The ‘Gender Thing’: When Therapists Should Know Better

“I’m fed up of this whole ‘gender trend’ thing.” “I can’t keep up with all the pronouns and ‘politically correct’ statements!” “One minute he’s a boy, then he’s a girl, then he’s a pansexual, aromantic, non-binary, or whatever else he’s seen on social media!” “I know it’s a phase, but whatever next?”

I frequently hear statements like these from parents, teachers, social workers, counsellors and psychotherapists, known collectively in my mind as ‘people who should know better’.

Labelling gender identity as ‘a phase’ is the equivalent of labelling self-injury as ‘attention seeking’. It demonstrates a lack of empathy, but it’s also peppered with truth. People who hurt themselves do deserve our attention and they might, at some level, be seeking it. Those who are exploring their gender identity are going through a phase, but this should be recognised as a phase/stage of ordinary development, rather than dismissed as something trendy.    

Sex is widely thought of as biological and determined by genitalia at birth. Gender, on the other hand, is a psychological concept which develops over time. It is less about the body we’re born in, and more about how we perceive ourselves – as masculine, feminine, neither, both, or something in between. It’s not a binary concept and it’s fluid rather than fixed. Ditto sexuality.

Psychodynamic theory emphasises early childhood experiences in shaping all aspects of our lives, including gender and sexual development. The processes of internalisation and identification mostly happen at an unconscious level, but there is a strong emphasis, as there is in most psychological theories, on the correlation between biological sex, sexuality and gender identity. These theories reflect cis- and heteronormative assumptions, and they don’t cover the extensiveness of developmental experiences.   

What if there’s a contradiction between the body and the mind? What if we’re labelled one way by parents, peers, professionals and society, but our thoughts and feelings don’t match? What if we’re just not sure?

Many young people I meet in therapy have had excruciating experiences of being mislabelled or misunderstood by ‘people who should know better’. These people use adolescents’ inconsistency as evidence of their naivety and ‘wrongness’. They ask, “How can I take them seriously when they keep changing their minds?” “Why don’t they pick a side and stick with it?” But it’s the ‘people who should know better’ who’ve got it wrong.

The onset of puberty is often the time when feelings about gender and sexuality come to the fore. As the body begins to develop secondary sexual characteristics, young adolescents are compelled to think about who they are, who they want to be and who they are (or aren’t) attracted to. The fluidity of their thought processes is frequently displayed as ambiguity, confusion and uncertainty, which also illustrates, perhaps, the fluidity of gender and sexuality per se. These are ordinary developmental processes, as children question and contemplate what gender and sexuality means for them.

Recently, I read a book about a crayon labelled ‘Red’ that moved me to tears. Red tried to draw a strawberry, but it came out wrong. He mixed with yellow to draw an orange, but it ended up green. The other crayons blamed Red for being faulty. But Red had been given the wrong label, and the happy ending came when he was accepted for what he was – Blue.

My advice? Don’t make assumptions. Don’t stick your own labels on the people you meet. Don’t attempt to shoehorn them into cis-/heteronormative pigeonholes. Don’t be someone who should know better. Be better.