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Decolonizing Your Practice with Trans Clients

Image of fists with trans flag and genderqueer flag colors in the air representing therapists decolonizing their practicing with transgender and gender nonbinary clients. The words gender liberation and decolonization are bold.

Decolonizing Your Practice with Trans Clients:

Actions Steps and Resources

As a reminder, my goal in writing this two-part series is to reflect on the ways in which TGNB-affirming* clinicians contribute to colonization (Part 1), while also offering, in this article, actionable ways of moving toward decolonization and gender liberation.

You may be familiar with what is now called the Multicultural & Social Justice Counseling Competencies (MSJCC; Ratts et al., 2016). The original elements of knowledge, attitudes and beliefs, and skills originated in 1992 (Sue et al.), and the most recent expansion added the emphasis of taking action

This model emphasizes that our work needs to transcend the clinical skills and interventions we have been taught. We need to engage in our own self-reflection, navigate the power dynamics that are inherent in every session, and better understand and advocate for change within the very systems that perpetuate the problems our clients are facing. 

As mentioned in Part 1, I believe that a clinician’s ability to wholeheartedly and effectively serve the TGNB population requires ongoing critical awareness, examination, and acknowledgment of the following: 

  • A likely skewed lens of the world
  • Your approach to treatment
  • How you operate around privilege and oppression (both personally and professionally)
  • The history of colonization and enslavement, as well as white supremacy
  • The ways in which you have benefited from various systems and/or internalized the intergenerational harmful impact of those systems

If you are unsure of how to transform your clinical work with TGNB people to work toward gender liberation with a lens of decolonization, here are some action steps and values you might find helpful: 

DIG DEEPER. 

History has its eyes.” Actively educate yourself, acknowledge, raise awareness, and work to change historical systems of oppression related to ability, race, gender, and body diversity. Aim to move beyond affirmation and “multicultural competence” to better understand your own colonized behaviors, as well as each client’s internalized transphobia and racism, and help clients move toward liberation. Antiracism Daily can be a helpful resource in this regard.

OWN YOUR ROLE AND RESPONSIBILITY. SAY THE THING.

We have a responsibility to acknowledge the impact of our racial and gender identities, the actions of our ancestors, our mistakes, our humanness, and our own innate strength and power; I recommend checking out Nora Alwah’s Ted Talk. We also have a responsibility to be authentic and transparent, and to believe what our clients tell us is their lived experience. 

Validate client experiences rather than attempting to empathize with an experience of oppression for someone with a marginalized identity you do not hold. Bear in mind that sometimes our clients may not feel able to tell us or ask for what they need, especially if they’re accustomed to making those in positions of power feel more comfortable. 

VALUE LIVED EXPERIENCE AS EXPERTISE OF THE SELF.

Decenter your privilege of the expectation of comfort from others. For those of us in positions of power/privilege, we become accustomed to systems and interactions being shaped around our needs, so it creates a dynamic in which those in marginalized bodies spend their lives making us comfortable (e.g., when Black people “code switch” in white spaces). Center your client’s feelings and experiences. Clinically, trust your clients’ awareness and knowledge about what they need and want. 

Professionally, seek opportunities to learn from those who have lived experiences with their own BIPOC and/or TGNB identities. Honor their lived experience without questioning their training, education, and competence. And pay them for their time! For example, Sonny Jane talks more about this.

PRACTICE SELF-COMPASSION AND CULTURAL HUMILITY.

Check your shame at the door. We improve with openness to being wrong, trying, failing, and doing better the next time. Following a mistake, shame can lead to inaction and avoidance due to thoughts of being “not enough” and fear of judgment. 

On the other hand, guilt allows us to accept responsibility, act to address the hurt our behaviors have caused, and learn from our mistakes for future interactions. You are imperfect, and that’s okay. You can still strive for excellence in TGNB care. Learn more about TGNB self-compassion.

USE A TRAUMA-INFORMED LENS TO HEAL, REST, AND SEEK JOY.

