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Get the Sound File of This Lecture Download the Lecture Slide Pack Click HERE to See the Transcript —> ExpandHello. My name is Daniel Winstanley. And I use pronouns he/him. I’m a counsellor in private practice in London until nine and I also do freelance training. And this presentation is Talking Respectfully about Sexuality and Gender Identity with Clients.
Aims and Objectives: The aim is to help therapists and trainees to consider how to talk respectfully with clients about gender and sexuality. And the objectives are to describe the challenges that therapists experience, talking about gender and sexuality with clients, to recognise the importance of appropriate language, particularly to LGBTQ+ and GSRD communities. We’ll get on to defining those acronyms later on. To identify some commonly used terminology relating to gender and sexual diversity, to describe some good practice around language use in therapy, and to identify gaps in our knowledge and sources of further information.
So just a little content note, this talk contains references to sexuality, gender identity, and some sexual practices. There will be mention of some lived experiences of oppression and discrimination. And there will be, I think, one, swear words. So and if that isn’t what you feel like listening to or looking at today, there’s lots of other content on the CPD hub, so perhaps you just look at another lecture today.
OK, so let’s start with welcome to the galaxy of sexuality and gender identity. You’ve been here all the time. So I think sometimes when we start to talk about terminology and sexuality and gender identity and sexual practice and relationships diversity, it can start to feel a little bit overwhelming sometimes and a bit scary.
So I like this idea of this sort of the galaxy. You know, this is a place of connection, substance, and that we all might have some sort of constellation inside us. And I guess I also want to highlight that this is a realm that we rarely open up in therapy, despite the fact that it can be really significant to some of our clients.
Now, that’s not to say that sexuality and gender is always the most important presenting issue that somebody has come in with. But we shouldn’t ignore the possibility that this might be present in the client story and something that we should be able to talk about confidently.
Sexuality and Gender. They’re complex, rich and multi-dimensional human experiences, but there are poorly covered in counselling and training according to research. Now, that isn’t to say that there isn’t this wealth of strategies and theory and approaches around and gender and sexual diversity, which means that actually there’s been at some point a conscious decision not to include this in many counselling curriculums. And partly as a consequence, the sense that, meaning that they’re quite challenging topics for many practitioners and particularly those who are newly-qualified.
So let’s have a brief reflection. You can pause the video at this point, if you like, and and maybe you want to make a note or just make a mental note. How comfortable do you feel talking about gender and sexuality with your clients? Can you describe any barriers or fears that you experience about this?
Okay. So as we go forward with this presentation, I wanted to name a couple of assumptions that I’m making. So the first one is that gender, sexuality and relationship diversity has always existed. Yeah, across time and across cultures. But the language used to describe them varies depending on the cultural and historical context. And actually, if you look at history, Western colonialism has had a role in suppressing some of this diversity in other cultural contexts.
This presentation describes some terms commonly used in a Western context, but the list is not exhaustive and it’s important to research the language the client may use or have grown up with, as well as listening to the terms that they use and prefer. This is really important.
What is it that makes talking about sexuality, gender identity difficult? Some researchers in 2014 did some research on this and they suggested that confronting homophobia and heterosexism is a key issue for counsellors who want to engage with LGBTQ+ issues. I would also add transphobia to that list as well. It wasn’t included in the study. And so we need to confront our own homophobia and transphobia, heterosexism and sexism. And we also need to acknowledge the reality of homophobia and transphobia in the lives of our clients, both internalised and externalised.
Other important terms include heteronormativity and cissexism. These terms allude to the fact that most societies are structured in such a way that cisgender and heterosexual identities are assumed to be ‘normal, natural, and legitimate’, and therefore unworthy of comment. While LGBTQ+ identities are positioned as ‘other/different’.
We’ve all grown up in society and culture, and so we will all, to some extent, have probably internalised some of these assumptions and that can make it difficult. And we need to confront these to some extent and process them before we get into the counselling room and talk to LGBTQ+ clients about these issues.
Why is language important? Why did I choose to look at language in this presentation? Well, research has shown that clients who are LGBTQ+ or other sexual and gender diversities may ‘self-censor’ because they take for granted that they won’t be understood. I’m speaking for myself as a member of the LGBTQ+ community, I think we’re often very aware of the possible judgments people may be making of this. And in order to navigate the world, we may have had to learn to self-censor a little bit and the counselling room is no different.
