Gender & Sexual Identity
The Psychologists at Serenity Psychology are able to write letters to aide clients in accessing Hormone Replacement Therapy (HRT) and Gender Affirming Surgeries.
Gender Dysphoria in Children, Adolescents and Adults
Serenity Psychology in South Perth specialises in Gender Identity and assists people of all ages, and gender or sexual identity. The Diagnostic and Statistical Manual-V-TR states that Gender Dysphoria is “a marked incongruence between one’s experienced / expressed gender and assigned gender, of at least 6 months’ duration, as manifested by at least two of the following:
A marked incongruence between one’s experienced / expressed gender and primary and / or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics).
A strong desire to be rid of one’s primary and / or secondary sex characteristics because of a marked incongruence with one’s experienced / expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics).
A strong desire for the primary and / or secondary sex characteristics of the other gender.
A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender).
A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender).
A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender). (DSM-V, 2017).”
If you or someone you know is experiencing any of the above, please do not hesitate to contact us at Serenity for any advice, or therapy in regards to Gender Dysphoria and the journey forward.
Transgender (Trans)
What does the word “transgender” mean?
Transgender – or trans – is an umbrella term for people whose gender identity or expression is different from those typically associated with the sex assigned to them at birth (e.g., the sex listed on their birth certificate).
Transgender Australians are able to change their legal gender in all states and territories and are recognised as their desired gender. Androgynous and genderqueer Australians are legally able to register their gender as 'non-specific' on personal legal documents related to sex.
In 2014, the Australian Capital Territory also passed legislation that removed the surgery requirement for changing the sex marker on birth certificates.
What is Gender Identity and Gender Expression?
Gender Identity refers to a person’s innate, deeply-felt psychological identification as a man, woman or any other gender.
Gender expression refers to the external manifestation of a person’s Gender Identity, which may or may not conform, to socially-defined behaviours and characteristics typically associated to males and/or females, such as those who identify as non-binary or queer folk.
What do the initials FTM and MTF stand for?
FTM stands for female-to-male and refers to someone who was designated female at birth but identifies and expresses himself as a man. Many FTM transgender people prefer the term "trans-man" to describe themselves.
MTF stands for male-to-female and refers to someone who was designated male at birth but who identifies and expresses herself as a woman. Many MTF transgender people prefer the term "trans-woman" to describe themselves.
Some Interesting Changes:
Transgender are identifying as MTF or FTM at a younger age.
It isn’t uncommon for children to be speaking out to their parents and/or carers saying they are in the wrong body.
It is now not uncommon for them to be as young as five years when first opening up about their gender identity.
What’s the difference between Sex and Gender?
Sex refers to the label of a person at birth as being either "male" or "female," based on their anatomy (e.g. reproductive organs), and/or their biology (e.g. hormones).
Gender refers to the traditional or stereotypical roles, behaviours, activities and attributes that any given society consider appropriate for men and women.
Is being trans-person ‘just a phase’?
No. Studies have shown that being transgender is not a phase, but a consistent Gender Identity. Trans-people often appear to be what some people refer to as ‘normal’ males or females, before announcing they are going to "change sex". The apparent suddenness of these transitions, and the rapid and dramatic physical changes that follow, fuels speculation among others that these "decisions" are very irrational ones. However, these individuals may have been experiencing the Gender Dysphoria for a very long time and have only decided to express their desire to transition, once they have overcome many obstacles and/or distress and ready to transition in society.
Is being a trans-person hereditary?
There has been no evidence that being transgender is a hereditary condition.
What causes a Gender Identity Issues?
There are many theories, but no one knows exactly what makes someone transgendered. Prevailing theories used to be psycho-social where the cause for transgender could be found in dysfunctional family relationships or childhood sexual abuse. However these theories are incorrect. Rather, a growing body of research is pointing to biological causes that originate before birth. Some researchers believe that there may be an incorrect amount of miss-timed secretions of male hormones, in particular, a lack of exposure or poor sensitivity to male androgens, during stages of foetal development may create a transgender individual- whether male or female. Other researchers have noticed brain structure differences between transgendered individuals and non-transgender individuals. However, there is no single or definite cause for having a transgender identity. Personally what does it matter why? It just is. It is important for us as a society to be open, accepting and non-judgmental of everyone irrelevant of gender and/or sexual identity, race, religion, size, age or anything else.