To effectively support TGNB clients, pay attention to both your and your clients’ minds and bodies using a trauma-informed lens. Bodies of all races carry the intergenerational trauma of our ancestors, and it is much more difficult to create a culture of liberation and internalized antiracism without first healing and resting our bodies. I recommend Resmaa Menakem’s book My Grandmother’s Hands; you might also check out The Nap Ministry on Instagram.

 Also, part of healing is uncovering moments of joy and pleasure, both for yourself as well as your clients. For example, encourage your clients to be on the lookout for gender euphoria, which entails experiencing a strong sense of comfort and/or joy during an imagined or actual moment of connection and authenticity in one’s gender identity, body, and/or expression. There’s more about this in Laura Kate Dale’s forthcoming book Gender Euphoria. Make sure to celebrate all of the tiny victories in addition to holding space for dysphoria and marginalization. For more information about this, I recommend Adrienne Maree Brown’s Pleasure Activism and Anneliese Singh’s The Queer & Transgender Resilience Workbook.  

“UNSCHOOL” AND ANTICIPATE A LACK OF CLOSURE. 

We may never achieve some predetermined maximum level of knowledge, awareness, and language expertise. But we can work to expand ourselves beyond the “schoolishness” of doing what we’ve been taught in Western and colonized systems of education and psychology. For example, Akilah Richards’ work examines unschooling as a path to liberation (2020).

BE PATIENT. TRUST AND VULNERABILITY ARE EARNED OVER TIME.

White supremacy, racism, anti-Blackness, transphobia, and colonialism have impacted the world for centuries. It is a naïve privilege to believe that the work of one person alone can break down the barriers. Safety is not universal. Trust has to be earned. 

Clinically, we cannot rush connection, courage, trust, affirmation goals, or growth without a cost to ourselves and/or our clients. It is not surprising that our clients distrust us at first; only if and when it starts to feel safer, they may slowly open themselves up to becoming more vulnerable. 

CONNECT AND NURTURE YOURSELF.

Connect with other social justice-minded professionals who espouse the values of anti-racism and anti-oppression, such as Inclusive Therapists and Joy and Justice Collaborative. Follow and support the work of healers who actively engage in the work, such as Alisha McCullough, Sonalee Rashatwar, and Haley Jones.

Communities that work together toward these shared goals create a sense of belonging and healing together. We also need to set and maintain boundaries to ensure we are appropriately recharging, checking in about our needs and wants, and creating an environment that best allows us to do effective work. 

CHECK YOUR VALUES.

Examine how true racial and gender liberation would serve you, rather than worrying about what it might “take away.” When this work feels hard, do you pull back or move through? Do your words, behavior, commitment, and expenditures stand in line with what you say you value? For example, consider the impact of supporting organizations such as Psychology Today that have problematic histories related to race, gender, and bodies.  

You might reimagine your practice policies, fees, structure, and paperwork when reflecting on the ways in which you are reinforcing colonization. For example, please see here and here for a discussion of sliding scales as a tool for economic justice. Also, I highly recommend considering the GALAP Pledge, in which mental health providers commit to offer free or insurance-based access to gender-affirming surgery assessments from an informed consent lens. 

Finally, consider whose voices are missing from your education, training, and ongoing work to improve your competence with marginalized populations. Are you centering yourself and/or those in positions of power, or pulling back to make space for marginalized voices? 

LEAN INTO DISCOMFORT. 

If you’re doing this work, chances are that you will often feel uncomfortable. Discomfort is not bad just because we experience relief when we move away from it. It is not others’ responsibility to make us comfortable, to lead us down the “right” path, etc. View discomfort as an opportunity to get curious (you might check out this radical anger podcast episode)! 

Consider that many people experience discomfort when first exploring the sexist and racist history of fatphobia, the harmful impact of diet culture, and the ableism inherent in much of our society. (For more information, see this writer’s related articles here and here; I highly recommend reading The Body is Not An Apology and Fearing the Black Body.) But the joy and grounding that comes from liberating ourselves and our clients from those harmful systems is worth the work!