Another important term is microaggressions, which was developed by Sue & Sue who are American multicultural counselling theorists. Microaggression are ‘brief everyday exchanges that send denigrating messages to a target group.’ This can also happen in the therapy room. And unless we’re careful and aware of the language that we’re using and how we’re speaking to clients, we can reinforce these denigrating messages to clients which can actually be harmful and also close down the conversation that we might want to have with clients. Therefore, we need to be mindful of our own assumptions, biases and language use in order to practise inclusive and affirmative therapy.
Furthermore, language around LGBTQ+ issues has got a long history and it has been used and still is used in the UK and elsewhere in the world to criminalise, pathologise, medicalise, marginalise, and abuse these populations.
It’s really important to use terminology that is appropriate to the clients because finding a language to describe your own experience of sexual identity and/or gender identity can be empowering and open the door to self-knowledge, connection, and community. It can be a really positive thing. I think sometimes people wonder why there’s so many different terms. Actually, it’s about try and reflect on finding the language that fits for you and how empowering and exciting that might be. I think that that’s what we’re talking about here.
King et.al, in a BACP document, I thought they provided quite a nice definition of LGBTQ+ affirmative therapy. So they describe the therapy in which LGBTQ+ identities ‘are regarded positively, prejudice is avoided, the stress of externalised and internalised anti-LGBTQ+ bias is recognised, and their sensitivity to LGBTQ+ development, culture and lifestyles. It is a therapy that knows what it is to be LGBTQ+’.
We can see here the importance of language and actually communicating with clients openly, but it does clearly go beyond that. So this is just one aspect of offering an affirmative therapy to our clients. We also need to understand development. We need to understand culture. We need to understand identities and have a deep understanding of that before we talk about that with clients.The purpose of this training is really to provide a jumping off point, to discover some more information, more research resources, more reflection, to really take you towards delivering a therapy that’s truly inclusive and affirmative.
II know some people will be coming from an international setting, but not everybody’s in the U.K. but I’m going to describe a little bit of the U.K. context because it’s relevant to me and and to some of the people who were listening to this presentation. So on this presentation, I’ve mapped some of the legal milestones for LGBTQ+ communities. I’ve also highlighted some medical milestones for LGBTQ+ communities.
The timeline starts in 1967, where sex between men is partly decriminalised in England. And so the age of consent for men was still 21 compared to, I think, 16 for heterosexual couples. And also it had to be in private. It had to be just two people. So group sex was not legal. Decriminalisation only took place in Scotland in 1980 and in Northern Ireland in 1982, which is the year that I was born. I’m going to be 40 next year. Then all the other milestones that I list here have occurred within my lifetime.
It’s not distant history and even in the U.K. and of course, it’s worth mentioning that the legal situation in many other countries, sex between men may still be illegal and transitioning may still be illegal. In fact, we may be working with clients who were born outside the UK and where they could have been killed because of their sexual orientation or gender identity. That’s the reality that we are working with.
I’m going to highlight a piece of legislation that was relevant for me because I think it’s important that we talk to both lived experience. In 1988, Margaret Thatcher and her government introduced a piece of law called Section 28. I guess in the 90s, I was being bullied because I was perceived to be gay at school. I don’t know if I knew that I was gay at that point. But simultaneously, there’s a piece of law called Section 28, which forbids anybody working for a local authority, including teachers, to talk about, actually, the exact terminology is homosexuality as a pretended family relationship.
And I don’t think I will ever forget that, that the UK government between 1988 and 2003 considered homosexuality was a pretended family relationship. Although I was able to get bullied, my relationships, my future family was pretend.
And so in 1992, the World Health Organization declassifies same-sex attraction as a mental illness. We actually sort of mark that every year with the International Day Against Homophobia and Transphobia, the 17th of May, but they removed it. Again, people, you know, some of our older clients will have grown up in a world where they were considered to be mentally ill. People like us, people in the mental health professions were part of this oppression, this medicalisation of attraction.
In 2004, we have the Gender Recognition Act passed that allows people to legally change their gender. But a 2020 report suggests that actually that really isn’t meeting international human rights standards. It’s actually among the worst in Europe according to the European Commission.
It puts a lot of emphasis on medical pathways. We have to remember that actually people who are trans experience and still having to deal with very much gatekeeping about how they can identify and how they access recognition.
For practitioners, it’s also worth mentioning that the Gender Recognition Act means it is illegal in a professional capacity to share somebody’s trans status without their consent. It’s really important that you are aware of the impact of the act on your professional practice.
