Persona Diploma in Person Centred Counselling
TRANSGENDERED IDENTITIES by Angie Fee
Are you a man or a woman and how do you know? Has our socially constructed system of gender positioning prevented us from acknowledging the fluidity of human erotic desire?
Definitions
Sex is a biological concept referring to anatomical differences – male /female. I am Angie and my sex is female.
Gender is a socially constructed category that describes our social role as man or woman, perpetuated through language such as feminine and masculine behaviour or dress. For example: I am Angie and I am a woman who dresses and behaves in a feminine way.
Transgender is an umbrella term for a variety of identities, which include transsexual, cross dressers, drag kings/queens, third gender, transman, and transwoman, gender-queer. Transgender is a concept of the
1990s and is an inclusive term for people who have broken away from society's expectation of sex and gender mainly based on the essentialist belief that we are born with a fixed, inner core nature that cannot be changed.
Gender as an absolute status
Two children are standing in front of a picture of Adam and Eve. One child says to the other, 'Which one is the man and which one is the woman?' The other child says, 'I don't know, they don't have any clothes on'.1
I want to pay particular attention to the emphasis on gendered identification in western psychological thought, and the effect this has on how we as counsellors position ourselves in relation to gender.
Dualistic thinking has propelled people to divide themselves into oppositional gender identities: gender identity has obtained an absolute status and is necessary for recognition and identity in society. I propose that ambiguous gender identities such as transgender and transsexualism offer possibilities for reevaluating and unsettling binary thinking, while potentially restoring the complexity and flamboyance of sexuality and gender.
Defining ourselves and others as either 'women' or 'men' creates a binary form of gender: our identities are almost invariably recorded as either 'M' or 'F'. We cannot answer the question 'who are you?' without referring to gendered language or masculine and feminine pronouns. The Adam and Eve anecdote illustrates the internalisation of anatomy as gender and at how young an age this is learned. One of the main instinctive questions we ask when sitting in front of a client is 'Are you a man or a woman?' It's only when the client doesn't fit into either category that we become more aware of our need to position them in this way.
Counselling, among other things, is about identifying with and owning the shadow aspects of ourselves that we have denied and perhaps short-circuited in our personal therapeutic work, sometimes because they haven't yet opened to thought. I think that gender is one of those areas – precisely because it is seen as a 'natural' aspect of our identity. Meetings advertise exploratory workshops such as 'Find the real woman within', 'Discover your true inner man'– clearly reinforcing the notion that gender is fixed. Gender attribution is a primary aspect of our initial meeting with others. We can imagine living without a religion, a job, or a relationship. But living without a gender identity would throw most of us into an identity crisis.
Who would we be? We resist experiences that disturb or do not fit into our binary categories of man and woman. We are well defended with theoretical understandings against any disturbance of our own gendered experience but this also makes us less psychically available, less effective.

Persona Diploma in Person Centred Counselling
As a trainer in sexuality, I have been struck by the number of people who struggle to fit into the notion of
'feminine' or 'masculine'. Gender is seen as having only two categories. Whatever lies in between is overlooked, as the 'aim' is to develop each side and become 'whole'. I have often heard women in groups long for some masculine energy to come in – what they usually mean is there is a shortage of men. Surely this continues to buy into oppositional gender behaviour, which then dictates how a man should behave.
More complex
The area of gender becomes more complex if you go beyond what it means to be a woman who hasn't felt broody and doesn't feel particularly feminine and identifies being a lesbian who works as an engineer.
Does this make her a 'tomboy'? A false man? An unfulfilled women? Does she have an overdeveloped masculine side? Many of my clients over the years – both heterosexual and gay men and women – have found themselves in this territory. Thinking they are coming with sexuality issues, it turns out they need help in thinking through what their gender means to them. Gender and sexuality are implicitly mapped onto one another, often unquestioningly. Making it difficult to see where one begins and the other ends.
We have only limited language for exploring anything other than feminine and masculine, and therefore many people's experiences remain unnamed. The words we use to talk about someone who refuses to conform to gender norms are not positive or affirming, but often humiliating and oppressive.
Karl wore a dress, was seen as unmanly and ridiculed. But he loved his wife and described himself as heterosexual – illustrating a clear separation between sexuality and gender. He identified as a biological male and a social woman who was heterosexual. He did not want surgery to change his body; he wanted to be able to wear feminine colours and fabrics and dress in a twin set and pearls. Does this make him less a man?
As therapists, we need to become more aware and open to exploring how we position ourselves in relation to the gender of the other. There is no framework for existing without a gendered identity.
Questions of sexual identity, gender identity and desire are usually answered within the binary framework, and counselling often defines individuals as having a 'true inner nature' – which fails to engage with the complexities of people's identities. This has fundamental consequences in how terms such as 'feminine' and 'masculine' are thought about, how sexual desire is constructed and how these constructions inform identities.
Sex=gender=desire?
Counselling and psychotherapy still rely on psychoanalytic principles for understanding normal gendered experience and this continues to permeate and influence normative cultural assumptions. The Oedipus complex is the story Freud creates about growing up and taming our initial multiple desires. Desire is shaped, legitimised and ordered, which in turn helps to structure subsequent norms that have been accepted unconsciously. This means that a coherent gender identity consists of congruence between anatomical sex, gender and desire. Sex is assumed to cause both gender and desire, meaning that a woman has to categorise herself as belonging to the female sex that was ascribed at birth: she has to identify with being a feminine woman and her sexual preference has to be heterosexual. Traditional ideas of feminine and masculine roles still permeate the therapeutic discourses. Even when we do get round to thinking of parenting role reversals, we are more comfortable thinking about men as possible mothers than women as fathers. Why is that?
The internalised norm
The theory and practice of therapy makes assumptions about psychological health and inherently pathologises and discriminates against diversity.