Though most of my early knowledge and training comes from white Western ideas and people, I have grown the most from queer, fat, TGNB, and BIPOC intersectional mentors, thought leaders, educators, clinicians, and other healers. I am a radically different (and better) version of myself when I am in community with others who hold similar values of anti-racism, body, race, and gender liberation, and restorative/reparative justice. So I can’t emphasize enough how important it is to expand upon this article with the intense heart and body work that comes with decolonization, restorative justice, and liberation. 

*Note: For the purpose of this article, TGNB indicates transgender and gender nonbinary populations, though you may come across other “umbrella” acronyms. No acronym will fully represent all experiences of gender diversity, so when referring to individuals, you should always use whatever language feels best for your client. The use of BIPOC sometimes represents Black, Indigenous, and People of Color (i.e., non-white people), and at other times it represents Black and Indigenous people of color primarily (Code Switch episode, Meraji & Escobar, 2020). When discussing BIPOC communities in this article, I am referring to the Black, Indigenous, and other communities of color who experience ongoing marginalization and oppression in relation to the colonized history of the Western world, including the intergenerational impact from their ancestors. 

Suggested Resources

As a reminder, there are approximately two dozen recommendations and resources listed in Part 1 in addition to the ones below. These constitute just a sampling of the vast amount of information available, and my recommendations are based on my personal experience, growth, and perception of their helpfulness. Lean into what resonates, and know that there are alternatives for anything that doesn’t. 

Communities: 

  • GALAP Pledge (A group of mental health providers in the US who have committed to offering free or insurance-based accessible referral letters for gender affirming surgery). https://thegalap.org/ 
  • Inclusive Therapists (A mental health professional directory, community, & justice movement). [@inclusivetherapists]. https://www.inclusivetherapists.com/ 
  • Joy & Justice Collaborative (A healing and mental health professional community, education events, & justice movement). [@joyandjusticecollab]. https://www.joyandjusticecollab.org/ 
  • The Blacker the Brain (Thea Monyee´ of MarleyAyo LLC is building a community of multidisciplinary practitioners & creatives to decolonize mental health/healing/wellness work). [@TheBlackerTheBrain]. https://marleyayo.com/unlearning 

Media & Web Resources: 

  • Alwah, N. (clinician, she/her). (n.d.). Nora Alwah. [@noraalwah]. [Website, Instagram profile]. www.noraalwah.com 
  • Breland-Noble, A. (clinician/vlogger, she/her). (n.d.). Couched in Color with Dr. Alfiee. [@dralfiee]. [Instagram profile, YouTube channel]. https://www.youtube.com/c/CouchedinColorwithDrAlfiee 
  • Cardoza, N. (editor). (2020 – present). Anti-Racism Daily. [@antiracismdaily]. [Online newsletter, Instagram profile]. https://www.antiracismdaily.com/ 
  • Feder, S, & Scholder, A.  (Director & Producers). (2020). Disclosure: Trans Lives on Screen [Documentary]. Field of Vision.
  • Finch, S.D. (coach & writer, he/they). (n.d.). Sam Dylan Finch. [@SamDylanFinch] [Website, Instagram profile]. www.samdylanfinch.com 
  • Hersey, T. (founder/blogger/coach). (n.d.). The nap ministry. [@thenapministry]. [Instagram profile; Blog]. https://thenapministry.wordpress.com/ 
  • Jane, S. (peer support/lived experience counselor, they/them). (n.d.). Lived Experience Studio[@LivedExperienceCounsellor]. [Website, Instagram profile]. www.livedexperiencestudio.com 
  • Jones, H. (LPC-intern & content creator, they/them). (n.d.). [@the_queer_counselor]. [Instagram profile]. https://www.instagram.com/the_queer_counselor/ 
  • McCullough, A. (clinician, she/her). (n.d.). Black and Embodied. [@blackandembodied]. [Instagram profile, Website]. www.blackandembodied.com 
  • McNeil, Toliver, M., Grinnell, M., & Wiltey, J. (Hosts). (2019 – Present). The melanated social work podcast. [Audio podcast]. Producer unknown. https://melanatedsocialwork.buzzsprout.com/ 
  • Melanated Social Work (clinicians/podcasters). (n.d.). [@MelanatedSocialWork]. [Instagram profile, Website]. https://melanatedsocialwork.buzzsprout.com/ 
  • Menakem, R. (clinician/author, he/him). (n.d.). Resmaa Menakem. [@ResmaaMenakem] [Website, Instagram profile]. www.resmaa.com 
  • Mullan, J. (clinician/author, she/her). (n.d.). Jennifer Mullan – Decolonizing Therapy. [@decolonizingtherapy] [Instagram profile, Website]. https://www.drjennifermullan.com/ 
  • Rashatwar, S. (clinician/lecturer/organizer, she/they). (n.d.). Sonalee Rashatwar. [@TheFatSexTherapist]. [Website, Instagram profile]. www.sonaleer.com 
  • Richards, A. (writer/coach/podcaster, she/her). (n.d.). Raising Free People. [@fareofthefreechild]. [Instagram profile, Website].  https://raisingfreepeople.com/
  • Taylor, S.R. (writer/poet/thought leader, she/they). (n.d.). The Body is not an Apology. [@SonyaReneeTaylor, @TheBodyIsNotAnApology]. [Website, Instagram profile]. https://thebodyisnotanapology.com/ 
  • Toler, M. (Host). (2020 – Present). Hearing our own voice. [Audio podcast]. Producer unknown. https://www.melissatoler.com/podcast 

