Expertise

Not long ago, I enjoyed coffee with Cavan O’Raghallaigh, an advocate for Equality Texas: he fights tirelessly for the LGBTQ minority of Texas – a tough gig on the best of days!

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After we talked politics and agendas, discussed mutually beneficial arrangements and planned for an upcoming conference, we got to talking about the work of therapy. What it is, how it can help, how it can hurt or hinder, and what realistic expectations can be at the outcome. He quipped “I came out as a transgendered man after years with a brain-care team… I tried hard to cooperate with therapy” and in the end, it made more sense to write my autobiography instead.

Basically, even with the best efforts of many therapists, this respected individual felt like he was working at cross-purposes with his counselors. Regardless of your thoughts on individuals who transition, doesn’t it seem a bit heartbreaking that a guy who was working to be a better person was stymied in many ways in his efforts? Most counselors claim specialties – eg. kids, divorce, career, bipolar disorders… in fact, clients reference these when choosing who to see. There are no rules though, about how much extra training one needs to claim that specialty. For example, does that therapist really know the intricacies of life development, the advanced history of child-rearing and how pediatric illnesses manifest in different ways than they do in adults or do they just like working with kids?

There is a classic argument here: does that professional need to have kids to be a good child-therapist? Most say no, if they’ve had the training, they’re still good therapists. Extend that to my colleague Mr. O’Raghallaigh – does his therapist need to be trans to be effective? Again, no – with the same caveat as before – with substantive training, they can still be competent therapists. There are a multitude of studies, books, theories and research white papers about working with children; it is an entire course or three in graduate school, whether one plans to work with kids or not. But the research is scant when it comes to people like Cavan. We don’t have much in the way of long term studies about gender dysphoria; it is barely covered in our educations, and the few books available read more like the bookstore’s self-help section than oft-cited texts. Where are his experts?

There are a few, the trainings are becoming more prevalent. From a consumer/client point of view, how do you know who has the pedigree and who watched E! coverage of Caitlyn Jenner and declared themselves ‘specialized?’

The onus is on you, the consumer to find out. Before investing your time and energy with a counselor, be clear about who and what you desire: Ask Questions! ‘What training have you had in that specialty? Have you worked with people like me before? If you and I don’t hit it off, can you refer me to at least one other counselor who also works with people like me?’

You are essentially hiring your therapist to become an expert on You: having the advanced training in your particular area of concern allows them to jump right in to your deep end, not wade through the shallows learning how to swim on your time.

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