Authenticity Isn’t Easy: Navigating Through Grief During Gender Transition, Ep. 140

So it you know, and it's both through teaching and through my clinical work. I did gender therapy for a while. I found myself in this really fantastic job with the US Navy between July 2016 and January 2019, where I was working with the transgender care team. And so I was a clinical case manager to that team and I w worked with Somewhere between 250 and 300 active duty sailors and Marines who were going through a command-approved gender transition. And so that job in and of itself.

I I don't I don't know that it necessarily cemented me into the field, but it it because it was a full time um that's all I was doing job, it really did give me some credibility outside of just being a trans person. Right,'cause a lot of times people within, say, gender therapy world they they don't necessarily always consider trans people to be able to

contribute to the field without immense um subjectivity and uh and the inability to reach objectivity. And so I feel like I can do a really good job of being both objective and subjective. And uh I've really enjoyed, you know, the opportunity to be a consumer and a provider within the transgender community.

So today, why don't we start by talking about how this concept for this particular interview came up for you, why this topic?

because a a member of their family, a spouse or a child in particular, is going through a gender transition, uh, mostly medical, sometimes social gender transitions. And so I was talking to them about like, well what what do you say to somebody who is expressing that they're they're feeling lost because the person they knew is quote gone. And you know, they s they sort of push back a little bit on that and said, Well they're not gone.

They're just becoming their authentic self. And I thought, well, I mean, I know I've heard that. I've heard people use that kind of languaging. And it got me to thinking like, I know that's not the language I use to talk about my experience of gender transition, and I've talked with hundreds of other trans people, primarily trans men.

And we all use different language. So I thought, has anybody actually done research to look into what are the different ways that we conceptualize and frame our gender, our gender identity, our gender expression? the our gender roles, um, our sexual orientation, the the prospect of of actually quote, changing genders or becoming our authentic selves or being gender affirming, like all these different, you know uh words and phrases that that people

j speak all the time and not very many people actually know what they mean when they're hearing these things. And a lot of times I don't know that we actually know what we mean when we say them. And so I did find one study, just one um that was focusing on looking at the um the types of f conceptual frameworks, social conceptual frameworks that um people use

uh to talk about their gender identity. Um and then I looked at um Uh, this same researcher then looked at some of the ways that the frameworks in which people well the frameworks that people use socially and then the conceptualizations we have of ourselves.

And so that's Kristen Norwood and she does she did a study back in 2012 or at least published in 2012 a paper called Grieving Gender, Trans Identities, Transition and Ambiguous Loss. And I went, oh, ambiguous loss. What's that? So then I went and looked up Ambiguous Loss and found that uh there was a book written um about ambiguous loss.

by Dr. Pauline Boss in the nineteen seventies. And so these two things came together and then that's when I started talking to people about it. And really, quite honestly, I experienced a lot of pushback. from trans people, from therapists who work with trans people, from family members of trans people, from people who work in um trans specific um organizations focused on youth.

There's a lot of pushback on recognizing and or supporting the grief and loss process for family members and also for trans people.

So tell me more about this idea of ambiguous loss. What does that really mean and how do you see this applied to this concept of gen of grief and loss in relation to gender?

which is goodbye without being gone, right? That that phrase captured it. So for example, dementia, addiction, or gender transition. Right? So for example, my father, he has dementia now. And sometimes he remembers who I am, and sometimes he thinks I'm one of his brothers. And so he'll call me Xander. Sometimes he'll call me Savannah. That was my uncle's name. And so, you know, he's physically still present.

I'm still physically present, but my relationship with my father is not at all what it wa has been or what it was up to, you know, for the for at least fifty four years of my life. Right? So So he's not physically gone, he's still physically present, but I have a loss that I'm experiencing because my relationship with him has changed dramatically.

So when we're going when somebody's in addiction, the same thing can happen. It's like you can see the person, they're right there, but perhaps they're just incoherent. They're not um capable of of recognizing, you know, what they're doing or where they are. Sometimes with mental illness, right? If somebody's in a psychotic um episode, they're you know, they're they're there, but they're not their the same person that you know, right?

in how they are in that moment. We gender transition with all the different conceptualizations and frameworks. Right. For some people this can feel like I can see my son or daughter. I can see my husband or wife. I can see my brother or sister, my mother or my father. They're right there. They're in the room with me. I can I can talk to them on the phone. I can Do email exchanges with them, but they're changing right before my eyes. And so I'm experiencing a loss, they might say, because

If that person's not my husband anymore, who are they? And who am I? Am I not a wife anymore? Am are we in a lesbian relationship now? Do I wanna be a lesbian? I mean, so we go th you know, people go through that. You know, it's like that used to be my son. Now they're saying they're my daughter and they're telling me that That they never were my son. And it's like, but I know I gave birth to them. The doctor said it's a boy. Um, so who am I if I'm not the mother to my son?

