Can We Talk About Trans?
There is real progress being made within Group Analysis (GA) on creating a discourse about gender and sexuality. The SIG on Queer Perspectives in GA is already generating a lot of interesting dialogue. This Queer edition of Context is another sign. As a queer member of GASi, I want to salute these developments.
Now seems the time to ask: can we talk about Trans? how are we as GAs responding to the explosion of societal debate in this area of identity? How are we responding to group members who identify as trans?
My aim in writing this is to open up, not close down; to raise questions, not provide answers. Also to share resources, as my sense is that clinicians are looking for these.
Please note that I am only considering issues concerning adults who identify as Trans, as this is within my personal and clinical experience.
In such a polarised debate, it feels necessary to begin by saying: can you trust me to ask questions about it without having an agenda? A political position that will direct my line of thought? Can we have a debate based on a clinical position rather than a theory about transgender in general?
The Societal Battleground
Here in the UK, 0.5% of the population identify as transgender (Census 2021). This equates to 262,000 people. Yet transgender rights have become a major societal battleground, as reflected in our political and cultural discourse. It has become a ‘dog whistle’ issue across the political spectrum, on university campuses, taking up inches of newspaper columns and social media exchanges, generating legal cases as one set of rights collides with another set of rights, for example feminist or religious.
At the same time, it is a welcome development that the life experience of people identifying as Trans is increasingly mainstreamed eg in TV series and publications. My own reading has included two powerful memoirs: Elliot Page’s Pageboy (Page, 2023) and Sarah McBride’s Tomorrow will be different (McBride 2018).
My personal monitor of how fierce the debate has become is when I present once a year on Gender and Sexuality on the Foundation Course at the IGA in London. It’s a mixed audience: some are clinicians but many are from different employment backgrounds. My aim is to introduce a queer lens into group analytic theory, particularly by inviting discussion on the social construction of gender, the rapid societal changes that are reflected in the Foundation Matrix of our groups and the power of groups to establish norms of respect and inclusion of difference.
Over the 5 years I have been doing this, the discussion has always been lively but gets distinctly ‘hotter’ at the point at which I raise the debate about transgender rights. It’s as if queerness in terms of the L, G, B and Q components of LGBTQ has been almost assimilated. Or at least, listened to respectfully. But queerness in terms of the T is definitely not. It seems to provoke something very primitive and enraging.
So what is it that gets so stirred up?
In my experience the debate very rapidly becomes about bodies. What hormones, what body parts, what surgical modifications, what does the female body experience that the male body doesn’t. Also the dialogue feels concrete, as if the feelings directed to the body cannot be symbolised. This feels different from the debate about queer orientation and the objects of desire.
This focus on the body seems to bring up two emotions that are never far away when gender and sexuality is discussed: shame and anxiety.
The shame of feeling ‘abnormal’ is hugely powerful in queer individuals.
In group analytic terms, we understand shame as a social construct: the queer individual feels the shame but it is not just from inside them, but also located in them by others. As Daniel Anderson has put it, this location of disturbance in transgender and queer individuals “can come to represent, in a literal way, the pain of all change” (Anderson 2023:121)
I wonder too if the idea of body modification brings up some existential threat of annihilation. Combined with the fear that an attack on binary assumptions provokes, we can begin to see why social anxiety has become so great.
So how can we talk about trans?
I suggest that one of the reasons for the explosiveness of the Trans debate is that, in societal discourse terms, it is still a new issue with new language. According to a leading psychoanalytic author in this field, Alessandra Lemma, transgender is an “emergent phenomenon”, the word itself only appearing in the 1990s [ Lemma, 2023: p4-6]. So it is not surprising that we haven’t yet got a fixed vocabulary.
Nor is it just vocabulary. There seems to be an assumption that there is a homogeneous category of people who are ‘trans’. Yet there are clearly different levels of transitioning that individuals seek, from social changes such as clothing to limited physical transition to a wish to align fully the body through surgery. As we know from all categories of discrimination, it makes it easier to make sweeping judgements about ‘them’ if they can all be considered the same.
Based on our clinical experience as group analysts, how might we understand the word ‘trans’? Would we agree with Lemma (2023: 9-10) in defining the scope of her clinical work with adult transgender individuals as follows:
- Individuals with “a history of longstanding discomfort in their bodies, often dating back to early childhood, and who identify with a binary gender categorisation”
- Individuals “who identify a problem in their experience of embodiment and gender for the first time around or post puberty and who may seek no or only partial physical changes”
- Individuals “who view gender as fluid and categorise themselves as gender non-binary or gender non-conforming”
Conclusion
My aim in writing this has been to open up a space for thinking about transgender, replacing the usual noise which drowns out reflection. If we can’t talk, we can’t think [Dalal 2012]
I feel we have an ethical imperative as clinicians to have this discussion. In terms of mental health, in 2018 Stonewall reported that 46% of trans people thought about taking their own life in the last year. In societal terms, it is interesting that this is higher than for people identifying as LGB, of whom 31% made the same statement {Stonewall, 2018]. Of course in human terms, both statistics are very worrying.
Finally, given how emergent this issue is, can we also share ways of keeping ourselves informed? Below, in addition to the references in this article, I list some of the sources I have found helpful. It would be great if anyone reading this would like to put forward their suggestions, whether clinical or mainstream, and in all forms of media.
References
Anderson, D (2022) The Body of the Group: Sexuality and Gender in Group Analysis, Phoenix Publishing House Ltd: Bicester
Census UK 2021https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/genderidentity/bulletins/genderidentityenglandandwales/census2021
Dalal, F (2012) Thought Paralysis: The Virtues of Discrimination, Routledge: Abingdon and New York
Lemma, A (2022) Transgender Identities: A Contemporary Introduction Routledge: Abingdon and New York
McBride, Sarah Tomorrow will be different: love, loss and the fight for trans equality, Three Rivers Press: New York
Page, E (2023) Pageboy: A Memoir, Flatiron
Stonewall 2018
stonewall.org.uk/resources/lgbt-britain-health -2018
Other reading
Hakeem, A (2010) Deconstructing Gender in Transgender Identities, Group Analysis, Vol.43(2)
Hakeem, A (2010), ‘Parallel Processes”: Observed in the Patient, Therapy and Organisaion, Group Analysis, Vol.43 (4)
Kay, J (1998) Trumpet
Morris, J 1974) Conundrum, Faber &Faber: London
Thurer, S (Ed.) (2023) Beyond the Binary, Phoenix Publishing House: Bicester. The whole book is recommended and specifically – Oren Gozlan Transsexuality Bibliography, chapter 8.
Sarah Tyerman (she/her) is a queer group analyst and psychotherapist in private practice in London. She has a special interest in gender and sexuality, both of which she suggests have been comparatively under-theorised in group analysis. She has presented on gender and sexuality on a number of courses and workshops for the Institute of Group Analysis, the Group Analytic Society International and the American Group Psychotherapy Association.