Transvox - Therapy and Counselling Tips for Trans+ People

[00:00:07] Hi and welcome back to Transvox and after a week off Jenny is deigning to join us again on the podcast and it's nice to see you again Jen how are you doing? I'm very well thanks Jill, deigning is an interesting word. I'm always delighted to be here. I was intrigued when you sent me a message quite recently when you mentioned behoving and I thought I've been chuckling to myself ever since the use of the word behoving.

[00:00:37] Did I use the word behove? I'm not sure I know what it means but I probably thought it sounded good in the moment. It did, it was very good especially on a chat link. Well look today, despite your regalia sitting in your Merlin and Mickey Mouse hat, Merlin cloak and Mickey Mouse hat which is an interesting thing. It doesn't really go does it? Just the match, I can't say that, just that word. Juxtaposition is what you're trying to say.

[00:01:05] That's it, of the sparkly hat and the starry cloak is a thing of beauty. It keeps you warm, that's the important thing. That's what matters. Well today we've had a listener's question. Oh right. Yeah. No, it's from a person called Chitty and is in Manchester again. We get a lot of stuff from Manchester. It's quite odd isn't it? So it's C-H-I-D-D-E-I. I like Manchester, Chitty. I like Manchester a lot.

[00:01:35] So it's not far from me. So we've had a question which runs along these lines. I always sort of truncate these emails because our listeners do like to send us long emails and it's lovely and I thoroughly enjoy reading them. But the gist of this is lots of trans people talk about having counselling. Is this something we should all have? What's the point of having it? What's the best sort of counselling to have as a trans person? And I thought, well, that's quite an interesting question isn't it?

[00:02:02] I mean, I'm sort of pulling that thing down. But I thought it was an interesting question to sort of stimulate a discussion around counselling. I don't know if it's something you've ever involved yourself in as a person or as a trans person. Yeah, I think, yeah, it is interesting because certainly for our community. I mean, if I think about when I was transitioning, I back then I had to. So that probably wasn't counselling. I had to have sessions with a psychiatrist.

[00:02:33] Is what back in 2005 to get referred for support, even though I didn't really feel I needed it. It was it was that was definitely a sort of tick box in exercise. I did. I did. I do remember when I transitioned, I did access our works staff support and counselling, which is very good at in the NHS.

[00:02:53] But again, that wasn't really, in a sense, about me getting to help transitioning more about navigating work and some of the stresses around transitioning at work. So I definitely use counselling there. And I have had counselling in therapy since, but not necessarily be focused on my gender identity as such.

[00:03:15] Because I think by the time I transitioned, I'd come to terms with that part, which I know a lot of people who are starting to question their gender identity or come to terms with that or think about transitioning. I mean, often therapy can be very helpful in that, can't it, to be able to talk through that. So that's sort of my experience. So I'm certainly deaf to somebody that's supportive of it. But I've also heard lots of stories where for trans people who felt that the counselling wasn't really helpful.

[00:03:42] And then sometimes I've heard, I know, I spoke to one colleague who felt it was downright, you know, unhelpful. So I think it is patchy, Jill, I think, is it fair to say? I mean, you're an expert in this field. I think it strikes me that a lot of counselling out there, there's maybe a lack of knowledge within the counselling profession on dealing with issues around gender identity.

[00:04:11] Would that be a fair comment? Because the people I spoke to, I felt most of them trying to educate them at the same time in terms of these matters. And I think, well, I think it's interesting, isn't it, to sort of break this down, because people here, you've already raised one of the terms, you've raised psychiatrist. And, you know, in the field of sort of mental, mental support, mental health, mental care, whatever you want to call it, you know, you've got psychiatrists, you've got psychologists. Yeah. You've got therapists, you've got counsellors.

[00:04:38] And it is quite interesting that people need different sort of, use different types of expertise for different types of issue. So, in, so psychiatrists are basically doctors who have mental health add-ons in their qualifications. So basically, in order to get treatment, in the old days, if you had a mental health condition, you used to go to a psychiatrist and things have changed somewhat.

[00:05:02] But clinical psychologists can also prescribe as well, sometime in specific areas of expertise. And, but basically, counsellors and therapists, or if you think about them, it's like a, it's like they're cousins of each other. So therapy is the umbrella term, and counselling is a branch of therapy. Okay, right. And there's a phrase which is called humanistic therapy or humanistic counselling, whatever that means.

[00:05:29] And what that is, is the sort of counselling that a lot of people will have experienced, which is called person-centred counselling. And it's very non-directive. So it's characterised by sitting with a counsellor who will say, hmm, how does that feel? And this is what I'm hearing. And this is what I'm seeing.

[00:05:49] And basically what they're doing is they're allowing a person to think, to reflect, to explore their own thoughts, feelings and opinions about a subject and to, and to ruminate. And it's particularly useful, I think, when you're gender questioning or your sexually orientations, you're working that through. Because in a way you don't want someone who's going to say, well, have you thought about, and what about this? And have you done this? Have you tried dancing on the spot? Or whatever it might be.