I don't know how to be the mother to my daughter or vice versa. Right. So that's that's where it's coming in, this idea of ambiguous loss when it's relating specifically to to the psychological ambiguous loss and in particular the gender transition component of that.

Right? We have a chromosomal sex, a natal sex, a biological sex, a sex assigned to birth. Right. There's a lot of different ways to phrase that. We have a birth certificate and the you the word male or female in most states, in some states they're changing that now. uh is recorded on that document, right? So biological essentialism. We're men and we're women and some of us or more male and female I should say. And some of us are um intersex or have a

um uh differentiation of sex condition where it's instead of XX or XY it's XXX or X XY or Y Y X. There's a lot of different combinations. And then there's the social constructionism construc conceptual framework, right? The culture influences precede biological influences. So it doesn't matter. It do like in my case, it doesn't matter if I had a social constructionist worldview, it wouldn't matter to me that my my sex recorded on my birth certificate

and the reproductive capacity that I was born with is categorized as female because I live in the world as a man now. And so I can completely deny or reject or dismiss entirely this concept of biological sex. and I can just live in the world as a man. As a trans man, a transgender man, a transsexual man, right? There's many different ways to talk about it. Whereas there are gonna be some people who are gonna say,

No, even trans people who say no biological sex exists, whether you call it biological or natal or chromosomal, right? These things are within biology, the science of biology. And so, for example I could say I live in the world as a man, my sex is female. I can say that. I actually do say that. I don't have a problem saying that. Now do I say it to my neighbor? No. Do I tell everybody I work with? No. Um but I tell my doctor, I want my doctor to know what my birth sex or natal sex is because

they it might determine which medications they prescribe to me, the dosage of that medication, the delivery method, the the the interval in which I take those medications. So I I do want them to know that. But it's not necessarily something that Everybody needs to know about. So when you think about just the different way that people conceptualize, there's a lot of tension between

biological essentialism and social constructionism. There is a way to overlap it a little bit, but most people find themselves in one or two of these groupings.

right that that that their their personhood exists within them in this non um physical way, the body way. And then a social self conceptualization, identity is malleable, right? Material and observable, meaning my body. how I appear to other people socially, by the clothes I wear, the way I style my hair, whether I put on or not put on, you know, makeup on my my face.

uh the w the intonations I take with my voice, right? So the sovereign self, the beyond the body, or internal to the body versus social self, which is the external, what we show to the world, what is observable by others.

So it's like those frameworks, those social uh frameworks, and then these conceptualizations of self, when you look at those those. four things, right? The two frameworks and the two conceptualizations, it turns out that there's four different sense making frames that can come out of that because of how you link the the two from one to the two with the other. So in the research it goes into um some great detail about these four different transition sakes making frames.

Uh labeled as replacement, revision, evolution, and removal. And so based on the interlocking between, well, what what's the difference between having a biological essentialist? and a social self-conceptualization. How does that manifest? Versus somebody who has biological essentialism as their conceptual framework, but self-sovereign. so conception of self. The next is evolution. That's if you take a social that's for people who take a social constructionist

you know, world view, um meaning man woman, not male, female, right? Social constructionism. And then you you merge that into somebody who has um either a social or sovereign self. And then the last one is removal, which is it's unanchored by either framework Or concepts. It's like it's individuals who completely create new meanings for themselves.

Um that was one of the that was the fourth um uh sense making frame that was identified from the participants in the research. So I thought that I found that really interesting and I see that that's a fairly common thing, especially nowadays, right? This research was done in two thousand or published in 2012. But if you think about 2021, there's a plethora of identity labels that people have now. There's a lot of this

self-sense making. But I would imagine that some of it is still influenced by social conceptual uh frameworks and also by um conceptualizations of the self. It's just that we don't talk in this kind of language. Uh you'll probably hear people more often than not say that are trans say, I don't really know how to describe who I am and how I feel and how I came to understand this about myself. It it's quite complex.

and convoluted, honestly. I I don't necessarily feel comfortable in explaining or describing it um most often. It did help to find this research. because at least it gives me an idea of how how one person was able to make sense out of the research that they gathered. But it's not like I've committed to memory and I can just say, Oh yeah, I have this framework and this conceptualization. Um I because I don't tend to talk that way and I don't you know, that's it's very academic.

