MHM Magazine

Issue 4 | 2022 | MENTAL HEALTH MATTERS | 23 MHM transgender or non-binary, as these terms relate to an individual’s gender identity which is a different aspect that shapes an individual’s gender. Other factors that make up an individual’s gender are: 1. Identity • An individual’s internal sense of self and how they experience and define their gender which isn’t necessarily outwardly visible. • This encapsulates an individual’s personality traits, likes, dislikes, hobbies, roles and expectations, which for a long time have been viewed within a binary and stereotypical framework. For example - Girls like pink, boys like blue. - Girls play with dolls; boys play with trucks. - Girls are sensitive, boys are brave and don’t cry. • An individual’s sexual orientation – who they are sexually, romantically and/or emotionally attracted to - is often conflated with their gender identity, however it’s a separate aspect to an individual’s identity. • Many people’s gender identity aligns with their sex assigned at birth (known as cisgender), however for transgender and gender diverse people, their gender identity differs from their sex assigned at birth. • It’s common for this difference to result in the individual experiencing dysphoria, which is often why they seek treatment (such as hormone therapy and/or surgery). While many transgender people choose to access GAHC, some choose not to and many others simply don’t have access, which of course doesn’t make them less trans. For example: - An individual assigned female at birth may not ascribe to the typical female roles, expectations and characteristics and so may not identify as female. - If this individual identified with the typical male roles, expectations and characteristics, then they’d most likely identify as transgender. - However, if they didn’t identify with either male or female, but an alternate gender, they’d most likely identify as non-binary, gender-queer or gender-fluid. 2. Expression • An individual’s outward expression of their gender in terms of their clothing, behaviour, mannerisms, voice and other characteristics that are often perceived within society as masculine or feminine. A helpful perspective in understanding gender, is that it’s not fixed, but rather exists along a continuum. Meaning the way someone chooses to express their gender, what roles and expectations they ascribe to can shift, which is why gender is often described as fluid. Many find it challenging to sit with the lack of specificity in gender diverse individuals and become unwilling to accommodate people’s requests to be referred to by different names or pronouns, if they’re not given concrete labels. The point is to try remain open, curious and respectful. You don’t necessarily have to understand fully, to still show respect and acceptance. While you may not entirely understand, by engaging with the person in the way in which they’ve requested, you’re interacting with them in a way that’s consistent and true to who they are – which is very important. If not, the person may not feel seen, heard or engaged with directly. In order to ensure your practice is supportive and respectful, try reflecting on the points of interaction the client has with you and your practice, from beginning to end. If you identify points at which the client may not feel accommodated, reflect on what changes you can make. Here are some ideas: • Inclusive Forms - If you require title and gender, either provide all options to choose from or allow space for the client to write their own. 0 Titles: Mr, Mrs, Ms, Miss, Mx. 0 Genders: Male, Female, Transgender, Non-binary, Gender Neutral, Agender, Gender Fluid. - Ask patient’s preferred name and pronouns – not just as a formality, but to ensure you and your staff address the patient accurately throughout the consultation, in reports and referral letters. 0 Most medical aids still require the legal name and gender assigned at birth, so you can explain to your client when and why you’ll have to revert to these details. 0 Remember, not all gender diverse clients are ‘out’ and so they may still need this information to remain confidential (this is especially important for younger clients whose parents may not know). Have a conversation with your client to clarify what information will be shared in reports and referral letters, in case of the need to adjust the details. • Clinical history taking - be respectful - Try to remain as non- judgmental as possible. 0 In order for a client to disclose their history and medications they’re taking fully, they need to feel safe and not judged. - Avoid irrelevant questions regarding the client’s genitals. 0 Reflect on whether you’d ask the same questions to a cisgender client – if not, think hard about why you’re asking your gender diverse client.