[00:06:17] What you want is that safe space where someone will give you the time and space simply to ruminate. So what you do is effectively, you're sort of, you know, it's therapy yourself, as it were. And that makes a lot of sense to me. I mean, yeah, that, sorry to double that difference because, I mean, I had to go see a psychiatrist because that's what the rule said at the time. And that's certainly not the case now.

[00:06:45] I don't think people go to see a psychiatrist in any matter to do with gender identity. It's the psychiatrist about other mental health issues, wouldn't they? Yeah. And I actually got prescribed hormones by my psychiatrist because at that time there wasn't gender identity clinics to easily access. But yeah, you're right about that, able to talk things through. And I think I would have really benefited when I was transitioning, coming to that point, about having somebody to talk through those matters.

[00:07:14] Because it's a pretty lonely place trying to come to those decisions that are life changing decisions to transition, for instance. That's a big thing to have to come to terms with that on your own. It is. And having somebody to talk through that, I think, has to be beneficial. It can. It can be useful. No, but there's a caveat. And I spent quite a bit of my time evaluating the effectiveness of therapy.

[00:07:41] And particularly with regard to this sort of therapy, counseling is successful really based on the quality of the relationship that you have with your counselor. So if you really trust your counselor, you really like them, you get on well with them and all sorts of different things, the chances are you're going to see a result coming back. If you don't, you won't. And there's a massive correlation between that.

[00:08:05] And what's interesting with most therapeutic interventions is that actually the major effect you're going to get from someone is going to happen within quite a few sessions. So it's quite surprising for most people who often have relationships with non-directed counselors. And I have bumped into this in my other practices when I've been in looking at them and assessing what's going on. I mean, you use the phrase non-directed counselor. Sorry. Yeah.

[00:08:34] So basically the humanistic style, I mean, basically is allowing that person just to almost coach and guide and talk and ruminate themselves. Right. And all the counselor does is doesn't give any suggestions, doesn't give any solutions, doesn't give any homework, doesn't give any prodding. And this is what's interesting. So there's a space for that type of counseling. And what we know is that actually once you've reached about a dozen sessions, the effectiveness of it actually starts to wear off.

[00:09:03] So what can happen with that type of counseling or that type of therapy is a number of things. It loses effectiveness. Okay. It can become immensely frustrating for people. And what happens is that's where you'll hear these terms, your therapist becoming your friend and the issue of transference coming from. Because when that type of relationship goes on too long, and I was doing assessment quite recently, and I bumped into a relationship that we've gone for over four years.

[00:09:33] Now, these are people who had been going for four years, twice a month, and charging 60 quid a session. So you do the maths on that quite quickly. And then you sit down and say to them, well, so has the issue been resolved? The answer is no. And then they moved to a different type of approach, and their issue was solved within five sessions.

[00:09:53] So this non-directive thing can actually, I mean, it's interesting, someone I know quite well who is a very astute person once said to me that this sort of type of therapy is like sitting, paying someone just to listen to me for an hour. Right. Wow, I'd love that. Yes. I could do that. And if that's what you need, that's absolutely fine, isn't it? Yes.

[00:10:18] And actually, if you think about this non-directive counselling style, it often fizzles into coaching, which you often see in performance coaching or life coaching. Yeah, I can see that. Yeah. And this non-directiveness has its place, and every single therapist and counsellor will learn this almost as their first set of skills. Right.

[00:10:38] And it's sort of known as a process approach, because actually what's happening is the process of listening, giving someone a safe space, allowing them to ruminate without sort of judgment, seeing that person as having value in their own right, separate to their views, can be very, very important for people. Because there's a place where someone maybe can go and be heard for the first time ever.

[00:11:04] And that's really important for trans people, because often some people have never heard them properly as a trans person before. Well, I think that's really interesting, because as I say, I'm just trying to think about my own experience. And when I actually was at a point where maybe I would have really benefited from that sort of counselling, which would have been around the time I was coming to the terms with a view that I was going to transition and what that means and the thoughts.

[00:11:31] Because, you know, I think many of us are quite lonely and isolated. I had nobody to talk to about it enough, friends or family. So almost had to do all that process with myself, which is very difficult. And now having that, that would have been really useful, certainly at that time, I think, just to help me talk through that. And I can see how, you know, the sort of benefits of that. And I think that's really interesting, that relationship.

[00:11:56] I think it's the ways that counselling can go do harm, though. Does that sound silly? I mean, could the counselling relationship be damaging to a trans person? It's very rare for it to be damaging unless there's transference, which means that actually the boundaries between the therapist and the person receiving therapy, they get breached in some sort of way.

[00:12:20] But the worst that can happen to a person is they're spending 60 quid a month or a week or a session or 80 quid or whatever it is that people pay. They're just paying that money just to have someone to talk at. And what it does, of course, if the therapist is exhibiting that approach for too long a period of time, in a sense, they're tying the client to them.

[00:12:45] So there are, one might say, and it's one of the ethical things that all counsellors and therapists have to think about, is whether this is a truly client-led process or whether the therapist is seeing that sort of client as just funding their next holiday. Because they are tired. You often see it on American programmes saying, well, I'm off to therapy for this next week. And I've been going for four years and nothing's actually happening. And actually they're just looking at you thinking, well, there's another 150 sessions coming in.

