) as gender is not the only aspect of identity. However, ultimately this will be your therapy and you are an expert in your experience. So, I will always ask you for feedback and for collaboration in our sessions. My role is much more an allied companion supporting your discovery.
Some of the core principles I apply to working with gender-exploring, gender-expansive individuals are:
· Naturally occurring variations in gender (expression, identity, roles, norms) exist and vary across cultures and time.
· Congruence of internal feelings with external presentation and recognition is essential for long-term well-being.
· Authentic gender identity emerges over time from multiple complex interactions.
· All gender identities and expressions deserve equal respect and should be protected from stigma, prejudice and violence.
· “Psychopathologies” such as anxiety and depression most often result from negative and oppressive reactions from others, rather than from within the individual.
· The process of therapy is non-linear and non-directive i.e. you explore your feelings and experience without me steering you into any particular direction or towards a specific gender identity. The outcome of therapy can be any consolidated identity, whether this might be cis, trans, male, female, genderfluid or non-binary. Ultimately, therapy is about finding your individual authentic core identity and supporting you in expressing it in a congruent way to help you feel happy and comfortable with who you are.
In particular, for children and teenagers living at home, the best predictor for a healthy life is family support. This means that I will also support parents in finding and implementing ways to best support the development of their child whilst attending to the needs of all family members.
However, as the above numbers indicate, even if a person has a strong sense of their identity, they may still face aggression, rejection, stigma or violence. If you (or your child) suffer due to gender-based victimisation, rejection, discrimination or non-affirmation this can lead to negative expectations for future events, internalisation of negative messages about the self and not living authentically. This in turn can cause mental distress. In this case the role of therapy would be to support you through these tough times and to build coping mechanisms and resilience. The goal remains the same: Enabling you to live authentically and happily.
I hope this was helpful. Please feel free to get in touch should you have any questions or would like to discuss some aspects further.
Lukas Dressler (he/him)
Counselling Psychologist (MSc.)
HCPC Registered No. PYL041915
Integrative Psychotherapist (MBACP)