Again, moving on to the next slide, it’s obviously very notable that some of these developments are extremely recent. In 2017, the U.K. counselling bodies issue a memorandum of understanding stating that conversion therapy, the practise of trying to change someone’s gender identity or sexual orientation including asexuality, is unethical.
I think actually the original document was a little bit earlier, possibly 2015, but they include asexuality and I think gender identity at a later date. So 2017, very recent. There’s currently a bill passing through the U.K. parliament. So I’m speaking in 2021 about making conversion therapy illegal in the U.K. at the time of recording. We’re yet to find out what the outcome will be.
In 2018, The World Health Organization also recognised that being trans is not a disorder, not a mental disorder, and replaces the term ‘gender identity disorder’ with ‘gender incongruence’. That’s a sense of distress and that the gender to one’s internal gender identity may not much the gender that was assigned at birth. I think the DSM-5 uses the term ‘gender dysphoria’ in a similar sense.
The same ICD-10 from the World Health Organization also acknowledge that paraphilias are not in themselves requiring psychological treatment. That means that some kinky identities and practises and we’re also sort of, in a sense, depathologised, and it states that they would only require psychological treatment if and they cause distress or potential harm either to the individual or to others if they weren’t treated. For those who have diversity of sexual practice, and that’s quite significant to them as well and to practitioners if we’re working with them.
In terms of ethical considerations, if you want for you to check your own country embodies ethical framework, I’m going to refer here to the BACP Ethical Framework. There’s a number of places where this might be relevant. Facilitating sense of self that’s meaningful to the persons concerned within their personal and cultural context. We have to understand their personal and cultural context in order to be able to do that. We have to educate ourselves.
And furthermore, non-maleficence, so a commitment to avoiding harm to the client. So I mentioned microaggressions before, but there are many other ways in which we can inadvertently, or in some cases deliberately, communicate damaging messages to clients about gender identity and sexual diversity. It’s important that we’re able to challenge those and really look at our own bias.
Finally, respect, showing appropriate esteem for people and their understanding of themselves. And again, the use of language is a really important way. We actually do this to clients all the time. We show them esteem by using their language to describe their lives. We do that all the time. This is another way in which we can do that. There’s more in the frameworks. I recommend you go back and reread it and look specifically with an understanding one’s gender, sex and relationship diversity.
Looking at some acronyms here. I did struggle a little bit actually to decide which acronyms to use for this presentation. So the first one that I’ve chosen to use is LGBTQ+. That stands for lesbian, gay, bisexual or bi, trans, queer, questioning. And so Q can stand for both queer and questioning. So questioning one’s sexuality or gender identity. The plus stands for and I guess the terms maybe don’t fall into the LGBTQ+. That might include asexual and intersex, which we’re going to come and see later on. Pansexual, agender, gender queer. So a lot of other identities.
The plus can also include, I suppose, specific cultural terms that might be used in another cultural context. So, for example, in North America, one of the terms that might be used is two-spirit, which is an indigenous term and for gender and sexual diverse people, and which I recommend that you do a little bit of research around. But just to sort of note that part.
And now LGBTQ+, that’s where a lot of my work has been situated for the last 20 years. And I guess I can acknowledge that although gender diverse people have been absolutely central to the movement in terms of kind of moving things forward way back to Stonewall in the 60s, but actually mainstream LGBTQ+, the movement and the organisations and the media perhaps haven’t centred them in their struggle and sort of tensions and debates and dialogues and within this population. And actually it’s important, I think, to talk about LGBTQ+ communities rather than a community because we don’t want to imply that there’s like one community, one way of looking at things. It’s a great deal of diversity.
And actually, indeed, the LGBTQ+ sort of mainstream movement, the mainstream organisations haven’t always worked with intersectional identities very well. So, for example, LGBTQ+ people of colour, LGBTQ+ people with disabilities haven’t always been sort of and listened to and had their voices heard within the movement or been put central to it.
I’m acknowledging that there are some debates about the use of this term. And one term that’s emerging and has been taken on particularly by some of the UK counselling bodies, including Pink Therapy, is gender, sex and relationship diversity. This term is a little bit broader because it includes things like relationship diversity, for example, polyamory or open relationships, which I’m going to come on to later on. And it also includes diversity of sex practice.