References

Alwah, Nora. (2020, October 26). Reclaiming our power: Making ourselves seen [Video]. TEDxCU. https://www.youtube.com/watch?v=mYi42ydUe7Q&feature=emb_logo 

binaohan, b (2014). decolonizing trans/gender 101. biyuti publishing. 

Brown, A. M. (2019). Pleasure activism: The politics of feeling good. AK Press. 

Cunningfolk, A. (2015, Aug. 11). The sliding scale: A tool of economic justice. Worts + Cunning Apothecary. http://www.wortsandcunning.com/blog/sliding-scale?rq=sliding%20scale 

Cunningfolk, A. (2018, Apr. 23). How to make the sliding scale better for you & your clients. Worts + Cunning Apothecary. http://www.wortsandcunning.com/blog/a-better-sliding-scale 

Dale, L. K. (anticipated, 2021). Gender euphoria: Stories of joy from trans, non binary and intersex writers. [Book preparing for print]. Unbound: United Authors Publishing Ltd. 

Gender euphoria. (n.d.). In Gender Wikia. https://gender.wikia.org/wiki/Gender_Euphoria 

Guenther, J. (2018, October 21). Psychology Today magazine loves white people: Especially beautiful and thin white women. Therapy Den. https://www.therapyden.com/blog/psychology-today-magazine-loves-beautiful-thin-white-women 

Hemphill, P. (Host). (2020 – Present). Finding our way. [Audio podcast]. Producer unknown. https://prentishemphill.com/new-page-4 

jackson, k. & Shanks, M. (2017). Decolonizing gender: A curriculum. [Zine]  https://www.decolonizinggender.com/

Menakem, R. (2017). My grandmother’s hands. Racialized trauma and the pathways to mending our hearts and bodies. Central Recovery Press.

Meraji, S.M. & Escobar, N. (Hosts). (2020, September 30). Is it time to say R.I.P. to POC? [Audio podcast episode]. In Code Switch. NPR. https://www.npr.org/2020/09/29/918418825/is-it-time-to-say-r-i-p-to-p-o-c

Ratts, M. J., Singh, A. A., Nassar-McMillan, S. N., Butler, S. K., & Rafferty McCullough, J. (2016). Multicultural and social justice counseling competencies: Guidelines for the counseling profession. Journal of Multicultural Counseling and Development, 44(1), 28-48. https://doi.org/10.1002/jmcd.12035 

Richards, A. (2020, Oct. 20). Raising free people: Unschooling our way to intergenerational healing. In Joy & Justice Collab: Empowered Learning Summit. [Presentation]. 

Singh, A. S. (2018). The queer & transgender resilience workbook: Skills for navigating sexual orientation & gender expression. New Harbinger Publications, Inc.

