The Struggles To See Quality Mental Health Support in the NYT
OPINION
By Justine Deterling
The New York Times published an article about non-binary-identified individuals called, “The Struggles of Rejecting the Gender Binary.”
Some observations:
Not everyone identifies as male or female.
One can’t identify as male or female. A person is male or female based on their chromosomes, regardless of how feminized or masculinized they my be and wether or not these traits contribute to a person having gender dysphoria.
In the New York Times article Salem is a troubled 20-year-old biological male. Many “non-binary” people rely on cloths and makeup to express what gender they are or what gender they feel like they are on that day (more on gender stereotypes in gender ideology here). Sam is no different:
'Why didn’t you wear makeup today?’
Jan Tate asked her client during a therapy session in May of last year.
“I didn’t feel the need to.”
“Would today be the day to begin using Salem instead of Hannah?”
There was a long pause and a hushed reply: “Yeah. But it would hurt a lot worse to start asking people to call me Salem and have them not do it than not to ask them.”
Another quote that demonstrates the centrality of hair and make up in current youth trans/genderqueer culture and to the journalists who report on it:
Their brown hair fell with a loose curl just past their slim shoulders. Unlike two days before, when Salem arrived for therapy with their full lips in dark red lipstick and a dash of blush across each cheekbone, and with their long fingernails painted a bright lavender, this afternoon there was only the nail polish.
Salem, like many non-binary-identified teens and young adults, is being given hormones despite lack of clarity about what s/he want to achieve with them:
Tate switched the subject to the hormones Salem had been taking for two months: a low dose of spironolactone, a testosterone blocker, and estradiol, a type of estrogen. Salem felt driven to feminize their body, to lessen their constant alienation from their own anatomy — and their self-revulsion — but wasn’t at all sure what the right combination of feminine and masculine would be. Different days brought different answers. From the hormones, their breasts were buds. “I could foresee breasts bothering me,” Salem told Tate, though they believed they wanted them. “I just have to hope the hormones don’t make too big of a problem.”
It’s good to remember hormones have health consequences.
An observation from the therapist:
Even so, Tate commented tentatively that Salem seemed more confident since starting the hormones, that Salem seemed to be making progress in accepting themself.
I am skeptical of the therapist’s observation that this person is truly getting better. “Seemed” is a week word. I have witnessed seemingly very nice mental health professionals at gender conferences who sincerely want to do some good by supporting social / medical transition in cases that involved very troubled people. It’s an environment ripe for confirmation bias.
“While I’m presenting myself as more comfortable,” Salem mumbled, head bowed, “the feeling I have is that I hate myself.” They sometimes called themself a monster. Tate has another nonbinary client who cut themself relentlessly across their shoulders, leaving “scars on scars on scars” that the client asked Tate to touch. Weeks before this session, Salem stripped naked in their bedroom and, with a marker, scrawled “tranny” and “faggot” all over their body, slurs that were inaccurate but screamed their self-disgust.
This is the background of the MSW, LCSWA, MED, CSOTP, therapist. It is a common profile for therapists who work with non-binary identified individuals. It is a profile of a therapist who specializes in supporting and validating what I would call “outlier” identities and behavior.
Jan Tate, MSW, LCSWA, MEd, CSOTP is a psychotherapist with a dual background in clinical sexology and clinical social work. Jan Tate earned her MEd in Human Sexuality alongside her Master’s in Social Work at Widener University in Chester, PA. Her areas of expertise include working with adults in the kink, poly, trans, GNC/NB, and LGBTQ communities, along with sexual disorders and general sex therapy. She encourages sex positivity for people across the spectrum of power role identification, sexual orientation, gender expression, as well as those who are unsure of, questioning, or evolving through identifications. e had no
All people should be supported in what is healthiest for them in their lives and sexuality as long as they are not impacting other people negatively. Of all of the identities and behaviors listed above, it is the validation of gender expression that requires the participation of the outside world. And this is something that concerns me greatly, that psychologists and social workers are enthusiastically validating this without considering externalities or that there may be downsides to the youths themselves. I believe young people are being trained to believe their value and happiness relies on other people and that they are entitled to force other’s to view gender they way they do. This is what a 3rd gender pronoun requires of society. We are already seeing examples of high school teachers and University professors claiming young people are manipulating adults with “queer youth” pronoun culture, where a pronoun can be changed day to day, and anyone not going along with current gender ideology may be severely socially punished.
In a few studies non-binary-identifed youth have more problems than trans youth. It may be a manifestation of other mental health issues related to the gender dysphoria or something masking as gender dysphoria. There isn’t enough research to say for sure. But other examples in the media paint pictures of youth with shifting identities, body hatred issues, and a strong need for validation from others.
Effeminate males and masculine females have almost no acknowledgement in society, except often to say something mean. Even butch lesbians and effeminate gay males have been looked down on within their own communities by more mainstream acting gay men and lesbians. This happens generally for two reasons. Because they aren’t attracted to that (“no fats, no fems”) or they want the community to appear more “normal.” I think recognizing this is an important part of understanding why so many same-sex attracted young people are adopting trans identities. Gender “outliers,” for the most part, haven’t been celebrated in popular culture. They aren’t always even universally accepted within the gay or lesbian community. Now that the media is celebrating trans issues, a non-binary identity, from a youth who isn’t undergoing full medical transition even, makes them special. They become worthy of newspaper articles and magazine covers. They aren’t awkward boys or girls or young men and women any more. They have power to demand acknowledgment through a 3rd gender pronoun request. They are unique. Their style is unique. Their pain is unique.
But it’s not unique anymore. It’s trendy. And these youths aren’t like David Bowie or Boy Goerge who’s genius needs no special pronoun. They are just citizens. And the public will get board of this the way they got board of “lesbian chic’ in the nineties and move on. And do you know what “lesbian chic” brought lesbians and bisexual women like me who take their relationships with women seriously? We got chewed up and spit out by women who wanted to look edgy. The media isn’t interested in lesbians at all anymore.
And when society moves on from their current gender fixation we will be left with a generation of gender nonconforming youth who have been raised by media, LGBT organizations, university campuses, validating parents, therapists, and teachers, to believe that for them to be accepted, for them to be valuable, for them to be loved, the entire society must have mandatory pronoun email signatures and pronoun acknowledgment moments before all social interactions. Then, what will make them worthy?
Tate said to me that “I often find myself gut-knotted after sessions with Salem, because of the things they don’t say” — because of the feelings Salem kept locked away, even from her, for fear that their experience was inexpressible, incomprehensible. She imagined Salem in an “abyss,” undergoing a torture that was the emotional equivalent of “taking a saw blade and cutting into the skin of an arm.”
I’m sad and feel for Salem as someone who struggled with serious generalized anxiety disorder that manifested itself as intense body dysmorphia when I was 20. I do not know what Salem needs. But I question if a they/them pronoun is it. And I question why psychologists and social workers aren’t asking the same thing.