The other thing is it takes some of the emphasis away from gender of attraction, which we’re going to come on to later as well. And looks at, I suppose, attraction and sexuality as sort of more diverse as well. It also means that we also start focusing experiences of heterosexual and cisgender people within that as well. We’re all diverse in some way. This is a term that is coming in as well. And I’m kind of sometimes used in the presentation also.
Terminology can be quite abstract and sometimes an image can help. I’d like to introduce you to the Gender Unicorn and which is a learning tool that was developed by the Trans Student Educational Resource. There’s the website in the notes that you can visit this. For those who can’t see the image, it’s a picture of a unicorn. Then on the right hand side, there’s a number of spectrums that go from zero to the other side of the screen, I guess. Those are Gender Identity, Gender Expression, Sex Assigned at Birth, Physically Attracted To, and Emotionally Attracted To. If you match in those, go down the side on the spectrum. I’m going to describe those in a minute.
The first one is Gender Identity. That’s one’s internal, private sense of one’s gender experience on the spectrums are Female/Woman/Girl, Man/Male/Boy, and then Other Genders. Yes, so we could identify as fully male and fully female or one other. So you can see and you can fill this out yourself actually as a useful reflection exercise.
We then have Gender Expression which is the outwards, what we show the world in terms of potentially clothing, hairstyle, voice, body shape, behaviour. The spectrum here is Feminine, Masculine, and Other. And again, we can be maybe have different aspects, different positions on the spectrum for all of those.
The next one is Sex Assigned at Birth. And they aren’t a scale–these are tick boxes because usually we don’t get assigned more than one of these. Now, later on the document I can look at, I think more correctly refers to this is the Gender Assigned at Birth. But the options are Female, Male, and Other/Intersex.
We then move on to Physically Attracted To and this is essentially called Sexual Orientation. This is which genders that we might be physically attracted to. We’ve got Women, Men, and Other Gender(s).
And then below that, we have emotional or romantic attraction, so Emotionally Attracted to. And again, we’ve got Women, Men, and Other Gender(s). That’s highlighting the fact that we might be physically attracted in a particular way, but romantically attracted in a different way. These might overlap, but they may also be separate.
And of course, as I said, these scales go from zero to like 100%. So we might not be physically attracted to anybody. We might have a zero for all those, which might mean that we identify as asexual.
It’s a really interesting tool. I invite you to look at that and to fill that out for yourselves. But it also introduces terminology we can look at in a little bit.
I’m in a bit difficulty with a slide transition here. Sorry.
Okay, one thing that I’d really like to highlight before we move forward is that identity is not the same attraction, behaviour, or expression. Let me give a couple of examples to illustrate this.
A YouGov survey in the UK in 2015 asked a large sample of British people to put themselves in a sexuality scale from 100% straight to 100% I suppose a homosexual gay. I’m not sure what terminology that they used, gay or lesbian perhaps. And about 23% of British people chose something other than 100% heterosexual. Actually nearly half of 18 to 24-year-olds chose something other than 100% heterosexual.
That doesn’t necessarily mean that all of these people will have sexual or romantic experiences with people of the same gender or different genders. It doesn’t necessarily mean that they identify as bisexual or pansexual. It’s acknowledging that we all find ourselves somewhere on a spectrum. I think that’s an important distinction.
And also Gender Identity. Again, the Gender Unicorn makes a distinction between gender identity as an internal and individual sense of one’s experience, and that may not necessarily relate to someone’s gender expression. And which, again, I think it’s really important to understand that. Somebody may not feel safe to change their gender expression, somebody may not feel it’s necessary to change their gender expression.We don’t know just by looking at somebody and hanging out with them what their gender identity is, which is why it’s important to really kind of try and understand why we ask about pronouns. We going to come onto to that a little bit later on.
At this point, I’d like to invite you to join me in a task. I’d like you to listen to your thoughts and feelings while we explore some gender and sexuality terminology. I think when we talk about terminology, it can get very heady, very cognitive. And of course, we want to use the intellect. That’s fine.
But I also invite you to tune into other information that might be coming in, by which I mean check in with your body. How is your body feeling? Are you experiencing any discomfort and reaction? Does any imagery bubble up? Take your time with it. If you get overloaded, take a break, and come back to it.
Perhaps you’d like to use the slide transition. So when I change slides, you might want to just take an opportunity either to pause, take a breath, and check in with yourself. We don’t get kind of too caught up in our heads and terminology. We’re really ripping a little bit of your other awareness and to this exercise.