What does it mean to Transition?
Transitioning is the process some trans-people go through to begin living as the gender with which they identify, rather than the sex assigned to them at birth.
Trans-people may or may not elect to have:
Hormone Replacement Therapy
Sex Reassignment Surgery (SRS)
Facial Feminisation Surgery (FFS)
Hair Replacement Treatment
Breast Augmentation Surgery
Mastectomy
Hysterectomy
Speech pathology (Vocal Feminisation)
Revisions of mental health services
Vocational training and support
For younger people needing to engage in Gender Transition it should be said that the earlier the person has their psychological and/or physical treatments, the less mental health issues they appear to experience long term. Additionally, the transition is easier for them such as for the facial hair on MTF, as it has not toughened and the voice not deepened beyond the help of a speech pathologist. Thirdly, it will minimise the risk of developing negative coping skills such as alcohol or addictions or negative psychological symptomatology from the emotional pain such as depression, anxiety, low self-esteem or feelings of hopelessness.
What does it mean to be “genderqueer”?
An umbrella term for gender identities other than man and woman. People who identify as “genderqueer” may see themselves as being both male and female, neither male nor female, or as falling completely outside these categories. Use this term only when an individual self-identifies as “genderqueer.”
What is gender non-conforming?
A broad term referring to people who do not behave in a way that conforms to the traditional expectations of their gender, or whose gender expression does not fit neatly into a category
Is there a difference between being a cross-dresser and being a trans-person?
Yes, cross-dressing refers to people who wear clothing and/or makeup and accessories, which are not traditionally associated with their biological sex.
Many people who cross-dress are comfortable with their assigned sex and generally do not wish to change it. Cross-dressing is a form of gender expression that is not necessarily indicative of a person’s gender identity or sexual orientation
Is being a trans-person mean they have a mental disorder?
No, but this remains a common stereotype.Transgender identity is not a mental illness that can be cured with treatment. Rather, trans-people often experience a persistent and authentic disconnect between the sex assigned to them at birth, and their internal sense of who they are. This disconnect is referred to by medical professionals as “gender dysphoria” because it can cause undue pain and distress in the lives of trans-people.
Do all people who transition have surgery?
No, many trans-people can successfully transition without surgery. Some have no desire to pursue surgeries or medical intervention.
At the same time, many trans-people cannot afford medical treatment nor can they access it. In light of these injustices, it is important that civil rights and protections are extended to all trans-people equally, regardless of their medical histories. It is also critical to the continued support for full access to health care coverage for Trans-people.
How do I know which pronouns to use?
Trans-people should be identified with their preferred pronoun. Often this is the pronoun that corresponds to the gender with which they identify. Not sure? It’s appropriate to respectfully ask their name and which pronouns they’d prefer. Some trans-people do not believe in gender binary and prefer not to use pronouns typically associated with men (e.g. him) and women (e.g. her). Instead, they would prefer if people simply used their names, or use a non-gendered pronoun such as “they”.
What are some Issues for people who do not have access to assistance, or for some reason are unable to transition such as community, religious or family expectations of them?
Gender Identity Disorder (GID) if left untreated, can result in clinically significant psychological distress, dysfunction, debilitating depression and for some people without access to appropriate medical care and treatment, suicidal ideation and death.
Delaying treatment can cause and/or aggravate additional serious and expensive health problems, such as stress related physical illnesses, depression and substance use problems, which further endanger patient’s health and the health care system.
It needs to be understood that it is traumatic for trans-people whether they are male to female (FTM) or female to male (MTF) to wake up every day, look in the mirror and see the wrong face, and the wrong body looking back at them.
Importantly, to be a trans-person is decided before birth, it is not a lifestyle choice or mental illness. However, mental health issues quickly become a part of their lives due to the stress and isolation that can come from trying to live their lives honestly and being true to themselves. Family, peer and community support is vital to their sense of wellbeing and acceptance of themselves. Remember that!
Historically it has been common that by the time they transition, their experience of stress, depression and/or and anxiety had risen dramatically due to the inability to gain paid employment, which means they were not able to afford the costs of operations and treatments to transition. Furthermore, the longer their issues continues, self-esteem plummets with mental health issues rising, which causes significant cost to the community and the mental health system.