[00:13:15] How many more of those can I generate? I could definitely see that. That happens. Yeah, I'm sure that does. Yeah, I just... Most don't, it has to be said. No, I'm sure that's the case. I'm sure most counsellors aren't doing it just because they want to get every penny out of somebody. I'm absolutely not saying there isn't anything like that. But yeah, I just say... Go on, sorry.

[00:13:37] I was going to say, and I think one of the things you illustrated earlier was that you talked about trans issues, but also non-trans issues. So a lot of people come, whether trans or not, because they have anxiety, depression, OCD, neurodivergence, whatever it might be, PTSD, whatever those things are.

[00:13:57] And actually, this type of very non-directive counselling over too long a period can get in the way and slightly insulate people against being able to find solutions to what they need. So for example, this non-directive style is not useful for people with PTSD because what it's doing is forcing people to relive that experience time after time after time again by forcing them to go back and relive it, think about it.

[00:14:26] And there's a sort of a theory that it's around exposure and such like, but in the modern world of therapy, we don't think those things anymore. So I would always say to you, if you're going to a therapist who has this approach and it's the first time you've done therapy and it's worth doing at least half a dozen sessions just to reflect and learn a little bit about yourself. Because having someone who truly listens to you in an appreciative way without judgment is often the first time that anyone's experienced that.

[00:14:56] That can be very daunting, actually very scary. And then usually what a good therapist will do will move you on to potentially when the effects of that start to maybe die down somewhat. They'll actually change their approach or they'll recommend a different counsellor who can exhibit a different style and bring in different toolkits to help people. I can understand that. And I can see how that can be the case. I think, is there a danger with counsellors?

[00:15:24] I mean, so when you're trans, sometimes people will assume everything is because you're trans, right? Yeah. So if you have a counsellor, you know, being trans, being a woman is part of me. And it certainly affects my mental health so far as having therapists because of my mental health, because I was struggling. But that's as much as society, the place of society and not feeling confident.

[00:15:50] And, you know, even as confident as I come across, I spent many years, you know, up to the mid-30s before transition thinking, why am I so weird? Right. With these thoughts, you know, with my gender identity, why am I, you know, I struggled. I did not struggle. People didn't realise I was struggling with it. And so there is this, can there be a dangerous assumption that, you know, you're struggling with your mental health because you're trans rather than you're struggling with your mental health?

[00:16:20] And part of it is the fact that it can feel difficult for trans people in the UK at the moment. I mean... Well, you see, what you're saying there is a good therapist will be able to understand the difference there because we know that people who come into therapeutic situations and then, if they're questioning, they make their decision and they move over, a lot of that anxiety, a lot of those other things will go away because actually the anxiety or the issues or the depression will be part of that.

[00:16:50] And then actually once a decision to transition has happened, that goes away. So there is trans-induced mental health situations. There's a lot of anxiety and the fact that people have to wait such a long time. So what happens is, you know, what a lot of counselling is doing, and actually it's not great for this, it's better to have sort of group support for these sorts of things. But it's that thing about being in a safe space with other people like yourself who would just hold you until the point you, like you get, if it's six or seven years ago at the first meeting,

[00:17:19] or you're going to have surgery. And, you know, that's what counselling or therapy can help with because the anxiety or the stress of just sitting waiting for people is something that can be alleviated by having this sort of talking therapy. And there are other different types of therapy there. There's art therapy, music therapy, all sorts of different types of therapy that aren't just talk therapy. And that's important to say as well. Would you recommend though, you know, that, you know, particularly if it does relate to gender identity, finding a counsellor that has some expertise in that?

[00:17:48] How easy is that? Because I have had some experience with counsellors and generally they haven't, certainly when I first met with them, necessarily had a great deal of insight into gender identity unless they've lived it. Well, I think there's two different things here. I think the critical thing that I said in terms of evaluation is actually the relationship we have with that person, irrespective of their own gender expression or whatever, or experience.

[00:18:15] So one of the best people, so as a professional qualified therapist myself and psychologist, I have to have therapy myself as part of our process in CPD, as well as having supervision. And so we have a lot of sessions. So we get exposed to lots of different counsellors, lots of different supervisors and all that sort of stuff. And that's really great.

[00:18:36] So I bumped into a therapist who had no knowledge of gender expression identity, nothing at all, but was just really down to earth, really practical. Someone that I bonded with, opened up to talks. We chatted a lot about this sort of stuff. And then she was saying to me, well, I don't know much about gender. Could you help me? And that happens a lot. And what she said with me, because she's very honest and upright, is let's separate your situation into two.

[00:19:06] And you need to perhaps go and talk to a specialist who understands more about the gender side. And you can stay with me to talk about the non-gender related things. And we can fit. And now that's fine. I had the luxury of being able to afford and being motivated enough to actually have two therapists at that time. And don't get me wrong, I'm not a person that's particularly into the therapy scene, as it were. So I've been much more, I've been brought up to be pretty resilient. But as part of one's own professional development, we have to have counsellings who have to make it work.

[00:19:36] So I would say that a lot of people, when they come to counsellors, particularly these non-directive ones, they run a risk of losing that sense of why am I going? So it's that thing about saying there's two things I want to think to myself. What's my goal in having this therapy? You know, what am I actually setting out to achieve? What is it that I want to change as a result of these conversations? And it may well be that you get a result quite quickly and you think to yourself, actually, do you know what? Let's say you're questioning.

