Behind the Curtain: Getting Started in Gender Exploratory Therapy

In this podcast Sasha and I explore the concept of 'Gender Exploratory Therapy.

This is the first episode in a short series which takes listeners behind the scenes of a gender exploratory therapy process. Although there has been plenty written about ‘Gender Affirmative Therapy’, very little has been written about a concept often described as ‘Gender Exploratory Therapy’.

This episode first went out in June 2021 and since then I have developed my thinking and so I tend to call this approach simple ‘conventional psychotherapy’ or ‘regular psychotherapy’. I now believe it was never necessary to describe it as ‘gender exploratory’ as ‘exploring gender’ is not really what takes place in this context. Instead a conventional therapeutic process is what occurs - and within this process of course there is some exploration of sex, gender roles, identity and other aspects that impact a person with gender-related distress.

In this episode Sasha and I discuss the specifics of establishing a therapeutic alliance when a person is questioning their gender identity. We describe different strategies involving issues such as names, pronouns, clothes and hairstyles and reflect on the different stages of therapy, which we will also discuss in subsequent series episodes.

The current heavy focus on specialism within psychotherapy is not, in my view, conducive to a holistic view of the person. Many people who have a mental illness - and their parents - fall for the idea that only a specialist in the field would be able to treat them. This is typically because they have over-identified with their illness and believe it is so extreme that they must have a professional who works only in this world. Sometimes this is true - for example if a therapist is not aware of ROGD, then their ability to treat a patient who has been affected by this phenomenon is severely curtailed. On the other hand, this focus on specialism can lead the patient to believe that they have been uniquely impacted rather than the arguably healthier view that they have become fixated upon one idea; that this idea could have been a number of other choices - such as OCD, anorexia, alcohol etc- and that escape from mental pain is the driving force behind it all.

I know we are making significant therapeutic progress when a patient I’m working with comes to realise that their fixation is driven by a desire to escape mental pain. From there, they realise that they have become mentally stuck and they need to find better, healthier coping mechanisms.