Gender is often a central component to who we are, but it is complicated and nuanced.
Society likes to think of gender as binary: all people assigned male at birth “should” feel and identify as men and “should” be masculine and all people assigned female at birth “should” feel and identify as women and “should” be feminine.
From before we are born, we are inundated with messages about how our sex assigned at birth should determine our gender identity, gender expression, and sexuality. But people are more complex than that! Some people identify with the “ends” of the gender spectrum (i.e. man or woman) and others identify as a combination of man and woman, neither, or something else. Some people may identify more fluidly and some are more constant. The diversity of gender is immense.
In addition, gender is different than sex.
Sex is a construct based on biology (anatomy, chromosomes, genetics, hormones, and hormone receptors, etc.). Gender has 3 interrelated components: core gender, gender identity, and gender expression. Core gender is an innate, essentialist, or core part of who we are; it cannot be labeled since language cannot begin to describe something so complicated. Gender identity is the label that we use to describe our core gender in ways that are more concrete and understandable to ourselves and others. Gender expression includes all the socially constructed ways that gender is expressed from clothing to hair to vocal expressions. Psychoanalytic psychotherapy can help unpack some of those messages to allow people to live more authentic and full lives.
Some people who identify as a gender other than the one they were assigned at birth transition. Transition is a process by which transgender and gender non-conforming people find the best way to express their authentic selves. What transition looks like is different for everyone. Transition can be social, legal, or medical. Social transition may include using a new name, requesting different pronouns, a new haircut, different clothes or using a different bathroom. Medical transition may include hormones and/or surgery(ies). Gender confirming surgeries may include facial, voice, chest/breast, body contouring, or genital. There are many different procedures and even different techniques for each of them! There is no one right way to transition. There is just the right way for you. Psychoanalytic psychotherapy can be helpful for helping you find the right path for you to feel congruent within your body and how you relate to yourself and others.
Letters are often required for surgery by the surgeon and/or the insurance company. I write letters for gender confirming surgeries from an informed consent model rather than a gatekeeping one. Transgender and nonbinary people have a right to make decisions about their bodies.
Psychotherapy can be helpful in preparation for surgery. Surgery (any surgery) can be difficult as it includes anesthesia, the operation, and recovery. Recovery can sometimes be difficult due to post–operative weakness, unmet expectations, pain and/or complications. My goal is to help you psychologically through the process by helping you prepare for gender confirming surgery and supporting you in recovery.