Um so I'm I'm still trying to make my own sense out of it without completely um crafting my own um s you know meaning making. I haven't done that either. I'm just not sure where I where I where I am in all of this different um sense making.

What kinds of words are they using, right? So if we think about the biological essentialism being about our sex, and we think of social constructionism being about our gender, well, how are our clients talking? Are they using language that's more foundational to a biological essentialism? Are they talking about, right, their sex versus their gender, right? Are they transsexual or transgender? That's that could be in and of itself, that's a controversial question to even ask.

Um, using the term transsexual can be often very um controversial. I use it because that's the word I use to talk about myself. It's not a word that people I I wouldn't recommend that anybody just start calling people they think are trans transsexual because it's typically not gonna be true. Um but typically people who are transsexual uh are using more of a biological essentialism frame.

right, to say, Yeah, you know, the the doctor said male and I grew up, you know, um, socialized as male and I and I um I may have had some incongruency, but there's gonna be a a variety of of levels of that. Some people have really severe

incongruency and some people have fairly mild incongruency with their with their sex and their gender. Um and so I listen to how people talk about their gender um and what terms they're using and of course Some people use a lot of terms interchangeably as if they're synonymous.

and they're not technically synonymous, so we have to kinda listen under or through that a little bit. Because for example, people might say, Oh, I'm a I'm a trans female, and but they take a very social constructionist viewpoint, so they're more gender-focused than sex-focused.

but they'll refer themselves as trans female. It's like, well maybe maybe it's trans woman, because female is the biological category. Or we're running into an issue where people completely um either disregard or are intent on uh dismantling or deconstructing are some of the words you might hear, even the notion of biological sex.

Um, which is why now there's there's um you know, movements in uh in Britain, in particular in the United States, of uh, you know, feminine groups of feminists who are pushing back on, yeah, there are definitely females and we are those.

Right, so there so it's there's some pushback on this from outside of the community. It's quite an interesting thing to start talking you know, to start talking about, but also to experience. So I listen to what people say And then I ask them questions that have to do with everyday kinds of ways that we might be expressing our gender. We might be experiencing our gender. So I'll pay attention to maybe how they're dressing and I'll notate it.

Um and I did that for one client um in particular that I recall where for the first like seven or eight times we met to ga together, this was somebody who was um You know, their original birth to get said male, they were identifying as a a transgender woman. They had not yet started any social or medical transition, no legal process at all. And they were showing up to therapy sessions in like

really disheveled, um, in their clothing, right? They weren't grooming, their hair was all messed up. They were in like raggedy sweatpants and a raggedy kind of overstretched t shirt and flip flops and And then all of a sudden one day they show up to session and they're wearing a really tight, multicolored um like dress from the 70s. You know, like think of uh, you know, like a go-go dancer dress, uh go-go boot.

and a parasol, um, and makeup and a new haircut. I mean literally I saw them one week before completely disheveled. They made a significant um switch in how they were presenting. And I it's because they had gone to the clinic and gotten their hormones and so they had started hormones and thought, okay, now I'm gonna do it, and changed everything about themselves, just like that. So it was really interesting to see that, to observe it.

um play out that way. And the things they started talking about, the topics changed. Um the way they sat changed. Um the everything changed. It was so fascinating. I hadn't had that experience before and um so it was new for me. So I was I was really paying attention to it. And, you know, I was I would I would ask them questions that had to do with um

What were the things they were doing just throughout their day that they considered gendered? Right? Because they would make comments like, you know, I I want to do more feminine things now. And I would say, Well, what are feminine things? Right? I I would just get them talking about those like cause then that would that helped me understand how they were making sense of their world.

Um and and largely what I I what I noticed was that there's a lot of because it's so complex, even the way people talk about their own experience can be kind of con complex and it can almost seem to um conflict, I guess. It can uh people can take both. They can hold biological perspectives and social constructionist. And this does exist. There's you know, people actually, you know, there's a field of study where it's combined together.

But generally speaking it's it's not as common. So so then having to sort out like are they just confused? Do they are they more set in biological essentialism than they are in social constructionism? Are they really okay? Are they comfortable with these things, you know, melding together a little bit? Uh so it's it's just getting into the nitty-gritty of how people talk about their experience.

