Very few individuals have ever questioned if their body matches their mind in terms of gender simply because the two are consistent with one another. Transgender individuals, conversely, are those who experience a mismatch between their biological sex and their psychological awareness of gender, feeling more comfortable in the identity of the other gender. It is not that they are sexually aroused by this identification with the other gender, but that it just feels authentic with respect to their true sense of themselves. Thus, being transgender is independent of one's sexual orientation in that some transgender individuals are attracted to members of the same sex and others are attracted to members of the other sex.
Being transgender is not an experience of the majority culture, and for this reason, many mental health care providers lack the education and experience to serve this population expertly. Several documents, such as the Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists (American Psychological Association, 2003), the Multicultural Counseling Competencies and Standards (Sue, Arredondo, & McDavis, 1992), and recent practice guidelines released by organizations such as the American Counseling Association (2005) and the American Psychological Association (2000), make clear the importance of being competent to serve populations other than the majority culture by providing culturally appropriate treatment options. Indeed, the sixth version of the Harry Benjamin Standards of Care (SOC) for Gender Identity Disorders (Harry Benjamin International Gender Dysphoria Association, 2001) specifically calls for counselors to be aware of both the issues surrounding transgender clients and the treatment options for this population. Unfortunately, the lack of literature focusing on the provision of services to transgender individuals leaves counselors with limited resources to draw on in serving this population.
We believe that gender role conflict (GRC) theory (O'Neil, Helms, Gable, David, & Wrightsman, 1986; see also O'Neil, Good, & Holmes, 1995) provides an innovative framework for addressing this lack of an extant literature in this area. GRC occurs when an individual experiences negative consequences resulting from the competition between rigid, sexist, or overly restrictive gender roles and incompatible situational demands. In applying GRC theory in counseling, the focus is on the situational constraints placed on people by their socialized gender role while allowing for an understanding of the experience of distress without blaming individuals for their situation (e.g., Wester, 2008). Thus, counseling based on GRC theory addresses the gender role messages learned from society, how these messages can be used to understand the client's experiences, and how the client can move beyond that societal teaching to live life on his or her own terms.
In proposing GRC theory as an aid in working with transgender individuals, we recognize two issues. First, some might consider it controversial to apply a theory based on gender to counseling transgender individuals--a retrograde throwback to an earlier era in which gender was bifurcated into strict categories of male and female, and those who deviated from those categories were automatically labeled as pathological. However, we believe that the reality of the societal gender mandate (e.g., Levant, 2001) means that the concept of gender and its associated conflicts needs to be included in work with gender-variant individuals. Second, we recognize that most counselors are likely to have limited experience with transgender clients. In the current article, we review the body of literature on GRC theory, link it to the experiences of transgender persons to illustrate how GRC theory is uniquely suited to gaining an understanding of certain aspects of the transgender experience, and also detail our suggestions for incorporating GRC theory into the process of counseling. …