Strings, S. (2019). Fearing the Black body: The racial origins of fat phobia. New York University Press.

Sue, D. W., Arrendondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Multicultural Counseling & Development, 20, 64-88. https://doi.org/10.1002/j.2161-1912.1992.tb00563.x 

Taylor, S. R. (2021). The body is not an apology: The power of radical self-love. (2nd ed.). Berrett-Koehler Publishers. 

Tucker, M. (2019, June 19). At the intersection of fat and trans. The Affirmative Couch. https://affirmativecouch.com/at-the-intersection-of-fat-trans/  

The Allied Minds Collective (2020, July 31). Psychologist’s stance on the “vilification of Karens” exposes the inequities embedded within mental health care. Medium. https://medium.com/@thealliedminds.co/psychiatrists-stance-on-the-vilification-of-karens-exposes-the-inequities-embedded-within-c76a35622aee 

Tucker, M. (2019, November 22). Helping TGNB young adults build self-compassion. [Webinar Training]. The Affirmative Couch. https://affirmativecouch.com/product/helping-transgender-and-gender-nonbinary-young-adults-develop-self-compassion/ 

Tucker, M. (2019, November 27). Helping queer and trans clients navigate fatphobia during the holidays. The Affirmative Couch. https://affirmativecouch.com/helping-queer-and-trans-clients-navigate-fatphobia-during-the-holidays/ 

Tucker, M. (2020, Aug 4). Deactivating psychology today and moving forward. https://www.wholeheartedpsych.com/post/deactivating-psychology-today-moving-forward

Learn more about transgender and gender nonbinary affirmative therapy

with M. Tucker, PsyD (They/she)

Two hands making a heart; one hand has trans flag colors and the other has genderqueer flag colors to represent self compassion for transgender and gender nonbinary clients

Blocks in black and white saying stress above bloacks saying resilience in transgender flag colors representing gender minority stress and resilience in transgender and gender nonbinary clients

 

13 Signs You Need to Decolonize Your Practice with Trans Clients

Image of trans flag and genderqueer flags with fists in the air representing therapists decolonizing their practicing with transgender and gender nonbinary clients

13 Signs You Need to Decolonize Your Practice with Trans Clients: 

Paying Attention to Your Colonization-Connected Behaviors

This two-part series is intended to first reflect on the ways in which transgender and gender nonbinary (TGNB)-affirming clinicians perpetuate harm connected to colonization, then to present actionable ways of moving toward decolonization and gender liberation. I am a queer, white, able-bodied, and “cis-ish” person (i.e., I do not feel discomfort in my body or with she/her pronouns, though I struggle with the construct of “womanhood”). I am an uninvited guest occupying the land of the Narragansett & Wampanoag people in what is now called Rhode Island in North America (note: I strongly recommend learning more about Indigenous culture, e.g. the All My Relations podcast).

While social justice movements tend to focus on addressing the oppression of marginalized communities, decolonization involves a discrete and critical understanding of settler colonization and the movement toward reparation of land and resources (Tuck & Yang, 2012). I cannot discuss decolonization without acknowledging that I benefit from stolen land and resources as well as oppressive systems that are violent toward Indigenous and Black communities, including that of mental health care. MarleyAyo LLC (2020) defines decolonization as the “intentional repairing and reclaiming of ancestry, traditions, and values lost or violently disrupted by colonization and the transatlantic slave trade.”

 

“…colonization was a direct attack to our physical AND spiritual beings…they cut off a line to that ancestral knowledge and almost guaranteed that history would be lost.”  – Decolonizing Gender (jackson & Shanks, 2020)

 

The history of settler colonization has deep roots connected to white supremacy and racism, anti-blackness, transphobia, fatphobia, and essentially any system, community, or person that vilifies, criminalizes, punishes, rejects, and erases those who at first glance seem “different” (Morgensen, 2012). For additional context, you can learn more about the 4 I’s of oppression in this Healing While Black podcast episode. Also, consider learning about the characteristics of white supremacy culture, which can show up in any group or organization as a reflection of the attitudes and behaviors of all people (regardless of race)–for example, believing there is only one right way to do something. 