And then also things that have to do with how do they want to be different in the world, right? It's when I when I was maybe a year on testosterone, it was pretty clear to me that people saw me differently, they were treating me very differently. So that led me to believe well That means I can be different. I can actually b change my own self if I wanted. Not just my outward self, not how I looked and sounded. I could actually

I could take up a new hobby. I could um join a different kind of social club. I could get involved in you know, activities that I had never either been interested in, like or maybe I was interested, but I saw that it as being like not not something I wanted to do'cause maybe it was

too feminine or it was right, there are all kinds of ways in which we get to reinvent ourselves. And there might even be some trial and error with that, you know, sort of like in adolescence with teenagers, they go through trial and error with uh what they wear and

thinking that they might like boys or girls and oh it's actually both and oh there's more than just boys and girls and right the the shifts and and turns and twists that come with adolescence. We get to do that um as adults which is both exciting and, you know, can be somewhat painful, you know, socially and and psychologically.

How do you talk to them about that idea? Um, I know it's something in my work that I see frequently, I see it with family members as well, and this idea that we had whatever concept growing up or, you know, and having this child and one day they'll be married and to a nice man and you know, whatever that was, and all of these ideas that there's this

this concept of loss, but for you, how do you talk about that with clients and with families? How is it different? How is it the same depending on who you're talking to?

um how to frame then uh the ambiguous loss that frame, right? There's even gonna be a different frame. So for example, when we look at um replacement, right, which is one of the transition sense-making frames, when we look at replacement, replacement again is anchored by biological essentialism and social self-concept. Right? So for example, um The what a trans person might say uh is, you know, I'm a different person now, right? They're they're replacing who they were with who they are.

Right. I'm a different person now. So the sex is viewed as natural, binary, fundamental component of their of their personhood,'cause they take this biological essentialist. viewpoint. I'm a different person. I've transitioned from female to male or male to female is another thing you might hear someone say, right? Male and female are considered fundamentally different categories of personhood from being a man or a woman, right, in this replacement.

frame. So for ambiguous loss, it's looking at grieving the loss of the self, the the f the the the self that's being replaced. So that that's that's where the lost would go. Like So somebody, you know, the idea of like I had a parent might say, I had a blue-haired, blue-eyed daughter, and now I have a blonde-haired, blue-eyed son. Um, right? So they're they're trying to frame their world in this replacement mode.

from this to this. And so the ambiguous loss is well that that person that they quote lost. The person that's being replaced, um A lot of people you'll hear trans people say, you know, I'd psyched myself up for the transition, thinking I was just gonna be like a a personality change. Um, I would grow a beard or I would, you know, I would I would grow breasts, whatever, you know, direction people are going in. Um, but then all of a sudden they didn't expect that they would feel grief

at the fact that they were losing their relationship as father to their child or husband to their wife or mother to their child or wife to their husband or wife to their partner, right? If they were in a lesbian relationship. So right so it's like They're they that's the loss they're experiencing is they're experiencing because I'm not that anymore, I'm now this.

And so if you go into the revision, that that sense-making frame for gender transition, it's still biological essentialism, but now it's in the sovereign self. Right. And so you might hear people say things like, um, they're the same person on the inside or I'm the same person on the inside. Right. So sex is viewed as an internal component of personhood. Their anatomy, their chromosomes, their hormones. They don't identify um or they don't indicate

you know, whether someone is a man or a woman. And you'll hear people say that, like that's a fairly common thing. You know, or people might say, I've always been a man uh or male or I've always been female. And so with the ambiguous loss, the focus there is um that maybe what's happening is somebody is partially avoiding grieving the loss. Of that self, right? Because they've made a revision. Instead of a replacement, they've just revised.

I'm still the same person. I've always been. Even though they may start to look and sound very differently, that to them is inconsequential. Right. Um and so so there might be a focus on making sure that there's not some sort of uh grief that maybe it's not i you know, make sure that it's just not being avoided, um, instead of just accepting, you know, on the surface, like, okay, you're still the same person inside.

Um but then when you go to the evolution sense-making um frame for gender transition, now this is social constructionism, and then it's sort sort of a hybrid of social and sovereign self. And so you what you might hear people say are, um, I'm progressively changing into my authentic self. Or they they're now their authentic self.

Um you might also hear people say things like, I'm both the same and different, right? This is getting to your point about what if it's both, right? I'm both the same and different. So with the I'm progressively changing into my authentic self or I'm becoming my authentic self, right, the before-self leads into and is part of the after-self.