The definitions that I’m using. There’s a BACP document by Dr. John Barker, which is really, really fantastic. I think if you go away and read anything after this, I would read this one. That’s the one that I’ve used for most of the terminology here. I’ve also referred to the Stonewall website, which is an LGBTQ+ an organisation here in the U.K.
So let’s see. The first term that I’m going to introduce is Gender Assignation. So on the Gender Unicorn, this is referred to as the Sex Assigned at Birth. I think more accurately in the BACP document, this is referred to as Gender Assigned at Birth or Gender Assignation. The reason for this is that sex is actually a little bit more complicated than this sort of binary constructs that is normally talked about. So generally, the gender is assigned at birth. So they look at sex characteristics, just look at the genitals and say, it’s a boy, it’s a girl, and there we go.
Even though it may be more complicated than that. There are sometimes people who were born with sex characteristics such as genitals or chromosomes which don’t fit the typical binary notions of male and female bodies. These people are sometimes referred to as Intersex and they may prefer the term Disorder of Sexual Development if they see this as a medical issue. But equally, the Inception Movement may also use the term Diversity of Sexual Development to highlight the fact that actually we all have diverse sex characteristics.
On the right, you can see that’s the intersex flag. It’s a purple circle on a yellow background. Definitely worth doing some research around intersex and the different status that that’s had of historically and also in different parts of the world.
The next term I want to introduce is Gender Status. So somebody may be Cisgender, but they may be Transgender or Trans. So the term cisgender or cis was coined because actually there wasn’t a term for the not trans, which again is an example of sexism. There wasn’t a terminology which marginalizing for people of trans experience. Now, there’s a lot of terminology around trans so I included a glossary below. But please do your own research because there’s a lot of inaccurate terminology around trans. It’s important to listen to the trans communities and ensure that we’re really listening to the terms that are appropriate and are accurate particularly among things like transition and so on. You can have a look at the glossary below.
Another term is Gender Identity. It’s really important not to make assumptions about what being a man or a woman may mean. Somebody identify as a Man. Somebody may identify as a Woman. And somebody might not identify with this sort of binary gender, in which case they may identify as Non-binary. Terms includes an Agender, you’re not having a gender. And partially male or partially female, which is sort of a Demi boy/girl. Both masculine and feminine, so bigender. And moving between genders, so gender fluid. Or sort of rejecting the notion of gender or Western notions of gender, in which case it’s genderfuck, which was my swear word that I was going to say.
But yes, it’s really important not to make assumptions. I think because of heteronormativity and cissexism, we can sometimes assume, okay, well, they’ve told us they’re a man. They’ve told us they’re woman. The questions are in there, but actually, that may be sort of relevant. People may experience pressures around sort of conforming to which gender norm even if they’re not trans.
I think another thing to say is if we’re referring to a trans man or trans woman, it’s important that we only need the trans if we’re speaking specifically about the trans experience, otherwise trans women are women, trans men are men. We don’t need to say that. And the flag on the right is the Non-binary flag for those who are interested.
We’ve got the Asexual spectrum. So Asexuality, or Ace, is an umbrella term for people who don’t experience sexual attraction. But it is a spectrum. I use the term asexual, but also demisexual, also experiencing sexual attraction often only in the context of where there’s already emotional or romantic attraction and grey-As. I think it’s important to let this terminology up. Furthermore, asexual people may or may not be a romantic, which is something that we’re gonna come on to later on. So just cause they’re asexual doesn’t mean they may not be in a romantic relationship, but they may be.
We then move on to Gender of Attraction. Somebody may be attracted to just one gender, sometimes called monosexual and these identities might include heterosexual/straights, might include gay, might include lesbian. Again, it’s important to listen and not all women who attract to women identify as lesbian. They prefer the term gay woman. You have to listen to the terminology that people use.
There may also be people who are attracted to more than one gender. So sometimes the term bisexual or Bi is used as an umbrella term for these groups. But increasingly, people may use the term pansexual. Pansexual kind of highlights the gender may not be the most important or even relevant in attraction to a partner.
It also points to the fact that there are genders outside the gender binary. So the bisexual implies some sort of binary that people may not be comfortable with. So pansexual is the term that you may hear. People may describe themselves as queer, which we’re going to come on to later on. On the next slide, in fact.
