Academic journal article Canadian Journal of Counselling and Psychotherapy (Online)

Transgender Therapy, Social Justice, and the Northern Context: Challenges and Opportunities/Thérapie Transgenre, Justice Sociale, et le Contexte Nordique : Défis et Possibilités

Academic journal article Canadian Journal of Counselling and Psychotherapy (Online)

Transgender Therapy, Social Justice, and the Northern Context: Challenges and Opportunities/Thérapie Transgenre, Justice Sociale, et le Contexte Nordique : Défis et Possibilités

Article excerpt

There is increasing social awareness of nondominant gender identities such as transgender identity; however, societal structures do not yet reflect this shifting landscape. Transgender identity is complex, as individuals may identify as transgender, as solely female or solely male, as female and male, or as some combination thereof. However, one of the most persistent and all-encompassing binary systems for classifying and differentiating people in Western society is gender (Bern, 1981; Claire, 2013), and people are generally uncomfortable with individuals whose gender identity is ambiguous or mixed. As a result, transgender individuals experience widespread prejudice, harassment, and discrimination (Clements-Nolle, Marx, & Katz, 2006; Harper & Schneider, 2003; Koken, Bimbi, & Parsons, 2009) and experience higher rates of mental illness and suicide (Clements-Nolle et ah, 2006; Grossman & D'Augelli, 2007; Hendricks & Testa, 2012; Rotundi et ah, 2011). There has been a recent increase in the literature regarding mental health issues and therapeutic interventions for transgender and gender-nonconforming individuals (Budge, Adelson, & Howard, 2013; Cheshire, 2013; Claire, 2013; Drescher, Cohen-Kettenis, & Winter, 2012; Hendricks & Testa, 2012); however, the experiences of transgender individuals living in northern Canada, and the therapists working with them, have not been adequately addressed.

Transgender individuals generally face multiple challenges. In addition to experiencing gender dysphoria due to living in a world that does not accept gender ambiguity, let alone the desire to change one's gender, transgender individuals are often unemployed or underemployed and they often struggle with substance abuse and depression (Clements-Nolle et al., 2006; Hendricks & Testa, 2012) related to prejudice and discrimination (Clements-Nolle et al., 2006; Harper & Schneider, 2003; Koken et al., 2009). The northern Canadian context-which in this article refers to Yukon, Northwest Territories, and Nunavut-presents further trials because of small and remote communities with limited services, the lack of a transgender community, and the prominent impact of colonization. These factors contribute to the isolation and marginalization of transgender individuals in the north and support the position that meaningfully supporting such clients in therapy requires more than autoplastic approaches. For therapists working with transgender clients in northern regions, challenges include professional isolation and standards of practice regarding confidentiality and multiple relationships being stretched to breaking points (Curtin & Hargrove, 2010; Rainer, 2010).

The purpose of this article is to explore the importance of integrating social justice into therapy with transgender clients, with focus on the northern Canadian context. A conceptualization of transgender experience as much more than gender is presented, and social justice practices are discussed as integral to supporting the mental health of transgender individuals. Through the experience of my work with a transgender woman, the value of social justice practices in transgender therapy is explored with a focus on how engagement in such practices assists therapists to be mindful of the intersection of identities of clients and therapists. In addition, I will highlight professional and ethical challenges and opportunities of social justice informed transgender therapy. Mental health professionals working in other remote or rural areas will identify many similarities to working in northern Canada; however, the northern Canadian context presents unique dynamics.

INTERSECTIONS OF IDENTITIES IN TRANSGENDER THERAPY

Access to appropriate mental health care is a social justice issue; this is particularly relevant for those who are significantly marginalized. In addition to addressing the high rates of depression and other mental health issues among transgender individuals (Clements-Nolle et al. …

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