Occupational Therapy within a gender identity clinic
Date: 16/09/2014 Host: @OTGeekHannah
Thank you to Hannah Webster @otgeekHannah for volunteering to host this chat. Below is Hannah’s introduction to the topic. Looking forward to chatting with you all.
The role of occupational therapy working with transgendered individuals – this was my business proposal for my final year of study (Bsc) and it has continued to be an area that fascinates me. I did not see this work as an assignment; I saw it as the future of occupational therapy.
Who is the service-user, what do they aim to achieve in life, what can’t they do now that they once loved, what do they believe in and what is important to them?
These are the questions we answer on a daily basis with our service-users as occupational therapists. We provided person and client-centredness and in doing so we create a therapeutic relationship whereby interventions can become successful.
However, as a profession, could we tackle the need of “I can’t cope being a man but I don’t know how to be a woman, can you help with that?”
This twitter chat aims to explore the role that occupational therapy could undergo assisting transgender individuals to live their life how they wish to.
Identifying as transgendered or being diagnosed with a gender identity disorder has been known to result in occupational deprivation and conformity; gender identity is often stigmatised throughout particular occupations and activities of daily living. Prior to identifying or ‘coming out’ as trans, individuals often engage in gender ‘congruent’ occupations and activities in order to reinforce a particular gender and/or to demonstrate to their wider friendship groups / work colleagues / family members that they are ‘normal’ and ‘happy’. However, when the time comes to transition into the transgendered lifestyle, these gender congruent activities can be challenged.
Our gender and social roles play a tremendous part in our lives; the places we work, the clothes we wear, the fragrances we use, how we speak, how we walk and how we behave. But, if you were transitioning from a man into a woman, how would you start adjusting to this lifestyle, how would you express to work that you can no longer use the male toilets, or how would you explain to your son that daddy is no longer a man? –These are only a few areas that are affected by changing ones gender.
With this transition comes a great commitment; living in the desired gender for at least 2-years is essential to be legally known as the opposite sex, and gender reassignment / conforming surgeries are often seen as the answer to physical and emotional [gender-related] confusion and discomfort however have often been found to provide minimal relief and do not meet the expectations of the individual.
Each [trans] individual is unique and their needs can be complex, current healthcare provision for a trans person is as follows: (not necessarily in this order and not every trans-person will receive all provisions)
- Speech therapy
- Hormone therapy
- Gender conforming surgery
- Removal of the biological gender identities – e.g. breasts and uterus
- Alterations of the physical body in order to meet the society or individuals’ ideology of the opposite sex – e.g. peck implants and cosmetic surgery
- Genital reassignment surgery (full)
As you can read, the options for a trans-person, who has completed two or more years of committed living as the opposite sex, primarily surrounds physical alterations – which for some individuals will prove to be 100% effective, however there are others who may not wish to undergo surgery – what will they receive? Also, what support is available to individuals within those two years of committed living?
People identifying and living as trans are likely to experience discrimination, low self-confidence, social isolation, depression and anxiety, and occupational deprivation – surely this meets the criteria for occupational therapy?
Suggested themes of discussion
- Social roles vs gender roles: We value people’s social roles (e.g. getting back to work so I can be the breadwinner once again) as a profession, had anyone considered the value of gender roles and how they can empower and diminish our confidence?
- Working with trans-individuals to address their occupational deprivation
- The occupational challenges faced by the trans community
- What can our role be: gender role transitioning
- Graded exposure of desired gender
- Exploration of gender ideology
- Presenting and living as the desired gender
- Other: please contribute any ideas for discussion.
I hope everyone enjoys my Otalk on 16th September 2014, anyone seeking references for this post can access them directly through me; this work is largely based on my ‘dissertation’ and I would appreciate acknowledgement and consent if this information is to be used externally from the Otalk community, blog and hashtag(#).
Hannah Webster, graduate Occupational Therapist and Reablement Officer for Mind
Post chat updates:
PDF Transcript: #OTalk – 16 September 2014