[00:20:05] Let's say you have two sessions and you realise, yeah, this is for me. Then you don't need to continue with this non-directive type of therapy. You can go and do something else or you can work with a different counsellor or you can work with the same counsellor, but expect a different set of methods and tools and techniques to be used. But I don't think people, often who are feeling low, depressed, anxious, whatever it might be, or going through the trance process. So, you know, scared and, you know, very on edge and stressed.

[00:20:36] Often that sense of agency, that sense of being oneself gets defrayed a little bit. And so what we can do is we can place a little bit too much power in the hands of the therapist rather than saying, OK, I'm going to, you know, I often talk to people and say to them on the therapy side or on the solutions focus side, which I sit more on the more directive style. I'll say after four sessions, I want you to come and tell me whether this is working or two sessions.

[00:21:03] And if it's not working, we'll either change or you can leave and find someone else. We have that conversation at the beginning. Lots of non-directive coaches, counsellors never have that conversation. It becomes a sort of habit or a pattern or a safety valve. Oh, I'm going to have my, I'm going to go. You often talk to people and say, I've got my therapist at five tonight. Oh, that's interesting. How's it going? Well, it's lovely. I thoroughly enjoy it going. Yeah, but how's it going? What's it achieving? Well, I enjoy talking to them. Yeah, but what's it achieving?

[00:21:31] Because if you haven't got a clear idea to give yourself the agency to work out what you want, A, you're spending a lot of money. And also you're not being true to yourself and really looking after yourself to get the level of self-care you need. I can absolutely see that. Of course, you can always do it my way and start a podcast with a therapist and get it for free. That helps. That's my long game. Well, you know, that's really interesting. Is it, I don't know how to ask this sort of one last question, right?

[00:21:59] It's a brilliant listener's question, because I think of so many things. Is, I know that sometimes, is there a risk, I don't know in the UK, I don't know how across the UK. I mean, is there a risk that you could come across a counsellor with maybe some gender critical viewpoint that, you know, becomes almost like a conversion therapy?

[00:22:19] You know, when you've had the debate about banning conversion therapy, you've also heard about people being forced into some sort of therapy type arrangement that's trying to persuade the individual that they shouldn't, that is not right. Is that a danger at all? Or is it as long as somebody's registered with the professional bodies, you should be okay? Is that where we're at?

[00:22:46] Well, you've asked a really clever question, which is how do you choose a counsellor or a therapist? So there's one or two different things there. First of all, there are gender critical counsellors out there. There's no doubt about that. One of the professional bodies in the UK allows gender criticism to be part of it. And there is no, you know, you're basically, if you're anti-trans or whatever it might be, that doesn't mean you don't have to be a counsellor.

[00:23:15] But it's probably likely that on someone's profile or on someone's website or whatever it is, that you'll see that people who are welcoming of trans people will always have it on there. You'll see that people who are welcoming of sexual orientation issues, psychodynamic relationships or something along those lines. They'll always say it.

[00:23:33] Now, the problem here is that you'll get a lot of people who are very happy to deal with trans people or LGBT people because there's a tag on all the professional bodies that says, are you happy to work with LGBT people? Most people tick yes. So the trouble is you can end up with someone who's happy to deal with you but doesn't have the expertise. That's much more likely than deal.

[00:23:55] So if you arrive at your first session with a therapist and you sit down and say, I'm trans and they exhibit any sign of gender criticism or anti-trans, you just leave. You simply leave straight away because actually you've matched yourself with someone who's not going to work for you because if they're gender critical and they have the right to be gender critical, but they don't have the right to try and can't do conversion therapy on you without your consent, but you can easily just walk away from a session and say, I'm not coming back.

[00:24:25] Well, that's sort of good to hear. I mean, they don't have the moral right to be gender critical in my view, but that's a personal view. I think I can never see that it is other than an abhorrent view, but there is little risk. I mean, you'll be able to see pretty quickly if somebody was. Yeah. Almost within seconds, you'll be able to pick up. I mean, because, you know, we as trans people are very, very attuned, aren't we, to this thing.

[00:24:52] And also, in a good counselling or therapy session, the first bit of the therapy session will be, especially if you haven't had like a chemistry session first, we'll be talking about how you work together. And there are people who hold specific views about all sorts of different things who end up working with those people very successfully. Oh, yeah, I guess that's right. I mean, just, I think we, yeah, I was just interested to see if they're quite likely.

[00:25:16] Because I don't, from what I experienced, I've spoken to people who've had poor experiences with counsellors. Not lots of people, but in my day, in a sense, my day job at the trade union rep, I'm quite often people who are struggling with their mental health and might be accessing counselling and services. I don't think I've been made aware of anybody that's felt they're specifically being pushed through some sort of conversion therapy route.

[00:25:41] I mean, I don't think it's not impossible, but it does sound to me, with a professionally registered counsellor, that's unlikely. Even with, you made the caveat that some bodies allow those views, that I guess it still wouldn't be allowed, they wouldn't be allowed to try and convert somebody. And the cons, any professional therapist or member of a professional body has to be what we call client-centred, which means that it's your issues which matter, not ours.

