54 - Finding a Therapist for Your Gender-Questioning Teen: A Conversation W/ Lisa Marchiano

In this conversation, Lisa joins the show to talk about the difficult task of finding appropriate therapy for a gender-questioning teen or loved one. What is it like working with indoctrinated clients or those under the influence of a partner, belief system, or ideology? Lisa highlights the parental expectations of what therapy should look like, contrasted against the complex and subtle relational dynamics between therapist and client. Stella, Sasha, and Lisa examine some of the common traps therapists fall into: either being too affirming or too challenging before sufficient rapport and exploration have taken place. The three also make an exciting announcement about GETA, a new Gender Exploratory Therapy Association.

Links:

Jonathan Shedler on This Jungian Life: Podcasts.apple.com/us/podcast/does-analysis-work-a-conversation-with-jonathan/id1376929139?i=1000538533899

Gender Exploratory Therapy Association: Genderexploratory.com

Extended Notes:

• What does good therapy look like for an adolescent questioning their gender?
• Parents often assume the therapist will explore all the options available to their gender-questioning teen. Instead, they are shocked that they pushed medicalization right away.
• There isn’t a biomarker for depression. Lisa explains how professionals really determine if someone is depressed.
• Why aren’t we doing the same process for gender-questioning teens?
• Therapists are being trained to not think of gender dysphoria as an unhealthy coping strategy. Instead, they’re being trained to go straight to helping them find “the cure.” 
• If someone comes to a therapist for anxiety, the goal is to reduce that anxiety. If someone comes to a therapist for questioning their gender, the goal isn't to reduce their inner conflict.
• What is the true job of a therapist?
• Lisa talks about multiple personality disorder and how therapists handled it in the ’70s and ’80s.
• Patients who were diagnosed and labeled with multiple personality disorder were more likely to commit suicide than those who exhibited the same symptoms but didn’t have a label to it.
• However, sometimes by giving people a diagnosis, that revelation gives them relief.
• Lisa talks about the problems the Vietnam veterans were running into when they came home from war. Everything from being spat on at the airport to suffering from PTSD.
• Therapists are working with indoctrinated clients, and how you approach it is an incredibly sensitive topic.
• It’s one thing to explore everything going on in a teen’s life beyond their gender. However, these clients are watching hours of YouTube transition videos and trying to educate themselves. The approach has to be different.
• When you have an indoctrinated client, they split off their ambivalence and feel 100% sure in their decision to medically transition.
• Lisa talks about the Gender Exploratory Therapy Association and how it aims to help parents, therapists, and de-transitions.
• There are many teens who are not good candidates for therapy. Lisa explains what she means by this.
• Lisa shares her WAIT acronym: WAIT = Why Am I Talking.

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