Psychotherapy for gender identity disorders by Az Hakeem
This article describes a special adaptation of group psychotherapy as a psychological treatment for people with a variety of gender identity disorders. It can be used as an alternative to or concurrently with hormonal and/or surgical interventions for transgender people. It is also suitable for individuals whose gender identity disorder remains after physical interventions. The article draws from a UK specialist pilot for such a treatment service and describes the explicit aims of the psychotherapy, the specialist adaptation of therapeutic technique required and observed thematic features relevant to working in this specific field.
From the article:
“A rigid adherence to a binary system of gender rules is core to gender identity disorders (Hakeem 2010a). It is common for patients to give a history of ‘not feeling right’ early in the evolution of their gender identity disorder. The mismatch between their interests and characteristics and what they perceive society to dictate to be ‘appropriate’ for their biological sex serves as confirmation to the patient of their transgender or other gender identity disorder.”
“In Gender Trouble, (Judith) Butler described gender categories as being fictional products, ‘performative’ effects of society rather than a property located within an individual (Butler 1990). Butler suggested gender to be an enforced, stylised, cultural performance perpetuated by society. The ritualised repetition of this performance gives the meanings that the particular society affords to gender the illusion of being ‘real’. This ‘reality’ feeds back into the society, perpetuating the cycle of repetition.”
“Although patients may refer to ‘male’ or ‘female’ clothes, attitudes, mannerisms, thinking styles and interests, it is the task of the therapist in this specially adapted therapeutic work to ‘de gender’ the things that patients have ‘gendered’ in their minds. Longstanding ‘gendering’ adds to identity confusion when individuals find themselves mismatched with the perceived gendered framework. If aspects of themselves are identified as qualities they had classified as ‘male’ or ‘female’, a gender conflict will be reinforced if these are incongruent with their biological sex.”