[00:26:10] So basically, there are conversion therapy camps in America. And I think the most famous case of a conversion therapy thing for male gay guys, I mean, someone said they were sent there five times and he couldn't wait to go because it was the best sex he ever had. And that's a very famous story. You know, you can't convert people against their will. No, of course. In America, they're going to have a damn good try over the next four years. It is utter nonsense. I think it's generally certain nonsense. I mean, it is interesting.

[00:26:38] My one sort of, that sort of relates to this. So when I got referred to a psychiatry department, it's called layered on psychiatry. This is, which I think that means psychiatry that's related to physical health. Yeah. And this was in my own employer. So I got referred and the person that leads that department said, you can see one of my students. It was a bit tick boxy because they knew I was already, I'd already transitioned. They knew I was. Yeah. So it was, they had to do that.

[00:27:06] But I remember my first session with this, I think it was a student, a student psychiatrist that was seen. They said to me, he said, Jenny, he said, we're going to support you. We can see you transition. He said, but they said this to me at the end of the session. But you need to say what, just to make you aware of one thing. It's my religion. This is what the psychiatrist said to me. And I said, yeah. So he says, yeah, I'm a fundamental Christian. I mean, I could only read into that that he thinks I'm a sinner, I guess.

[00:27:36] I'm not making assumptions about fundamental Christians. But the only reason he'd be saying to that is saying, I am going to support you. Well, actually, my belief is that you're a sinner and that's not right. I mean, they still supported me because I had no choice. I did think it was odd. I mean, I did then make it my aim over the next few sessions to convert him to the ways of trans, but I didn't succeed quite in that. But I did think that was interesting. I mean, I felt, on one hand, I felt weird. Why are you telling me this?

[00:28:04] Because your religion shouldn't impact on your practice. But on the other hand, they were being honest and open with me. So I suppose that's fair enough, is it? That's a classic student where they... Is that right? Well, yes, because the whole point of being a therapist is that you never divulge anything about yourself because it has no bearing on the client situation. Yeah, I did think that. Yeah. But it was nice. I did appreciate the honesty. I did think it was weird, you know?

[00:28:30] At a human level, sometimes it's better to know because actually, at a human level, if you're looking at that person thinking, can I trust them? Can I genuinely open up to you in a way that you could be empathetic and you're telling me your fundamental christian and think I'm a sinner? I mean, my own view would be I wouldn't go back to that person. Now, I know you're contrary. It was just a stepping stone to be getting deferred to Charing Cross at the time. So, yeah. The identity clinic. So, I really wasn't bothered. Just had to go through the steps. And I didn't hate the sessions with him.

[00:29:00] I found him interesting. I found it really... My brain, I found it interesting to think why he would raise that. So, I thought it was more of a challenge. I don't think it ever came up again. I just thought it was interesting, you know, that, of course, we all hold... And it'd be daft to think that therapists don't hold their own views, you know? They do. Religions. And I think... The professional job is to not let that seep into their work. Yes. And it becomes more...

[00:29:27] It becomes more important to know more about your therapist when actually you're going to do what we call more directive type therapy. Yeah. So, if you think about these talking therapies, you've got the non-directive type. But then you start to get into a more guided type of therapy. And I think probably most people, especially if they've come through the doctor's surgery, will have bumped into CBT. Is that what's often CBT? Cognitive Behavioural Therapy? Cognitive Behavioural Therapy. Yeah. So, basically, that's more of a guided thing. You've been asked specific questions. You've been...

[00:29:56] There's a sort of learning or teaching element to it. So, you're learning stuff about a particular technique. And then you're learning and practicing how that might work. And you're thinking about how that might change things. So, we're now on the road of a more directive approach. And there are massively successful results that come from CBT. Again, if you're going to have massively successful results that come from CBT, they tend to come very quickly.

[00:30:26] Now, the problem in the National Health Service is this. Having learned that, what they've done is reduced the process to like watching a video and having a questionnaire. And, you know, sometimes you get four sessions with someone. And often these people aren't actually qualified psychologists and therapists. What they are is that people who've built up a learning or a specialism in the NHS around CBT. So, all they can do is deploy CBT. And what they haven't got is the counselling background sitting on the back end of it.

[00:30:55] So, you can have non-qualified therapists and counsellors deploying CBT tools. And, of course, what happens then is... And the number of people I meet in a more involved or complex therapeutic place where they've been through non-directive and they've all been through CBT. And they'll say to me, it doesn't work. And the problem is CBT does work, but it needs to be like all expertise. It's got to be in...

[00:31:23] It's got to be deployed properly in order to get the benefits from it. It's got to be appropriate. I mean, you know, it's just got to be appropriate. Some things work. I mean, we've talked briefly. It's not quite therapy, but with people with... Us understanding neurodiversity more and more. I'm sure therapy doesn't work... Can't work the same for all of us. We all think differently and process differently. So... Yeah. But if you get the right sort of therapy and that melds with what you need,

[00:31:52] then absolutely it seems like it works. And that's good to hear. I mean, this is really interesting, Jill. I feel like you mentioned an education approach. I feel like I've been educated just in this last... And I think that's more because we're chatting on a podcast. But there's tons of other therapies that work for different people. So, for example, we did talk about you don't have to do talking therapy. It can be art therapy. Really interesting. Where basically you use the medium of art to be able to have a discussion.

