Depth psychotherapy with transgender people

This article presents an introductory and transpositive approach for doing depth psychotherapy with transgender individuals. Combining contemporary psychodynamic, Jungian and gender identity theory, this approach reflects the unique path of transgender identity development. Transgender identity is not viewed as inherently pathological. Rather, the issues that emerge in psychotherapy with transgender clients, like with all people, are about the self and self-in-relation, negotiating identity with outer reality. For the transgender person, however, psychological issues are particularly related to faulty mirroring during periods of identity construction because the transgender self is often invisible to the outside world. Transgender identity development involves a body/mind mismatch and is affected by social stigma associated with gender variance. Transgender individuals negotiate their transgendered self in a world that sees gender as binary, resulting in a tension between desire, authenticity and avoidance of stigma. A composite trajectory of pre-, during- and post-coming out of transgender identity development is presented and potential therapeutic themes and interventions for each of these phases are discussed. Challenges and resolutions are illustrated by poems from clients of the author's 37 years of clinical experience with this population.

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