The construct of gender liberation expanded on the work of Ignacio Martín-Baró, a social psychologist who lost his life because of his revolutionary work; see Helping Queer Clients Become Their Own Liberators (Spector, 2020) for more details. Gender liberation involves shifting our focus from basic gender affirmation with the TGNB community toward liberation by addressing power dynamics, advocating for systemic and social change, and freeing ourselves and our clients from the systems of gender oppression (Singh, 2016; note: Anneliese Singh is a phenomenal speaker, writer, and researcher in this area–see also her TedX talk). This includes an awareness that the concept of “transness” itself is a historically white construct, meaning that gender fluidity and diversity existed and were accepted for centuries prior to settler colonization (e.g. A Map of Gender-Diverse Cultures; see also The Platypus Poem by J Mase III). 

I have chosen not to explore these constructs more deeply because a) individuals who have experienced that history and live it every day do not need an explanation, b) it’s not my place to tell their stories, and c) there are many other appropriate sources that do so (e.g. Adrienne Maree Brown, Rachel Cargle, & Alok V Menon). It is my responsibility to listen, learn, and do better to honor the voices, bodies, and land that have been telling the story for years and continue to do so. 

 

“Cisheteropatriarchy holds its roots in colonialism, and dismantling and unlearning these Western agendas forced upon us is a necessary action in the liberation of all oppressed peoples. If we are to obliterate white supremacy, a key component of that necessary project is recognizing and dismantling transphobia as an ongoing destructive phenomenon directly rooted in colonialism.” (Paramo, 2018)

 

Some clinicians may be completely new to these concepts and what this work looks like. Other clinicians may already be doing this work more intentionally. Still other clinicians may have no choice but to do this work because of their own personal experiences of marginalization, oppression, and intergenerational trauma. 

13 common forms of colonization-connected behaviors in your clinical work with TGNB people

To be clear, it would be toxic allyship to consider completing a ‘checklist’ as the way to do this work, given the need for decolonization to be a long-term commitment. Decolonization work is ongoing with the intention of returning land, resources, and opportunities to the populations from which they were taken, as well as supporting Indigenous and Black communities as they continue to navigate intergenerational and present-day trauma.  

Regardless, it may be helpful to reflect on possible warning signs of colonization-connected behaviors in your clinical work with TGNB people, including the following: 

1. Limited historical knowledge 

(e.g. relying on mostly white and/or cisgender people and systems to teach you what you need to know about settler colonization, antiracism and gender; understanding a lot about trans identities but less about working with BIPOC clients; having little understanding of how colonization, white supremacy, and fatphobia intersect with gender)

2. Exploitation of BIPOC and/or TGNB people 

(e.g. expecting BIPOC and/or TGNB experts to train/consult with you for free; asking TGNB and/or BIPOC clients to explain things to us; using before-and-after photos of TGNB bodies without considering the potential felt objectification and dehumanization)

3. Relying on diagnosis and “the written word” 

(e.g. doubting someone’s knowledge of their gender because of their developmental stage or another diagnosis like autism; noticing yourself getting bogged down by what is written in the DSM, WPATH manual, or trans guidelines; focusing on whether or not someone meets the criteria for gender dysphoria to accept their TGNB identity)

4. Performative/toxic allyship 

(e.g, telling yourself that you are anti-racist while rarely engaging in action steps that help you to learn, grow, and change in movement toward anti-racism; privileged ‘allies” jumping to judge others who make a mistake when talking about race/gender without inviting them into a conversation; expressing how important this work is but not being willing to pay for consultation/supervision/training to improve competence).

Deborah Plummer’s work talks more about how to take anti-racist allyship to the next level.

