Gender: A Wider Lens
Gender: A Wider Lens
25 - Behind the Curtain: Depth Work in Gender Exploratory Therapy

25 - Behind the Curtain: Depth Work in Gender Exploratory Therapy


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After the therapist has laid the foundations of therapy and established a trusting relationship, the process moves into the middle stage. This is the meat of the therapy! In this episode, Sasha and Stella explore the dynamics that can elicit change in the individual. They consider the curious vs. fixed client, self-esteem issues, broadening the client’s focus, and how to speak meaningfully about gender in therapy.


The Importance of an Unhappy Adolescence:

Gender Care Consumer Advocacy Network:

Extended Notes

  • What’s the true job of a therapist when a parent brings their gender-questioning teen in for counseling?

  • Timing is important when approaching therapy. Both Stella and Sasha keep phrases and viewpoints their teen is saying in their back pocket to bring up for exploration at another time.

  • If you’re not careful, it can turn into a “gotcha” moment for your client. You want to avoid that.

  • Teens have very harsh inner voices and, as therapists, it’s important to look into this in a gentle way.

  • A lot of adolescents understand the importance of their mental health, which is why they’re so critical of themselves when they don’t have happiness. It’s a vicious cycle.

  • Whenever there’s an outburst, people might be dismissive and say, “Oh you should talk to your therapist about that.” Although true, there are better ways to reassure a child that their emotions are perfectly normal.

  • Parents don’t like to reveal some of the bad things that happened to them throughout their life, but sharing some of these experiences with their children really humanizes them.

  • When you don’t divulge information, you make your relationship colder. By sharing information and life experiences, you create a deeper friendship.

  • People love to throw out diagnoses left and right, but sometimes these are just children going through normal teenage things.

  • Stella shares an interesting pattern that happens with her clients when they go from gender distress to seemingly being fine, and then back to gender distress.

  • As a therapist, it’s important to position yourself as someone who explores unknown questions together with your client.

  • It’s important to think big picture and dive into what else is going on in their life and not just focus on the teen’s specific gender issue.

  • Teens have reported that social media causes a lot of distress and time wasted. Too much time on these platforms causes them a lot of mental health issues.

  • As therapists, it’s also important to show the client how they can find their strong voice and say no to things that aren’t serving them or causing them distress.

  • What is the sexual self? How do you define it?

  • Therapists need to not hurry this process. A strong relationship can develop over years and so there’s time to explore challenging subjects pieces at a time.

  • The political narrative around puberty blockers is not matching what Stella and Sasha are seeing in their clinic, is it because they have a more biased cohort?

This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:

Learn more about our show:

Gender: A Wider Lens
Gender: A Wider Lens
Therapists Stella O’Malley and Sasha Ayad explore diverse perspectives through a psychological lens, fostering open dialogue on gender identity, transition, and the transgender umbrella. Their work with gender dysphoric clients and unique experiences yield an informed outlook delving into gender's psychological nuances. Interviews with clinicians, academics, transgender individuals, parents, detransitioners, and others touched by gender provide varied insights and intimate inquiry into the taboo yet relevant topic.