So it's not a replacement and it's not a revision. It's just a natural evolution that they're going through, right? That's how they're making sense of it. In the I'm both the same and different, right? the the male and female are divergent yet compatible, right? They can I they can um identify or occupy both identities, just not at the same time. So you might hear people um who are maybe non binary, gender nonconforming, gender fluid, where they they kind of feel a sense of like

Well I'm kinda male some days and I'm female other days or I feel more like a man or more like a woman. They might even change the way they dress. For them it's more of an evolution. And so loss is a little bit neutralized for people that may have this gender transition frame. um because i i it in some ways they're gaining something um that's new because they're they're evolving they're e they're there's something different about them that's new and exciting

um that doesn't cause the same sort of um uh maybe internalized sense of incongruence or dysphoria um or the external, right? So so ps you might hear somebody say, you know, Um, I had a son, now I have a daughter. I have the memories of my son and I'll build new memories of my daughter going forward. You know, Lacey was my daughter, Kyle is my son. Like they're speaking about the same person. Lacey was my daughter, and Kyle is my son. So they're talking about the same child.

So that's kind of the evolution. So it's like ambiguous loss, like how to talk about the loss people might be experiencing, it it can depend on these

on these frameworks. Um and then the final is removal, which is it's unanchored of course, remember, by any of the either of the frameworks, essentialist, uh the biological or the social constructionist, or by either social or s uh self. uh or sovereign uh conceptualizations of self. Right? So you're gonna hear people say things like, Sex and gender are irrelevant to personhood, right? They just completely remove the notions of sex and or gender from their identity entirely.

So you might hear people they're like other kins or they they take on new terminology that people don't yet know. So they're not easily sort of pocketed into something that people go, Oh, I know what that means. Um Or they'll say, I'm neither male nor female, right? People say that. You hear people say it all the time. They're creating a non-sexed gendered self.

Right. So some people create a like a new identity, a new gender. Some people just reject gender and sex altogether. Right. So the ambiguous loss focus would be um Uh for some people this also would then help them to somewhat avoid or it might even alleviate a sense of grief and loss because if you can just sort of reject it all, um you might not

feel the need, there's nothing to grieve. That doesn't mean that there won't be grief, but in this framework it's harder to see um that that process. So, you know,'cause some you might say to yourself, Well How how do I reconcile losing my dad but keeping my dad at the same time? Right? It's it's even more ambiguous in some sense, but it it the loss doesn't seem to be as tangible.

Right. Um or I used to think I had a daughter who became my son, but now sex has become irrelevant to my perception of Jackson. Right? It's just Jackson now. It's not the son or daughter. It's not even the child, right? It's like Jackson. It's this it's this person. Um so it it it again, it's it's still complex. Um and it would it takes time to really feel comfortable.

thinking in this way, talking about it. I mean maybe even people can hear me as we're talking. Like it it doesn't just roll off the tongue, that's for sure. It is still fairly heady and academic. But when we get down to these phrasings, right? I'm neither male nor female. I'm both the same and different. I've always been fill in the blank.

Or I transition from blank to blank, right? These are phrasings that we've heard our clients say as, you know, if we do if we've done any significant work in the trans community. So when we think about just the phrasing, then that will help us. just recall what the sense making framework is and what the ambiguous loss focus can be.

Well, there's it's gonna be no different within the trans community, right, which is made up of many, many, many different identity groups. And so we're gonna have people that make very different sense of the world. They have different moral foundations, they have different v core values, and so we bring, right, that part of ourselves Um, we bring into our, you know, it's part of ourself as a trans person. So we we're bringing this whole complex person.

you know, ourselves into the trans community. And so we're going to uh encounter other trans people who who are adamantly opposed to how we make sense of the world and how we make sense of our own body and our experience. We're gonna meet therapists who um who have a worldview and a conceptualization that's very, very different. And and if we don't if we don't get um to a place where more of us can be open to and hold that there's many, many different ways

to make sense of the world, to make sense of our being, and to make sense of our identity and those expressions of that identity. Um, without that, I think we're gonna have people who are gonna be either um misdirected They're going to lose direction. I think there are going to be people who are going to experience more gender dysphoria than maybe they need to because.

They don't know that there's so many different ways that they can frame and conceptualize themselves because they've been given, you know, a packaged deal. Here's how you should conceptualize yourself and here's how you should frame your experience. And that's it, right? That's the only way to do it because

you know, that's the dominant narrative um, you know, in the trans Twitter universe. And it's like that's just not the truth, right? That's so so I think it takes a certain amount of self efficacy. We really need to be able to um know exactly what we need and want and we need to advocate for ourselves. We need to be able to set boundaries. We need to be able to right we these are things we have to either learn or we need to cultivate. We need to go seek people who can help us.

you know, um hone those skills or else we're going to be like a pinball on a pinball machine just getting whacked around by people who are who are directing us uh uh into how to be the right kind of trans person.

And um that's not gonna work for um a large number of people. A large number of people in the trans community are going to be grieving um what are what I would phrase as gendered meanings. Right, they're going to be experiencing a loss of gendered expectations and a a loss of gendered relationships and a loss of gendered identities.