 

 “Achieving a healthy white-identity resolution and feeling racially secure enough not to exhibit racial superiority does more for eradicating racism than just being an enlightened ally.”  ~Plummer, 2020

 

5. Shame and shutting down

(e.g. feeling frustrated about how hard it is to to “keep up” with the movements and language; defensiveness and/or shame reaction when you make a mistake; dismissing or challenging a perspective shared by a BIPOC and/or TGNB colleague or client about their experience; feeling offended/hurt by a client’s decision to see a “lived experience” clinician)

6. Treatment barriers

(e.g. limited treatment access; high cost of full fee; not taking insurance or having an inaccessible sliding scale range; and/or requiring multiple sessions for a surgery assessment without transparency and collaboration)

7. Saviorism and lack of humility

(e.g. believing that if you don’t do this work, no one will; not seeking training/consultation/supervision when you have a growth edge, i.e. room for improvement; frequent signaling to your TGNB and BIPOC clients, colleagues, and friends the extent of your allyship)

8. Poor boundaries 

(e.g. taking on additional clients for extra money; not saying no to people because we feel guilty; not prioritizing our own self-care and work-life balance) 

 

“…it should not be forgotten that one of the privileges of whiteness is having a gender that is defacto more legitimate and more coherent because of the binary framework in which it necessarily exists.”   -binaohan, 2014

 

9. Colonized gender norms 

(e.g. making an assumption about a client’s desired gender destination; encouraging forms of social/physical expression that someone hasn’t asked for; using any language/identifiers for gender/body part/surgery etc. that the client hasn’t already expressed or without checking that the language feels okay for them)

10. Colonized race-related norms

(e.g. failing to acknowledge the impact of colonization; assuming that all clients desire and feel safe coming out in all spaces; being unaware of resources that are specific to BIPOC TGNB people; using research and clinical interventions that have not been normed on BIPOC people)

11. Colonized body and ability norms 

(e.g. reinforcing the racist history of fatphobia and diet culture by encouraging a client’s attempts at weight loss via dieting; focusing on client weight as a potential barrier to surgery rather than framing from the perspective of medical fatphobia and helping to advocate for client needs; making an assumption about a client’s health status based on their weight and/or eating habits; using ableist language, making assumptions about someone’s capacity to do something, or limiting communication and processing methods). Please see Fearing the Black Body (Strings, 2019). 

12. Time and outcome expectations 

(e.g. using language that suggests a “full transition” or “complete surgery”; assuming that trans men want to be masculine; finding yourself thinking that clients are moving too slowly and pushing someone to come out to their family and friends)

13. Insisting on comfort 

(e.g. having a shame reaction and apologizing excessively when you make a mistake or client provides feedback; mentioning how hard it is to keep up with the language; not bringing up racism or anti-Blackness unless the client mentions they are struggling with the sociopolitical climate; addressing your privilege in the room the first time and then not bringing it up again)

Decolonizing Mental Health is Hard: Take a Moment of Reflection

Notice what comes up in your body and how it feels as you reflect on the above examples. Did you notice any feelings of shame? Embarrassment? Discomfort? Denial? Guilt? Relief? Irritation? Uncertainty? 

After checking in with your body, consider how these examples are connected to your clinical training and approach to treatment, your knowledge of history  or lack thereof, and your worldview. 

I believe that a clinician’s ability to wholeheartedly and effectively serve the TGNB population requires ongoing critical awareness, examination, and acknowledgment of the following: 

  • A likely skewed lens of the world: past, present, and future
  • Your approach to treatment: personally, professionally, and systemically
  • How you operate around privilege and oppression inside and outside of the therapy room
  • The history of settler colonization, enslavement, and genocide; white Western education, research, training; and lingering medical and mental health care trauma
  • The ways in which you continue to benefit from and engage in the perpetuation of those systems that have caused harm or, for those who belong to historically marginalized communities, the ways in which you have internalized the impact of those systems

As you continue to move through this work, you will uncover the countless ways in which colonization is woven into the fabric of our personal and professional lives, which has a direct and ongoing impact on the oppression of marginalized communities. Those in power may seem to benefit in terms of resources and capitalism. But the psychological, emotional, and intergenerational impact of colonization affects everyone, not just TGNB, BIPOC, and other marginalized communities. We all will benefit by working toward racial, gender, and body liberation, as well as striving for decolonization through supporting Black and Indigenous communities to reclaim their ancestry, values, land, and rights. 