[00:32:20] Or you can just show through art what you're feeling, how things go. Particularly good for kids. Writing therapies often used in therapeutic interventions where you get someone to, for example, write someone a letter who's bereaved. And then keep that because it's a record and a sense of retaining the sense of someone you've lost. Yeah. You've got music therapy. As you can see, they're all to do with senses. You've got dance movement therapy, drama therapy. You know, being able to...

[00:32:50] And all these things are about how do I access the part of myself that's less... Almost less judgmental about myself. So I can get past that. And then, you know, what you've got is a bunch of therapies. You've got the CBT stuff. But you often get... What's very popular is a lot of modern type stuff around animal assisted therapy. So working with horses, working with dogs, going... Doing gardening.

[00:33:17] I mean, gardening has become a massive thing in therapy. You know, people coming together, creating that sense of purpose, working in a community, starting a garden. Oh, yeah. I mean, our trust... The trust... One of the mental health, the trust I work for had a... I don't know, still go in. A great scheme called Growth Point where people with children with mental health would go. And, you know, they would do all of that as a... And it was a really successful therapeutic approach.

[00:33:47] I wonder if they're still around. I mean, it's a double check. I should know. Growth Point. This was in North Staffordshire. I've seen directly because I've supported staff that work in those services and how passionate they are and how effective it is for people, you know, who have maybe coming out of mental health services, you know, the acute side of that, but needing that support. You know, they're out in the community, but need something. And that therapy working together with other people and things like that. Fascinating subject. And I suppose one good thing about, I guess, modern life, we often...

[00:34:16] I mean, I think the last podcast we were talking about how horrible modern social media is, for instance. But the fact that therapy is so much more embraced now than it was when we were growing up, you know, or certainly through the 80s, the 90s where people would never admit to having therapy or it was seen to somehow be... I think the world's changed on that. Don't you think? Well, it has. And I think what's happened is... So you've got therapy.

[00:34:44] You've got complementary therapy. And you've got alternative therapies. And also you've got drug therapies. So actually, when you're working with any sort of experienced practitioner, you'll be looking at all those different types of things. So any good... So when someone comes to me and they talk about anxiety, one of the things I'll be looking at is their sleep patterns and what they eat. Yeah. So, you know, you have to look at people's holistic living conditions to understand what's going on.

[00:35:13] That makes sense too. Yeah. So things like yoga are seen as a complementary therapy. And actually, you know, people will do yoga and massage, meditation. They'll take herbal remedies and such like. They'll go to hypnotherapy to, you know, to manage their, you know, fear of bees or whatever it is and PTSD. They're actually freely consuming complementary therapies. But they don't think about it as being actually linked to talking therapies, which is just cancelling.

[00:35:42] Now, where it gets a bit more esoteric is where you go into alternative therapy, where you go to crystals, guided healing, sound bathing, you know, all those different things. And for some people, they're extraordinarily cathartic. And for some people, they work really, really well. The biggest challenge... I mean, I must have struggled with things like crystals or Reiki. I know people do. I struggle with that sort of... If I'm being honest, in my brain, it always feels a bit woo-woo rather than anything.

[00:36:10] But if it works for people, I guess the important thing is whatever the reasons that people get something positive out of it, that's still worthwhile for that in itself, you know? But you see, for me, what was interesting, because I haven't come through a conventional psychology route, I went and got qualified in energy psychology and Reiki and all those sorts of healing practices because I was interested and curious about my own professional practice. And also, I was meeting people who were talking about these things and talking about the benefits of it.

[00:36:39] And there is a word that describes a benefit from something which doesn't have any legitimate background. And that... It's a placebo, isn't it? Of course it is. And that is a massively successful way of being cured from various things. I mean, the results of placebo are sometimes more significant than actual interventions, especially from a poor practitioner. But just going back to our talking therapies, because it's interesting, we've touched on things like CBT,

[00:37:08] but you might have heard the phrases transactional analysis, which people talk about the parent-adult child, and that often links into family therapy. Because again, especially for trans people, what you'll find is you often have a situation where someone... And I've talked to many people who've said, you know, I've announced I'm trans, I'm changing, and all that sort of stuff, and you'll say, how are your parents, how are your family, how are your kids taking their very badly? Because they'll talk about the grief of having lost their son, but they gained a daughter.

[00:37:38] But they don't say it that way. What they've done is lost a son. And so there's often a lot of family therapeutic issues or needs. Because often what can happen with a parent of a trans child, it can often help, it can often affect the parent in terms of understanding their own identity. You know, what did I do wrong to have created a trans child? Was I not a good enough parent? And all these different things. I mean, you get all this sort of insecurity.

[00:38:08] Also, how are you going to support this person? What do we say? What can't we say? What should we say? What you've done is you've... What some trans people have done, inadvertently because they've got to look after their own needs, but what they've done is they've thrown a stone in the pond and created ripples all over the place that they're not in control of. So often family therapy can... And you might actually, as I've done, I've had a whole family before with two parents and three siblings in a room together.

