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These questions were compiled from correspondence from child psychotherapists received during the course of commissioning contributions to this special issue on a theme of working with gender identity in the consulting room. It became clear that whilst there was a great deal of impassioned consensus about the dilemmas and challenges for us as psychoanalytic practitioners when we are working with children who have trans, fluid or uncertain gender identities, there was also widespread reluctance to voice these questions openly. We are indebted to Jay Stewart, founder and CEO of Gendered Intelligence, an organisation whose aims are to ‘increase understandings of gender identity’, for working with us to expand our understanding of the perspective of trans communities and to offer some answers to our ‘FAQs’.
At the moment ‘gender dysphoria’ is a clinical term, so in a way using these words is in itself the very naming of a mental health condition. At Gendered Intelligence (GI) we talk about people being trans, or identifying as trans or questioning their gender identity. If we use these types of terms we can centre more fully our identity, who we are and who we want to be rather than figuring ourselves as a person with a mental health problem. We do know that many trans people experience mental distress, sometimes in part due to their identity, or perhaps more accurately, because of the discrimination they face or poor experiences that they have being in the world. As trans people, we need to be able to develop resilience, to manage the setbacks that we might experience, and therapeutic opportunities can help here. For some of us, we need a safe space to explore our feelings about our gender and to form thoughts and make decisions.
In my work with young people and their families, the feedback about statutory psychological services is that they can be ‘hit or miss’ in terms of ho