I've seen my current therapist for almost a year now. He calls himself an occupational therapist or youth worker, I don't understand either of those terms. He knows I'm trans but we never really talk about it. I've really been struggling with dysphoria and depression recently, in fact I've said before that I'm sure 99% of my problems stem from being transgender. The problem is, I really don't know how to talk to him about dysphoria. I'm seeing him in two days and I don't want to beat around the bush anymore, I've tried to hint that I want to talk about it but he doesn't seem to catch on. So, I'll just have to say it. I think the topic is uncomfortable for everyone involved though. He is a cis guy. The admin there assign everyone a therapist and they gave me a male therapist based on my gender, which I am thankful for but it causes some awkwardness. I don't even know if he knows I have breasts since I bind when I go out and even if he does, it's not like I want to talk about that with a twenty-something year old guy. So I can't talk about top surgery or chest dysphoria. And I'm not going to talk about bottom dysphoria...I feel like maybe we're way too close in terms of age, he's at most six years older than me. I feel like he doesn't really get it or he just sees it as something smaller than it really is. I mean, it's a big deal to not have your mind align with your body or at least, it is to me but I was telling him that I didn't want to go to prom and this was literally our conversation: "So, when you were born the doctors said you were..." "Female." "But you feel you should be..." "Male." "And what do you identify as?" "...Male." "And how does that affect going to prom?" "They're going to make me wear a dress and makeup. And I'll have to go with a straight guy and everyone will think I'm his girlfriend." (The girlfriend part was possibly an exaggeration :lol "What's wrong with that?" "Everything." "I think your goal this year should be to go to prom." "I don't want to." "I think you'll change your mind by then. It's still eight months away." And I don't see how that helped. I'm not going to do something just because he thinks I should because I think he's wrong because he wasn't really listening? I'm pretty sure in the little record I have, it said I'd had undiagnosed gender dysphoria since four years old and my old therapist wanted to give me a clinical diagnosis (at fifteen), why would I change my mind in eight months? I'm a very quiet person too, I don't like opening up about myself and on my list of secrets, being transgender is pretty high up. It's probably my third biggest secret ever and it's hard because this guy is like a virtual stranger who I'm supposed to tell all my feelings to. I don't want to cry or anything, that's awkward. I don't even cry in front of my family. So, how do I get past this discomfort? Because I have to bring it up Monday, I don't want to pretend I'm fine anymore :help:
Yikes. A good therapist shouldn't be telling you what your goals are (or even should be.) They should be exploring what's important to you, and helping you identify goals... but the goals should be yours. Additionally, the communication about the disparity between your assigned-at-birth sex and your actual gender wasn't handled very sensitively from what you've described. Could you have a conversation with him and directly tell him how you're feeling? The training and experience that occupational therapists and youth workers have is different than the training therapists have; they are more occupationally-centered professionals, and generally don't have a lot of psychologicai training, and probably almost no training on sexuality and sexual orientation... which might be why it feels uncomfortable to talk to him. Unfortunately, many therapists, even those with doctorates or masters degrees in psychology, are pretty uncomfortable talking about sexual stuff. It's their own shame getting in the way, and it's also their fear of making the client feel uncomfortable. But it's an important issue in many people's therapy issues, and it should be something the therapist is OK going into... and yet, many avoid it. You can, if you choose, take the bull by the horns and directly address it, and simply see where he goes with it. You can even ask him if this is a topic he feels comfortable delving into, and what his experience is with it. He should feel comfortable answering that question honestly, and if it isn't something he's comfortable with, the two of you can discuss what to do... whether he wants to get supervision and additional skill-building in that area so he can work with you, or whether you might be better suited to another therapist. In any case, with regard to the specific issue about prom. the issue should really be around what sort of outcome you want, what might be needed to make that outcome possible, and whether there's any way get what's needed to make it happen. There may be possibilities that haven't been explored, but if the therapist simply ignores the key issue, that isn't being helpful to you.
