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

Using a Disability Model in the Psycho-social Rehabilitation of Candidates for Gender Reassignment

MACARTHUR, BET U.S.A.
E-mail: artsanalys@aol.com

The social definition of disability enjoys widespread acceptance and applicability in the field of rehabilitation. It proposes that the significance of human difference, and social behaviors related to them, is based less on physical limitation than on universal social agreements, which vary little across cultural groups. Using a disability model in the rehabilitative psychotherapy of applicants for gender reassignment has proven surprisingly successful (despite the presumptive controversial social and political aspect of doing so). Psychotherapy patients with gender disorders who are introduced voluntarily to a disability model in their treatment find it quite helpful in orienting them to various social adjustments, which their gender situation requires. They benefit from opportunities to identify with disabled people as they learn to adjust their expectations to others: face shame; grieve functional, role and relationship losses; and work to reinforce physical function, social roles, and emotional bonds that are retained. Adjustment to new roles and abilities is facilitated by the challenge to neutralize comparative assumptions, competitive habits, and attitudes about difference. Patients are introduced to the principle of relational leadership, a positive social behavior through which the person with a difference provides cues or information, which help to define social situations for non-different participants. The therapist’s role is important in reinforcing this positive social behavior in patients.