 

“If Black women were free, it would mean that everyone else would have to be free since our freedom would necessitate the destruction of all the systems of oppression.”  – Taylor, 2017 (in How We Get Free: Black Feminism and the Combahee River Collective)

 

In the next and final installment of this series, I will further discuss actionable ways to begin transforming your work with TGNB clients.  I want to reiterate that this work is multifaceted and is not meant to focus on completing a list of “to-dos.” Rather, it is an opportunity to reflect on your practice and the ways in which you can continue to do better and to help heal the harm caused by our ancestors and our modern-day systems.

Please see below for an extensive list of resources created by TGNB folx and/or BIPOC* who expand on these topics. Another resource list will be provided at the conclusion of my next article as well.

*Note: For the purpose of this article, TGNB indicates transgender and gender nonbinary populations. The use of BIPOC sometimes represents Black, Indigenous, and People of Color (i.e., non-white people), and at other times it represents Black and Indigenous people of color primarily (Code Switch episode, Meraji & Escobar, 2020). When discussing BIPOC communities in this article, I am referring to the Black, Indigenous, and other communities of color who experience ongoing marginalization and oppression in relation to the colonized history of the Western world, including the intergenerational impact from their ancestors. 

Resources for decolonizing your clinical work 

Books: 

  • binaohan, b (2014). decolonizing trans/gender 101. biyuti publishing. 
  • Strings, S. (2019). Fearing the Black body: The racial origins of fat phobia. New York University Press.
  • Taylor, K-Y. (2017). How we get free: Black feminism and the Combahee River Collective. Haymarket Books. 

Podcasts:

Electronic print & audiovisual resources:

General Websites & Social Media Accounts: 

  • Brown, A.M. (writer/thought leader/podcaster, she/they) (n.d.). Adrienne Maree Brown.  [@adriennemareebrown]. [Instagram profile, Website]. http://adriennemareebrown.net/ 
  • Cargle, R. (public academic & writer, she/her). (n.d.). Rachel Cargle. [@TheGreatUnlearn, @TheLovelandFoundation, @Rachel.Cargle]. [Website, Instagram profile].  www.rachelcargle.com 
  • Mase III, J. (poet & educator, he/him). (n.d.). J Mase III. [@jmaseiii]. [Instagram profile, Website]. www.jmaseiii.com
  • Menon, A.V. (author/speaker/performer, they/them). (n.d.). Alok V Menon. [@alokvmenon]. [Instagram profile, Website].  www.alokvmenon.com 

References

Decolonization. (2020). By MarleyAyo, LLC. [Definition]. In Thea Monyee´ presents: The Blacker the brain – Free to heal – Decolonizing our practices. www.marleyayo.com

Morgensen, S. L. (2012). Theorising gender, sexuality and settler colonialism: An introduction. Settler Colonial Studies, 2(2), 2-22. https://doi.org/10.1080/2201473X.2012.10648839

Peramo, M. (2018, July 17). Transphobia is a white supremacist legacy of colonialism. Medium. https://medium.com/@Michael_Paramo/transphobia-is-a-white-supremacist-legacy-of-colonialism-e50f57240650 

Singh, A. (2016). Moving from affirmation to liberation as psychological practice with transgender and gender nonconforming clients. American Psychologist, 71(8), 755-762. https://doi.org/10.1037/amp0000106  

Tuck, E. & Yang, K.W. (2012). Decolonization is not a metaphor. Decolonization: Indigeneity, Education, & Society, 1(1), 1-40. https://www.researchgate.net/publication/277992187_Decolonization_Is_Not_a_Metaphor 

Learn more about transgender and gender nonbinary affirmative therapy

with M. Tucker, PsyD

Two hands making a heart; one hand has trans flag colors and the other has genderqueer flag colors to represent self compassion for transgender and gender nonbinary clients

Blocks in black and white saying stress above bloacks saying resilience in transgender flag colors representing gender minority stress and resilience in transgender and gender nonbinary clients