Episode 28

Published on:

18th Jun 2021

28 - Behind the Curtain: Wrapping Up Gender Exploratory Therapy

As they wrap up their initial Behind the Curtain series , Sasha and Stella discuss important issues surrounding the termination of therapy. How do we know when the therapeutic process should end? Does a resolution of gender dysphoria mean it’s time to end the therapeutic relationship? Does the start of a medical transition indicate a good time to end? And how can therapists leave the door open for a client who may want to return at a later date?  

Extended Notes

  • ● When a long-term client leaves. It can be a bittersweet moment.
  • ● If the therapy process is working well, the client should be proactive in how they’re building new connections.
  • ● Therapy is a lot like riding a bike. You are a little wobbling and then, next thing you know, your training wheels are off!
  • ● What do you do when you have a client who has resolved their issues around gender identity, yet other issues are cropping up?
  • ● Upon the discovery of certain deeper issues, some clients realize that they cannot trust themselves.
  • ● Sasha has seen her clients feeling ashamed for their prior thinking.
  • ● Some of Stella’s clients wished the whole event didn’t happen. Well, it did. Let’s forgive ourselves a little.
  • ● Sometimes what feels like progress and going forward can also sidetrack you and you find yourself going completely sideways. Life gets us like that, but therapy helps us process these changes in a healthy way.
  • ● The goal in therapy is not to just help them de-transition. The goal is to help them find the right answers for themselves.
  • ● When is it time for a client to leave?
  • ● What do you do when you, as a therapist, make a mistake?
  • ● Sasha has a lot of her thoughts and opinions online. There have been times clients have read that and disagreed with her, and if the relationship hasn’t been built, this can really hurt progress.
  • ● Stella knows it’s ended badly when the client is always on her mind and she’s rethinking of ways to better handle the situation.
  • ● Stella is curious to know if people “relapse” with gender the same way people might with food disorders.
  • ● Stella has noticed people talking about their feelings of transitioning as if it were a drug.
  • ● It can be so frustrating to see a patient not make progress, yet they still keep coming. There must be something there.
  • ● Stella also worries for younger patients who use therapy as a crutch. She doesn’t want to create chronic patients.
  • ● What do you do when you feel it’s time to terminate the client relationship, but the client still wants to keep going?

  • This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:
  • Rethinkime.org

  • Learn more about our show: Linktr.ee/WiderLensPod

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About the Podcast

Gender: A Wider Lens Podcast
Two therapists explore the expanding concept of "gender" from a psychological depth perspective.
Gender dysphoria has become a minefield for public discussion, with many afraid to express their views or question the narrative. Our mission is to examine this important and complex topic from a range of perspectives, but always through a psychological lens. By openly considering and examining gender identity, transition, and the transgender umbrella, we hope to give all interested parties permission to engage these fascinating topics with less fear and more honesty. Interviews and discussions will involve clinicians, medical professionals, academics, transgender people, parents, detransitioners and other interesting individuals whose lives have been touched by the concept of gender.

Conversations between two practicing therapists give listeners an opportunity to contemplate gender from a depth perspective not currently taken up in most of today’s accessible debates. As a result of their work with gender dysphoric therapy clients as well as their personal divergent experiences with gender, Stella and Sasha hold a refreshing and informed perspective.

Is gender identity a facilitation of development and expression of creativity, or can it be a defense against painful existential realities of living in a human body? What can we discover about masculinity, femininity, identity, gender performance, and sexuality when we peer beneath the surface and dive into a deeper psychological exploration? What is the relationship between body, mind, identity, culture, and psyche?

This podcast engages listeners in an intimate and fascinating behind-the-scenes inquiry about a topic as taboo as it is salient today.

* We are sponsored by ReIME and Genspect.
Rethink Identity Medicine Ethics (ReIME) is a non-profit organization dedicated to improving long term care for gender variant individuals. To learn more, visit https://rethinkime.org/

Genspect is an international alliance of parent and professional groups whose aim is to advocate for parents of gender-questioning children and young people. Parents are concerned that their kids are not receiving appropriate treatment and support; many do not feel free to speak out about their concerns.
To learn more, visit https://genspect.org/
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About your hosts

Stella O'Malley

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Stella O’Malley is a psychotherapist and author who works in private practice in Ireland. Her work focuses on parenting, family dynamics and working with teenagers.

Much of Stella’s counselling and writing focuses on mental health and the importance of well-being and she is a regular contributor to the media. She is also the resident psychotherapist for the current TV series, Raised by the Village, a family programme that helps troubled teenagers reconnect with themselves and their families.

Stella's first book, Cotton Wool Kids, was released in 2015 while Bully-Proof Kids: Practical tools to help kids grow up confident, resilient and strong was released in 2017. Stella’s latest book Fragile, was released in 2019 and focuses on overcoming anxiety and stress.

Stella was the presenter of the documentary Trans - Kids: It’s Time To Talk broadcast on Channel 4 in November 2018 and she contributed a chapter to the 2019 book, Inventing Transgender Children and Young People.

The Jungian analyst, Lisa Marchiano, and Stella launched Secrets of the Motherworld in September 2019, offering thoughtful exploration of the most intimate aspects of motherhood in a bid to help mothers feel less alone.

Stella is a Clinical Advisor for the Society for Evidence-based Gender Medicine and a founding member of the International Association of Therapists for Desisters and Detransitioners. She is also the lead facilitator for the Gender Dysphoria Support Network.

Stella holds a B.A. in Counselling and Psychotherapy and a M.A. in Cognitive Behavioural Therapy.

Sasha Ayad

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Sasha Ayad is a Licensed Professional Counselor who works in private practice, and has treated adolescents for over 10 years. Her work focuses on teens and young adults struggling with issues of gender dysphoria and gender identity.

She became interested in the sharp rise in teenagers who declare a trans identity for the first time during adolescence. She discovered, through working with hundreds of families, that many teens were developing gender dysphoria only after adopting a transgender identity. She questions the practice of medical transition for children and teenagers, and her clinical work focuses on developmentally appropriate, least-invasive-first talk therapy.

Sasha is also a founding member and Clinical Advisor in the Society for Evidence-based Gender Medicine and a founding member of the International Association of Therapists for Desisters and Detransitioners.

Sasha’s previous work experience includes:
- School counselor for middle and high school students at a charter school for underserved communities

- Behavioral therapy with children on the autism spectrum

- Individual and group counseling for women and children impacted by domestic abuse and sexual violence

- Developed and ran the first counseling program at a large state supported living facility for adults with intellectual disability

Sasha holds a B.S. in Psychology and an M.Ed. in Counseling Psychology.