[00:38:35] One or two with neurodivergence. Father who actually responded really well to a different sort of therapeutic approach. And a mother who was interested in talking therapies. And as a therapist, what we've got to do is be able to be skilled enough to adapt to all the different therapeutic processes that will work in a group like that. You can't just sit there and use your non-directive, hmm, how does that all feel?

[00:39:02] Well, because actually what a lot of people want when they come to therapy around trans people, parents and families, they want answers. They want to know. They either want to know what it means for them or they want to know how do I help the person concerned. Or the rest of the family. You know, what should I do? What should I say? How does that work? Look, so there's very, and often sometimes a lot of charities, what they'll do is they'll have two types of support. They'll have therapeutic support, but they'll have what they call practical support, which is just guidance.

[00:39:31] You know, this is what happens. This is what you need to do with surgery. This is what you need to do to get medication. This is what self-care means. Shared care, I should say. This is what's going to happen in terms of clothing, in terms of physical changes with hormones. People need to have that. I mean, I was talking to someone quite recently who was, they were a family and they had four boys. And there was her, a husband and four boys.

[00:40:01] And of course, what happens? One of the boys is trans. And this person hadn't parented a girl ever because she's got four boys. Okay. Yeah. And so you have all these things which come out. Now, often as a trans person, we see ourselves at the center of our own lives. And we don't always, and I've seen this on Facebook groups a lot, Jen. I'm sure you've done. Oh, my parents are terrible. They keep misgendering me. They keep doing this. They keep doing that.

[00:40:27] And I talk to a lot of parents who just, you know, brought someone into the world, give them a name. They had what they thought was either a son or a daughter. Now, this thing is, this whole situation's up in the air. It's hard for everybody. You know, I can see that. There are also, parents are terrible. I mean, I think the idea of disowning somebody because of their sexuality or gender identity is still, I really struggle with that. But I also, I reckon that, I recognize that with my own parents, that they were,

[00:40:55] they weren't so overtly hostile, but they really struggled with it. And I was in my 30s, you know. And I've, you know, I've met a lot of parents. And I can see, I can see, I can see that. I think, I think that is changing more and more where people are understanding. So hopefully the next generation of parents, I think, you know, the generations of parents that, you know, are young people now, they're going to understand these matters more, I think. And that's the difference.

[00:41:21] I mean, you know, my parents came from an area where there was nobody trans much about, you know. So I get that. And it does affect. I've been acutely aware. I've used the term, maybe it's the wrong thing. But when I transitioned, I did see it as a selfish act in of it. It was only about me and myself. I didn't transition for anybody else's benefit. And I did know that it was going to affect other people. And possibly negatively in terms of my parents. I struggled with that. Yeah.

[00:41:50] They were, parents have always been lovely. And, you know, they came to accept it very, you know, pretty, you know, a couple of years. They got more comfortable with it and so forth. But I didn't, I was aware of that. And I think, I think that's right. But also, you know, we shouldn't dismiss the fact that, you know, trans peoples, you know, when they're not supported by their family, they're the ones that are suffering, you know, as well. I get, I get that we live in, we're not an island, are we? No, no. I think that's the first thing.

[00:42:18] I mean, standards of parenting are pretty poor, actually, because if you look at the way parenting itself's gone, generally, I mean, there's no parenting classes anymore and education such like. So, you know, I talk to a lot of people who find it very hard to parent for all sorts of different reasons. But when we're then thinking about moving further forward, we're then starting to think about, actually, I have issues which are not to do with my transness. So I may have depression, I may experience anxiety, I may have ADHD, I may be not neurotypical,

[00:42:48] I may have bipolar. There's all these different things. And then, of course, there are a range of experts that you will go to, to look at those different areas. And that's where things, people, you've heard of CBT, but a different version of that, it's called DBT. And that's the advanced version of it, which is quite interesting. Some people have heard of Gestalt, which is a talking therapy, non-directive talking and therapy, which is quite interesting. Some people have heard of EMDR, which is like an eye movement desensitization.

[00:43:17] Oh, I know, for trauma. Yeah, that's right. I had a colleague explain that, how they have, I didn't fully understand it, a colleague I work with. We set up some hubs for staff, you know, suffering from trauma in the NHS. Yes. I was fascinated by that. I don't know how it works, but it seems to work for people. Because needless to say, I'm qualified. And I like a qualification. But also, you've got things like BLAST. You've got all sorts of different types of things.

[00:43:46] You've got integrative family systems. You've got, you've got, and so what I suppose I'm, why I'm saying all this is that if you're sitting with a counsellor who's still, you know, who you've maybe done more than 12 sessions and you're thinking, am I getting something more from this than just having a place to come and chatter to someone who I'm paying, who actually has just become a friend. And actually, if it's not moving you forward, and especially if you've been put on drugs by the doctor.

[00:44:14] Now, he, I'm chatting to someone at the moment who's in their 80s. Their wife's died. Surprise, surprise. Because people dented, I was a bit older. They've gone to the doctor. They're very upset. Well, wouldn't you be having married for 70, 67, 63 years or something? You lost your wife. And they've come to therapy, talking therapy because of grief. And, you know, that's absolutely fine. Nothing to do with trans issues at all. And they've gone to the doctors and the doctors put them on antidepressants.