So with the term Queer, which is the Q in LGBTQ+, some people, particularly older LGBTQ people, may consider ‘queer’ a slur. However, it has been reclaimed. It was reclaimed in the 80s. Queer is sometimes used as an umbrella term to cover the spectrum of the LGBTQ+ community. It is also a term used by people who might wish to reject, to challenge or to question the idea of specific norms and labels relating to gender, sexuality and relationships, and the power structures that underpin them.
So they may be rejecting perceived norms within the LGBTQ+ community. It’s very rich history, queer theory, and it’s really informed our understandings of gender and sex diversity. If you’re interested in reading more Meg-John Barker’s book, Queer, A Graphic History is an accessible introduction to this.
We’re now moving outside what’s traditionally grouped within the LGBTQ+ category and to talk about sexual practice. And so the gender, sex and relationship diversity includes sexual practice. BDM stands for Bondage and Discipline, Dominance and Submission, Sadism and Masochism. Kink refers to ‘non-conventional sexual practice, concepts or fantasies’.
So somebody may identify as kinky or it might just be a practise that they have. I know it’s the stock image that’s come up is a weapon and handcuffs, which may form part of somebody’s BDSM or kinky lifestyle, but it needn’t necessarily. There are lots of other aspects, including sort of role play that people might take part in.
If you’re looking for sort of a useful introduction to talk about sex and sexual practice in the counselling room, there’s a presentation on the CBD called Sex and Counselling by Michael Pearson, and I thought it was really informative and very reflective. So I’d recommend that you have a look at that. And I’ll include some links as well. But often something that isn’t really talked about in the Counselling Room yet. It may be important to our client’s lives or it might not be relevant to the presenting issue.
Moving on to Relationship Diversity. I think there’s an assumption sometimes that everybody wants to be in a monogamous couple relationship. This is probably another example of affection or maturity. Barker’s document highlights the other possibilities that are around their practise. Singledom, being single and this idea emerging of solo-ness or solo poly, which is and I suppose seeing oneself is the primary relationship and your relationship with yourself and actually being comfortable in that.
And then we have Monogamies. It’s important that it’s monogamies, not monogamy because there’s different kinds of monogamies. Serial monogamy is different from lifelong couple monogamy, for example. There is secret non-monogamies. What we might term as affairs or infidelity. Also open non-monogamies such as polyamory or being in an open relationship.
There’s also Aromantic experience which means that people who don’t experience romantic attraction and again, that’s the spectrum. And Relationship anarchy. Relationships are the keywords for relationships styles that kind of question the idea of romantic relationships being privileged. Sometimes a monogamous couple relationship is considered the pinnacle and actually relationship anarchy would look at friend relationships, for example, as important and worthy attention.
Again, there’s lots more information on the websites that I’m providing. And also sex work. Sex work can sometimes question what we think about relationships, about sex as well. It’s important to consider that this may be part of the experience of our clients as well.
Other terms. Sometimes a client may use terms to describe themselves that have been reclaimed, or have a specific usage within their communities. For example, as a gay man, sometimes I hear people use the term ‘fag’ that is generally considered a slur. Those sorts of terms should be approached with extreme caution. We shouldn’t use these terms unless the client’s self identifies with the term and invites you to use them. Assuming that someone identifies with the term can be incongruent and often offensive.
If you look at Richards and Barker’s book, which is Sexuality and Gender for Mental Health Professionals, there’s a glossary and there’s also a shadow glossary. So I really recommend that actually. It’s a great book and the shadow glossary of terms that we need to be approached with extreme caution. It’s really good to be aware of these words and some words, we really shouldn’t be using, and others and we should be really cautious about using.
Just to highlight that as well, that there are many, many more terms that I haven’t mentioned today. But we also need to understand what these terms may mean to different communities and to different clients and not use them in an unquestioning way.
I’ve just talked about a lot of terminology and what I asked you to do at the start of the exercise was to monitor what came up, and you might need find that you’ve got to pinch your heads. That’s fine. Have a little checkup, check in with yourself and see how you’re getting on.
So were you excited? Did you feel freed up? Did you feel curious? Did you feel shame? Did you feel discomfort? Did you feel detachment? Did you feel overwhelmed? I have to say, I’ve been doing these presentations for some time and sometimes, the overwhelm can trip into a little bit of why does it have to be so complicated? And so I’ve heard that from from participants in training before.
