XVII Harry Benjamin International Gender Dysphoria Association Symposium
31 October - 4 November 2001, Galveston, Texas, U.S.A.

Providing Therapeutic Care outside the Binary Gender System

AUGE, REBECCA U.S.A.
Co-authors: Lin Fraser, William Henkin, Kim Hraca, Dan Karasic, Luanna Rodgers, Anne Vitale & Laura Goldberger (U.S.A.)
E-mail: luanna@ix.netcom.com

We are a consultation group of individual psychotherapists in private practice in the San Francisco Bay Area, all working with individuals who express some variety of transgender issues. We have realized that here in the San Francisco area, we are working at the forefront of a burgeoning transgender movement that challenges conformity to common gender stereotypes, the need to ‘go stealth’ after transition, or even the need to declare oneself a man or woman. San Francisco is the first city on the United States to extend transgender health coverage, including hormones and surgery, to its civil service employees. Transgender health care, including hormonal treatment, is available free of charge to adolescents (age 16 or older) and adult residents of San Francisco who could not otherwise afford such care. Additionally, San Francisco provides civil rights protection on the basis of gender identity, as well as race, religion and sexual orientation. Fundraisers, political groups, art, theatre and the written and spoken word all reflect the energy of the transgender movement here. San Francisco is a place where those who are different from the mainstream congregate and flourish. The idea that transgender identity is a valid identity in itself, not a path to being a man or a woman, is being considered and lived. Many more people are opting not to have surgery or to seek only those surgeries that are important to them, regardless of the standards of having a classically gendered body. Some are exploring what it means to be a third gender or transgendered in a society that traditionally has seen only two choices. In other words, an increasing number of individuals are exploring a life where blended bodies and gender roles are an end, not the means, to express their gender identity. As therapists in this climate, providing genuine therapeutic care means using a wider lens. Do we forge a new model of gender relevant to our times and culture? How do we best serve our clients and uphold ethical standards? We will each provide a brief summary of our impressions, discuss what we are seeing, and consider some hypotheses for the future. We will then open the topic for participant discussion.