[00:44:41] And, of course, drug therapy is part of therapy. And one of the things you're doing when you're putting drugs in your body is, I mean, one of the classic things with drugs is that two or three of the most prevalent anti-anxiety treatments have a side effect, which is to increase the symptoms of agniacy. So, you know, having, again, and this comes back to things like diet, exercise, having a more holistic approach to things, including talking therapies.

[00:45:10] And what you're doing is it's important to see yourself as being the captain of your own ship here and saying, how am I doing? You know, am I getting the right support from the health professionals around me? Am I actually going to, you know, am I going to a therapist? And it doesn't seem that I'm moving forward. And then reserving the right to say to yourself, it's not working. I'm going to stop it. And you can say to the therapist, I'm not getting as much from this as I want now. Next session will be my last session. Or this session will be my last session.

[00:45:40] And all therapists will understand that and will respect you for and will actually be pleased that you're moving on. Because part of the therapeutic process is like being a good parent. A good parent will give you the skills to be able to thrive on your own. And the problem with a lot of the non-directed processes is they slightly tie you to the open strings a lot. So put yourself at the centre of your own ship and pilot a course. And you can also talk to, you know, some of the good trans charities have one that we know.

[00:46:10] But there's lots of good trans charities out there. And they will have people like me you can go and talk to and just say, this is where I am. This is my treatment regime. This is what's going on for me. And I say, well, what is the support you actually need? What are your goals? And they'll say, well, my goal is to do this. I want to achieve these three things. Well, that's nothing to do with therapy. So because a lot of people when they come to a trans charity and for help, they'll say, I want counselling. And very few people say, well, why is it a counsellor?

[00:46:38] What's the question to which counselling is the answer? And the thing is, if you go to a counsellor, it's a bit like the, I think the old phrase is, you know, the man with the hammer sees every problem as a nail. So if you go to a counsellor, they'll say every problem is needing counselling. Whereas you go to a more holistic practitioner, they'll say, well, actually, do you know what? You need some meditation, maybe a bit of, you know, of these other things which are not talking therapies. Maybe you just need to get out and get into a group of other trans people and just start to socialise a bit.

[00:47:07] People have therapy because they're lonely. But the point, the therapy that matters most for loneliness is to learn to be with other people. Now, you need, you may need a bit of therapy to build your confidence to go back to being with other people. But therapy will not sort out loneliness. Only being with other people would sort that out. So I think taking ownership, becoming this sort of, you know, the, sorry, I've got myself locked into this analogy, being the captain of your own ship.

[00:47:37] But I think this is, I think this is really important. And I do think that a lot of trans people, because we have to sit here waiting for people to give us green lights. Yes, no, come to this, come to that, take this, take this, don't take this, don't take that. We sort of get a bit disempowered by the process. I think when you're a bit older, as you and I are, especially you, we're a bit more, we're a bit more arsey, if that's the expression, and we're more likely to stand up for our rights.

[00:48:04] And if you need someone to help you to go to, say, a therapist to get the result you want, come to some of these trans charities, they'll help you. Yes, absolutely. That's good. That's good advice. And as one captain we're both fond of would say, make it so. It's what you need to do. Especially, especially if you're making a jumper. Indeed. And I think on that frivolous note, we should probably call it...

[00:48:33] Fascinating stuff, Jill, as always. We've been going a long time on this one. And I think what we should do is, what's important here is that when you talk to a counsellor, you've met one counsellor. Like, you know, when you've met an autistic person, you've met one autistic person. I can't speak for the entire community. And I know we've got some plans to... Or I've got feelers out to talk to two or three different people who are counsellors and therapists. And I know you know someone as well. And I think that would be fascinating to get to.

[00:49:02] Yeah, it would be great to hear some other voices on this. Because it is such an important point for our community. It definitely is. That's fascinating stuff, Jill. Absolutely. I feel like I've been educated. And as well as having another free counselling session from you, Jill. Well, I mean, as soon as the podcast comes to an end, you'll be saying... And I'll be saying to you, well, how did that feel? So I'll see you next week. See you all next week. Bye. Bye.

[00:49:31] Thanks for listening to this episode of Transvox. It's been a joy to have you with us. If you want to make contact with us, you can contact us at jillian at transvox.co.uk. And all of our money goes to our nominated charity. And Jen, you've chosen the charity for the next number of episodes. Which one have you chosen? Our charity is called Beyond Reflections, which is a charity that provides support

[00:49:57] and counselling to trans people, non-binary people and their friends and their families across the UK. An amazing charity doing some amazing work. Really important. So please, if you can give. Great. And if you want to go and have a look at Beyond Reflections, it's beyond-reflections.org.uk. But as I say, if you'd like to make a contribution to what we're doing, because we love to help the people who help us.

[00:50:20] Again, if you've got ideas for the show, things you'd like to ask us, questions, comments, applause, or brickbats, feel free to send it all in to Jillian at transvox.co.uk. Until the next time, goodbye. Bye-bye.