Right. These are things that we live these things. Now, is this gonna be as true for a 14-year-old who's going through a social transition as a 54-year-old who's a good one? whose um you know a relationship is ending and they're starting a medical transition? Absolutely not, necessarily. Right? So we we we have to hold in in mind the context of the person, the place, and and the time, but in general, right, if we're married, there's a particular set of expectations.

whether we buy into them or not, whether we adhere to the social norms associated with marriage or not. they're they're external to us as well. And we may be married to somebody who holds more traditional views of things than we do about gender. And so they're gonna be impacted whether we are or aren't and whether we want them to be or not, right? So it's just a it's also just thinking about the the truism of of lived experience, right? And that's all the rage now is

getting thing from the lived experience. Well, I value the lived experience of people who share very, very um divergent worldviews for me and I value the lived experience of people who challenge me and and and want me to speak differently. Um, I'm not going to probably, but I do value, right, that lived experience of the family member who's grieving and the family member who's not grieving. I think that they're all valid. um experiences um of their circumstances and situation.

and may or may not have ever gone the heady academic route to really define it and say, you know, option two, that's me, that's how I explain this thing that I'm going through with a sprinkling of option four. And then to sit in the room with somebody who is option three and have that potential dissonance and discord in the way that they present and how they make sense of it.

is kind of a funny thing to think of saying'cause you can't really use that for other affinity groups. So I have friends who are blah blah blah. Um but sometimes it works and the you know, people use that phrasing. And so what I find is that um Again, I think they're well intentioned. Uh what I think is that what happens too often is that people are very limited in their exposure to multiple um trans people who frame their identities and their experience in multiple ways.

And so uh for example I had I had an encounter with a therapist just a couple of months ago who um has a family member that is non binary. and is really, really active in asserting the the family member is very active in it in asserting that

that being non-binary is somehow superior to being binary, right? They they kind of use languaging that makes it sound like somebody like me who would is quote binary trans man that somehow my lived experience is either less valid or it's actually problematic because

somehow I'm reinforcing some really terrible thing they might call like hegemonic masculinity or something like that, right? So again, all academic terms. But that's how people so this this therapist was was heavily influenced by that family member. And so uh now they're working with some clients and some of them are non binary, some of them are gender fluid, gender nonconforming, but that doesn't mean that they all have the same

uh views as this family member. It doesn't mean that they all take the same um have the same concepts of themselves as a non-binary person. They might be using the same terminology, but they might live it out very, very differently. But I could tell from my conversation with this therapist that they didn't really think or they didn't realize that there might be if you met a hundred nonbinary people, you might hear like

close to a hundred different ways that they conceptualize and frame their identity, even though all using the same word. Um and so I I just, you know, I I do it fairly um diplomatically. and casually and gently, um, by just maybe telling some stories, you know. Oh well I was working with a non binary client a few years back and this is what they said and I I might in it you know just sort of interject in that way.

because I I don't subscribe to a call out culture. I'm not gonna I'm not gonna call out a therapist. I'm just gonna maybe give them some other examples to see if they're they can expand their worldview, right? Their paradigm of how they're viewing gender. Uh because I don't think that they're malicious. I don't think they're um have ill intent. I just think that they have very limited exposure. And they're going out into the world and saying, I'm a gender therapist.

And maybe it's too soon for them to really hang out that, you know, that sign. Maybe they need a little bit more exposure, a little bit more training to understand um just how diverse our community is. Or else they might lose those clients because they don't like how they're being talked to, or they might um they might get a um a more oh more vulnerable client that is susceptible to being directed if they're taking a more directive, you know, um intervention model. And so they might easily be

you know, directed and it turns out it might be a misdirection for them and they're only gonna find out about it later. Um meaning the client, right? The patient's gonna realize, oh, that really wasn't the right thing for me. Um, but maybe they're not even working with that therapist anymore. So the therapist might not even know that it wasn't working for that client at the time.

So with a curiosity of not assumptions about how things should be, but with awareness of how they are for that person's worldview and their lived experience and kind of checkity checking our belief systems at the door. But I I'm glad you bring up that peace and that conflict even within the the clinical community of how these frameworks can create conflict. and how we define ourselves and then how we expect others to define themselves as well.

s compassion for the self and for the clinician to also maybe ex you know, practice some self compassion for you know, not needing to get it right with each client and maybe actually, you know, misstepping from time to time and just you know, just having compassion for the fact that we're human and we're we're imperfect.

um and and that that's that's just part of life. Um that and and there are ways to you know, there are ways to to deal with the grief. Um I I just wanted to give a few more phrasings because I think It helps people to understand, maybe from statements that they've heard, what I mean by some of this um the grieving that's going on. So for example, um you might hear clients, whether they're trans or or family members, say, I love him as my son, but not as my daughter.