I think it’s important to sort of check with that about yourself. Where does that come from? What’s that about? Is it that you’ve never needed to question it or that you’ve never been allowed to question it? And if you never needed to, well, I’m going to use a term that may alienate people, but that’s an example of privilege. Yeah. We’ve never needed to question it. We resent the other people may have a more complex understanding of their sexuality and gender identity. So potentially, you might be somebody who belongs to the charmed circle. If you’re straight/cisgender, you may not have had a cause to question this.
It’s important to say, though, that might just mean that you have to do a little bit more work in this area. And likewise, I identify as a gay mab doesn’t mean that I don’t have learning to do around my own attitudes towards my own gayness or the gayness of other people and around gender and so on. I would say we’ve probably all got work to do in this area, reflective work to do about the messages that we’ve absorbed. When I say it’s privilege, I don’t mean that as a criticism. It’s just a state of not having had to question because to some degree has a level of acceptance of your sexuality or gender identity.
But whatever came up for you, it needs to be acknowledged and processed before you get into the room with the client, because we don’t want to be having these reactions for the first time when we sit with the client. That’s really important.
The other one that I wanted to mention is like detachment. So that can happen sometimes. It’s a very cognitive bit of work. I sometimes like what I would term in a scientist or in a colonialist comes out. Again, it’s important just to sort of acknowledge it and try and keep it in check a little bit because this isn’t about, I guess, to put people in boxes. This is about, I guess, finding a way to talk about this galaxy of gender identity and sexuality. It’s about finding a unique language for ourselves.
If I get a little bit detached or a bit science-y, I think it can be really helpful to go on YouTube or actually seek out real voices for these communities. We can watch that little bit later on. But do a little bit of research and listen to people talking about how finding a language to describe their unique experience, to describe their identity, what that’s opened up for them, how that’s enable people to connect and create community. That kind of takes us away from this kind of very science-y way of looking at things.
Further reflection. Some of those might be new to you, none of them may be new to you, but what identities do you want to understand better? How will you research or explore this? And when will you do it? Maybe take a moment to make a commitment. “I’m going to spend a little bit of time doing a little bit research on this site that I don’t understand.” Or “I’m going to sign up for a training.” Really say, as I said before, around gender identity as a trans and a binary experience, I would definitely recommend that you get some specific training around that and just to acknowledge that I’m a person of cis experience and I’m not trans. And so, you know, I can’t speak authoritatively on this, but I do talk about it because it’s important.
So I’m going to talk about good practice. First, services should have clear public statements that homophobia, heterosexism, transphobia and cissexism are unacceptable behaviours and they should have clear complaints policies because that gives people a sense of safety. If you work in a service, think about that.
I’d also recommend that you look at the language that you commonly used during intake and assessment. So can you make the language more inclusive, more gender inclusive? So instead of husband or wife, can you say spouse? And instead of, I don’t know, boyfriend or girlfriend, can you say partner? But also can you say partners because some people may not have one partner. They may have more than one partner.
Seek out specific expertise if needed. So what I was saying before, look for CPD, consultation, additional supervision. We can’t assume that all supervisors, unfortunately, are fully informed about gender, sex and relationship diversity. We may need to seek out that expertise if we’re working with this client group.
Ask about sex life either as standard during assessment or once trust is established. But don’t assume that clients want to have sex at all, what sex means to them, or what kinds of sex they should be having or would be having. Not everybody will practise sex in the way we expect them to.
So, again, I’m going to talk about pronouns here. And just acknowledge I’m not trans myself, but I talk about pronouns because I think it’s something that we should all understand. I do recommend that you do some research and find some articles or training that’s been written by people with trans experience about pronouns. I’m including a couple of websites at the bottom of this section.
So pronouns terms like he/him, she/her, and they/them. And there’s a range of other pronouns as well. It’s really important that we get this right for our clients. Some of you may have seen if you get therapy today and a BACP member, there’s a really great article called Why Pronouns Matter and I recommend you give that a read if you can.
As I said before, it’s important to use gender inclusive language and be especially aware of gendered modes of address, for example, ‘sir’, ‘madam’, ‘mate’. That may be a microaggression to use that term to somebody. Always use the person’s correct name and pronouns if you know them and say your name and pronouns when you introduce yourself for the first time and ask what is theirs? So you can say, for example, “My name is Daniel and I use he/him pronouns. How should I refer to you?”
Include your pronouns in your email signature, your Twitter bio, and so on. It’s about the process of normalising that we can’t assume somebody’s pronouns. If you publish that and it’s also a subtle way of letting people know that you’re open to a discussion about pronouns.