Nicely, times are changing and the more educated we are as a society the easier it is becoming for people of all walks of life. However, we still have a way to go so spread the word people.
Trans-people can develop mental health issues for many reasons including:
Family, peer or community rejection.
Cost.
Ignorance.
Lack of hormonal therapies and time frames relating to specialists they must see to ascertain they are ‘truly Trans’.
Suicide and self-harming behaviours are a common occurrence in the trans-community as in any other community. Again there are limited statistics on this group regarding suicide. However, 10 years ago it was approximately 43% and is now believed to be 25%, so it is a relief to see those statistics dropping. Although they need to drop a lot more.
Self-mutilation is a huge factor for many trans-people. The issue of feeling they have the wrong genitalia and the constant reminder that they are in the wrong body can become too much and lead to attempts to self-remove these body parts with disastrous outcomes, and at a great human and economic cost. The stress can result in trans-people to self-harming, by the cutting of arms and legs, or worse damaging or removing their offending sexual characteristics MTF - Scrotum and Penis: FTM – Breasts.
Alcohol and drug use are known to dramatically increase in this cohort due to the psychological and emotional pain they experience, as these substances are seen to ease the pain even if only temporarily.
Transgendered children and young people are a particularly vulnerable group for any number of reasons such as:
Someone whose gender presentation appears different to their biological sex could be vulnerable to transphobic bullying, but could also suffer from homophobic or sexist and sexual bullying. On average, transgender children leave school earlier than any other group, and a recent survey has shown that 25% have attempted suicide, and a further 25% have considered it. (http://trans*kids.synthasite.com).
Possible signs of a trans-child, or young person who may need additional supportincludes:
Lack of concentration
Poor educational performance,or conversely, total immersion in school work
Reluctance to use the school toilets
Reluctance to do physical exercise especially if it is strongly associated to the birth gender, including a reluctance to use the showers and changing rooms.
Truanting
Sickness and Absenteeism
Self-harm
Few friends
Often homophobically bullied
Often at the receiving end of severe bullying by others
Of course, some children may exhibit many of the above signs for other reasons than gender identity issues. However they do show that the child may be very unhappy andneeds further support for whatever reason. A culture and whole school environment that celebrates difference and diversity, and one in which all children and young people can see themselves reflected and valued is paramount.
How can I help a trans-person?
There are many ways to help, love, and/or support someone you know who is a trans-person.
Educate yourself.
Accept people for who they are.
Be aware of the attitudes of others.
Use names and pronouns requested by the person.
Don't make assumptions about sexual orientation.
Educate yourself and others
Sexual Identity
Sexual Identity is generally explained as an individual’s emotional, loving or romantic and sexual attraction to others, and is not always who a person is having sex with. It can be either gender: males or females. To both genders: males and females, or to no gender, which is commonly referred to as being asexual. The term sexual orientation is when individuals choose to identify, or not, with a particular sexual orientation.
People use a few common labels to identify their sexuality. Your sexuality isn’t defined by who you have sex with – it’s about how you feel and how you choose to identify yourself. The important thing is that you choose what label feels comfortable, or you choose no label at all. You might find, like many others have, that the label you choose changes over time.
Bi-sexual: Is when you are attracted to males and females.
Lesbian: Attracted to same sex or gender and applied to females who are attracted to females.
Heterosexual: Attracted to the opposite sex or gender.
Homosexual: Is when you are attracted to the same sex or gender and applied to males.
Polysexual: Is when you are attracted to many people, but not of any sex, gender or sexual identity.
Pansexual: Is when you are attracted to many people of any sex, gender or sexual identity. The labels of queer or fluid are often used in this context when a person is articulating their personal feelings in this case.
Asexual: Is when you do not feel attracted to anyone sexually.
Sexual identity and orientation is one part of an individual’s overall identity, and it is important to value difference, demonstrate acceptance and respect of their choices, based on their own sexual attraction. It’s important to recognise that we’re all different, and that the things that feel right for us are different from the things that feel right for someone else. We should be respectful of and positive about other people’s sexuality or sexual relationships, and support their right to explore their sexuality in a safe, consensual and responsible way.
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