Right. So this is a somebody who's struggling with uh with somebody who's who's doing some sort of transition um from from male to female, right? I definitely feel that I lost my daughter and I haven't quite worked that through, right? I've lost. They feel they've lost this per they're not dead, right? Although it's interesting about this idea of um

The idea that we don't die, right? That's why it's ambiguous, sauce. We don't die, but some people use a term called dead name and then they get angry at their parents for referring to them by the name that was given to them by these parents. So they're like, I'm still me. Uh you know, I'm just becoming more authentic. Quit using my dead name. So we're it's almost like a mixed message. Well, are you or aren't you dead?

Right. I think parents might that might confuse some people because we're we're mixing, you know, metaphors maybe. Um the loss of your imagined future for your child completely gets turned on its head, right? Like I had this whole like you said, I had this whole future planned out for my son or my daughter, right? My grandchildren. Some people might say I'm I'm grieving the shell of a dream that has vanished. Right, that's another, right? That's a bit more, you know, um

um you know, something out of literature almost, right? Um the grief came not from losing a daughter, but from losing my identity as my daughter's father. This is a phrase that I took from the research. Right? So this father is saying I I I'm not grieving that I lost a daughter, I'm grieving that I'm no longer longer the father to a daughter.

'Cause there is a message out there in the world, you know, Daddy's little princess and father-daughter dances, right? Like so this guy had a really strong connection with being the father of a daughter. mm, I don't know if he has sons. Maybe he doesn't know how to be a father to a son. How how are you a father to a son who is now well past the age of, you know, tossing the ball in the front yard as, you know, to use something really conventional?

Um my ideal life included having a husband, a man who took the lead. Now it's 50-50. I've lost my ideal notion of a marriage. Right? So here's a here's a wife, right, married to a husband. Right? A woman married to a man and she wanted that conventional sense of a marriage and she had it. Right. Her husband did take the lead. Now her husband is going through a gender transition and wants to um doesn't wanna take the lead anymore. Doesn't wanna fulfill the

the gendered expectations of a husband, of a man in a relationship. And so now this this wife, right, this woman is completely um destabilized in her own sense of self and her marriage. Right. So these are things that we might hear people talk about. Right. This is the non-academic heady stuff. So if we're listening, right, we can just be listening for how people are talking.

About their experience. And then, and then maybe we can go back and say, okay, it sounds like they take more of an essentialist than a social constructionist. you know, um frame or worldview of them s you know, so we can do that and then we can mirror that back not using academic language.

And and I this launches into its own conversation about what is loss, how do we resolve it, and what does resolution mean. But I'm curious for you, when you when you're working with someone, what are the phrases that let you know, okay, this person is working through this or maybe has worked through this for now if we're looking at coming out as an ongoing process. Um what does resolved ambiguous loss look like?

of of their gender transition, right? The replacement, revision, evolution, and removal uh sense making frames. There there were a couple in particular, um, evolution and um removal that were that for some people that's just where they start. Um and and in in those two sense-making frames, there seems to be, at least based on the research, there seems to be uh a much milder experience of of law. Uh it's not so um central to personhood because they're making sense.

of their of their world and their experience by saying, I'm both the same and different or I'm neither male nor female and so those actually seem to be uh two of the the sense making frames that come with the lower levels of this grief, right? It's the ones where people are a bit more um, you know, very um beholden to either biological essentialism um or social constructionism, but mostly biological essentialism.

where they're going from one thing to another or they're stating, I've always been, right? I'm just becoming I'm just my external is finally matching my internal is another way you might hear it say. So individuals like that, it's like I think what what would be helpful is to not necessarily move them out of those frameworks into another framework, but to help them within their framework

um maybe come to a different understanding of the s the sense of themselves in relationship to the world and other people. Um it might be that they're feeling a lot of pushback. So think about the Think about if your patient or client is the um quote husband of that wife who's like

I had this expectation of a 50-50 or a non-50-50 relationship. My husband was gonna take the lead and now I've got this other person and they're saying they're my wife and they wanna do 50-50. So just think about you're working with that client. And in that relationship with their wife or spouse, I'm not sure how they would even talk about it, that might be exacerbating a lot of their um sense-making because they have this strong pushback.