If when you start using pronouns, for example, if somebody has told you that they change the pronouns recently that they’re using and if you make a mistake, apologise and move on because actually, if you get it wrong, but then you make a fuss about it, you can make somebody feel very uncomfortable. So just say, “I’m sorry, I meant…” and then just move on.
Some more in pronounce and learn to gently correct others if they mispronoun/misgender someone who’s not there. This could be really relevant, for example, those of you who are in multidisciplinary meetings to make sure that we correct others who perhaps either accidentally or deliberately are using the wrong pronouns. That’s really important out of respect for our clients.
Ensure that questions about gender on forms, embrace the full spectrum and giving multiple choice and free text options around pronouns and also including title. Mx., for example, which is a gender neutral term than Mr. or Mrs. or Miss. Ensure that all service staff, including reception staff have received training so they can use the correct names, titles and other pronouns.
And obviously, for some people, we may not be familiar with pronouns that we’ve been asked to use, so it can be really helpful to practise in a safe environment just on your own even. I think that’s perfectly legitimate. Just practising on your own using the right pronoun about the client, but also in supervision. And just so we’re more likely to kind of get it right and it feels fluid and natural when we start talking to clients when you use the correct pronouns with them.
There’s a couple of websites below. There’s a really great cartoon on on a blog called Robot Hugs. There’s a link there, but it just really explains how to try and get pronouns right. There’s also a great website, mypronouns.org, which goes into a lot more detail about why it’s important and how to try and get it right.
So some further tips, as I said, it can be useful to practise talking about issues in safe spaces before trying them out with clients. In fact, I would say it’s essential. We can use supervision.
If you’re familiar with talking about these issues, you could just talk to a friend. That’s totally fine. Or you might want to talk about it in personal therapy, but just to really try and resolve that before you sit down with a client.
In terms of terminology, take the lead from clients. And if in doubt, check with them so you can say, “Can I just check I’m using that term correctly or and what terms I use when I’m referring to such and such.” “What are you comfortable with?”
And continue to educate yourself and seek out voices of real people. So blogs, podcasts, YouTube videos, as well as academic articles. And when I say real people, I’m saying about the value of lived experience. I’m not suggesting that academics aren’t real people. Be honest. And so obviously, it’s not ideal, you want to try and educate ourselves in advance and as much as possible. But if you encounter maybe a practice or a term you’re not familiar with, I think it is better and I would feel more comfortable as a client if someone were to say, I’m not familiar with this, but I can find out.
It’s so important not to expect your client to educate you. We can’t expect clients to teach us. This isn’t free CPD. And actually clients feel really odd.
And that said, I think there is a nuance here because, for example, when I’m working with a client who’s a gay man, I might say, well, you know, I had some experience, you know, from my own experience, but I am anxious what it’s been like for you. I think that there’s a difference there and it’s a nuance difference between that and expecting the client to educate you. Be curious but relevant. I ask them about their experience is different from expecting them to tell you everything about their particular practise or identity.
And finally, be aware of the limits of your expertise. Again, this is such an important ethical requirement. If you really haven’t done the work, then you must be prepared to refer on rather than actually inadvertently perpetuating damaging messages towards the client.
So I’ve identified some open questions that actually, I was thinking we could use this to clients, but I really think this could be useful for yourself to look at as well. So you could practise this for yourself first and then these might be things that you incorporate into your client work.
What relationships are important to you? What aspects of identity are important to you? How would you describe your sexual identity? How would you describe your gender identity? Are there any words or language that you’d like me to avoid? Are there any words or language that you’d like me to use? And again, these could be really important questions to explore with clients.
Give it a try and see how they feel. Just finally, a reminder that language uses is the tip of the iceberg. Correct and sensitive and client-centred language is an important aspect of providing affirmative therapy is actually only a small aspect of it because, you know, it runs deep. We could use all the correct terminology and still actually perpetuate harmful messages to our clients.
This self-reflection and CPD required to work effectively with gender, sex, and relationship diversity requires an ongoing commitment. It’s a process, not a one-off event.
So there are other trainings here on the hub, I would say, again, coming back to this BACP document free to access, written by Dr. Meg-John Barker. I think it’s a really great place to start to look at some of the issues and identify the next steps.
So just a reminder about me. My name is Daniel Winstanley. My pronoun is he/him. There’s my website. Thank you very much for listening to this presentation. I hope you find it useful and please don’t forget to claim your CPD certificate. Thanks very much.
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