Persona Diploma in Person Centred Counselling
Broadly speaking, counselling and psychotherapy have become part of an unobserved process that pathologises sexual differences and gender variations, and relies on a way of thinking where anatomical differences and the presence of genitals offer a certainty about who we are. The western medical model still judges and controls people around ideas of biologically normal variability in gender and sexuality.
Sexuality in contemporary western society is still linked to gender differentiation, with heterosexuality being viewed by a substantial percentage of the population as the expression of some essential nature.
The term sexuality is often thoughtlessly and easily used: by not making heterosexuality a distinct concept from sexuality, there is a danger of naturalising it and allowing it to become the 'unspoken' in psychological theories, unconsciously thought of as an organising principle. This is one of the many unexamined assumptions and prejudices that influence working with ambiguous genders and sexualities.
Challenge of transgender
The concept of transgender and the experiences of transpeople pose important challenges to the inclusivity of counselling and psychotherapy. Transpeople are probably viewed by most practitioners as having mental health problems relating to their gender identity rather than as bearing the burden of oppressive social norms. One consequence is that this population remains largely hidden to providers of counselling or psychotherapy.
To overcome this exclusion we need to become better informed. Dichotomous gender categories mask the diversity of human identities and bodies. Also, transgender issues and behaviours can characterise heterosexual and gay relationships. The invisibility occurs because most people haven't found the language to conceptualise themselves in this way yet. As Bornstein2 says, 'I think that everyone has to work at being a man or a woman. Transgender people are probably more aware of doing the work, that's all.'
Transpeople challenge society's perception of a sex and gender ideology that dictates an equation between body and gender. They advocate gender diversity as a healthy part of human life. Gender variation challenges our most basic ideas about what is right and wrong, normal and abnormal, healthy and unhealthy. This challenge has the potential to liberate.
Violet, 30, wanted to explore whether or not she should have surgery. She identified as a lesbian but felt increasingly anxious about 'not feeling like a normal woman'. She had joined a trans group. Violet was not having difficulty with her sexual identity but with her gender identity. She was having trouble fitting into being a social woman or a social man and so found a place where she didn't have to be either.
It made me think about the term 'coming out' that's used for sexuality and perhaps the need to come out as a gender? Having only two gender categories is the source of confusion and oppression for heterosexual, bi and gay people, when to me it's obvious that there are multiple genders being produced and sustained all the time.
Contemporary analysts have been contesting the traditional psychoanalytic assumptions about gender and identity. Dimen and Goldner have questioned whether a single unified gender identity is necessary to be considered healthy. Maybe it's the attempt to create a single gender identity which creates pathology?
Yet in my work with Violet, I needed to be alert to the temptation of denying the inevitable gender ideology that we have all internalised, assuming a gender-free space, a liberal stance of flexibility and ambiguity, any attempt to claim an ungendered position will surely deny unconscious gender processes.
As much as I am challenging the gender binary in the room with clients, I cannot ignore the reality that gender is a central organising principle, and the thought of not having a stable gender identity is a frightening thought.
It's not possible to stand outside this position. We need an understanding of ourselves and our clients as stable subjects with a coherent sense of self in our particular cultural context. At the same time we need

Persona Diploma in Person Centred Counselling to have an understanding of ourselves as fluid and changing in order to accommodate the possibilities for gender multiplicity. This means being able to stay with multiple meanings, shifting identifications, and bearing contradictions and ambiguities that cannot be understood within the gendered, binary language of psychotherapy.
Beyond the binary system
There are gaps in the training of counsellors and therapists that leave important issues of gender largely unexplored. The binary categorisation of gender into male and female has simplified complex phenomena. Clients who present with concerns regarding gender tend to believe in a fixed binary view of gender, believing that they have a problem because their experience of their gender does not fit into the dominant binary view. The counsellor also takes on this view, seeing traditional social and gender conformity as a therapeutic goal. I think most of the population takes the binary gender system as a given, because they have not been shown any other way of thinking about it. I am not suggesting that we abandon binary categories, but we need to unravel their main associations and become more aware of how they function within therapeutic discourses? The debate between social constructionist (gender is socially determined) and essentialist (gender arises from nature and can't be changed) approaches has mainly occurred within the disciplines of social sciences but they have much to teach the mental health disciplines.
The concept of transgender poses a challenge to the normative story that psychotherapy provides, based on a society that ties sexuality to gender and gender to desire. When desire is liberated, it can subvert the concept of what is 'natural' – which in Western society is a bedrock for understanding sexuality and gender. This raises the question of whether therapists can acknowledge and bear the fluidity of human erotic desire before it is socialised and categorised into psychological straitjackets. What might it mean to live with the anxiety and tension that is created when we let go of our 'core gender identity' that we have believed to be the one truth and certainty about ourselves? Instead of understanding gender as describing a core part of our personality, I believe that we, as counsellors and psychotherapists, must begin to see it more as a way of perceiving and experiencing the world that is learned, and then performed. By engaging with ongoing sociological debates, counselling and psychotherapy can contribute to a re-gendered social world.
Angie Fee is a UKCP registered psychotherapist, supervisor and trainer in private practice. She teaches Sex,
Sexuality and Gender on postgraduate programmes at psychosynthesis organisations in London, Sweden and Amsterdam, has an MSc in psychosexual therapy, and is researching transgendered identities for her
PhD.
References
Shapiro J. Transsexualism: reflections on the persistence of gender and the mutability of sex. In: Epstein J, Straub K.
(eds)
Bodyguards: the cultural politics of gender ambiguity. New York: Routledge; 1991.
Bornstein K. Gender outlaw. New York: Routledge; 1994.
Dimen M, Goldner V. (eds) Gender in psychoanalytic space. New York: Other Press; 2002.