So one of the things we can do is maybe um find a way to interject a completely different um but not challenging the wife necessarily, just giving another option to the client, to the patient, um, of well there's uh there's a lot of different ways that you and other people

you know, look at this situation and maybe just try to mi do some expanding, you know, expansion meaning making with people um to let them know that that the experience they're having with this one family member or with their family maybe in its entirety is not necessarily the experience you're gonna have with your coworkers at at your job or your classmates at school or your your peers, um, you know, in your you know, your social um organizations. You know, to otherwise it it might it might um

almost um I think it could stunt somebody into they might not even go through transition. Some people stop transition because they think they're only going to encounter these negative things. Um, a lot of people I think can stop transition because going through gree grief is uncomfortable, right? It's uncomfortable in the body, it's uncomfortable, you know, in the mind, it's uncomfortable emotionally. Um

it's we're not necessarily sure how to talk about it. And so sometimes people will just sort of put the brakes on and and back up because they don't want to go through that. So it's I think it's just setting the stage to let people know like

Um, you know well w w what what c what are the what are the feelings of grief that you have? Just introduce it, like'cause they might not know that it's acceptable for them to have it because there's a long there's a strong message out there that well there's nothing to grieve. There's nothing to grieve because supposedly the more dominant, the more societally dominant um sense making frame for diff for gender transition, the two are either I've transitioned from this to this.

or I've always been this or this. Those are the two dominant ones. And so, you know, if you're if you're a person who believes that you're transitioning from male to female and you're encountering a a transgender social circle with where everybody else believes that they've always been female, they were never male. Well that's gonna be a really interesting social space to be in.

Um and so they might expect, oh well that's how my therapist is is gonna think of things too and that's how my my peers are gonna think about it. They might not know that there's all these different frameworks. So it's just inviting people to talk honestly about how they're feeling and introducing them to the possibility that there's that there's some perhaps there's some loss and they might be experiencing some grief.

some of the um aspects I um of gender identity and gender behavior that are taken for granted. It's like Well, what do you love? You know, what do you love about your big sister? Oh, I love this, that, and the other thing. Well m well maybe maybe your big brother is gonna do those things too. Right? Like maybe an older sibling, maybe that's just an older sibling.

Way of being in the world. Maybe it's not a big sister or a big brother, right? Maybe we can reframe for people, like you you might hear people say, Oh, I'm

Do what you want to do, like be however you want to be. So sometimes the grief and loss that we associate with our gender transition is because we feel beholden to. men don't do this or women don't do that or men can't do this or women can't do that. And so people who take a I'm a neither or or they're all stupid, they don't have those same they don't run into those. It's more the people who have gone from one thing to the other.

Um that's that's more likely to happen or people who are like I've always been, they're they're gonna be able to integrate more. Um, you know, their hobbies or their activities, they're not as gendered.

So Transgender Emergence uh is another book I'd recommend. And then I would also recommend that people um go online and locate the um the Kristen Norwood um essay that was published. In 2012, grieving gender, trans identities, transition, and ambiguous loss.

It's in a journal called Communication Monographs, but it's available for people who have access to those different portals either through a l academic library or one of those um places where academics converge online and they have access to each other's papers. Um so so that's definitely a place to to look into that.

Um, because there's so much information. Like in order to in order to deal with and talk about ambiguous loss, it's good for us to get a very, very good understanding of what it is. And I say why not go back to the source? Who wrote the book on it? Who who basically quote discovered ambiguous law?

So a a lot of reading would be my recommendation'cause that's my go-to. Um and then uh then additional trainings just in things that have to do with trans people, mental health specific. So for f you know, I mentioned earlier I am a faculty member with the WPATH Global Education Initiative.

um or institute, they're changing their name. But it's not the only one. There's a there's a new certification program out of Texas called the Queer and Trans Affirming Professional Certification Program. The first cohort is going through right now. I'm

I'm also on faculty with them. There's lots of trainings that you can people can do online um that are that don't cost anything, right? That people can get more and more training. Go to conferences that have either a very large or almost exclusively transgender focus, in particular healthcare, which will have the behavioral health component to. So just expose yourself, right? Expose yourself to a a wide diversity of trans people

um and trans thought and trans you know conceptualization and worldview. That that that will help and and we can never stop with that. Like I can't even stop because it's It's forever changing. Our community is very dynamic, very fluid. That means the terms you learned yesterday are gonna be outdated tomorrow in some contexts, right? So we have to constantly be evolving with this ever evolving community.

So I w it would be great if somebody repeated, right? Maybe and did a a a larger cohort of participants. Like, let's find out, do these still stand true to this day? And what else? What else haven't we learned and what can we know?