Pronoun Problems: Cultivating Compassion To Gender and Sexual Minority Clients

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By Sonia Singh, PhD candidate

“I don’t understand these/they/them/their people. I feel like they just need to figure it out and it makes the clinical writing sound atrocious.”

This is one of the first things one of my clinical supervisors said to me during our initial meeting related to one of my clients who identified as gender fluid.

I sat silently feeling dumbfounded, upset, and angry at this supervisor and quickly recognized my lack of power in the room as a graduate student trainee.

My experience with this supervisor continued to be difficult. I felt unsafe letting my supervisor know I identified as a part of the queer community and continued to subtly advocate for my client.

“THEY.” I would emphasize when I spoke about my client. “THEY.” I would correct whenever my supervisor used an incorrect pronoun for my client.

Finally, one day when my supervisor repeated those initial words to me, I said back, “You say the grammar is hard and the pronouns are difficult for you – but I cannot imagine what life is like living as someone who identifies as gender fluid in a world that pushes the gender binary so hard. That sounds a lot more difficult.”

And as much as I would like to say that moment caused it shift in my supervisor, I cannot say for sure if it did or not. I do know it provided insight to me about how little training we receive as graduate students about gender and sexual minority issues. Further, how little training professionals in the field receive about these issues.

To most people, this anecdote seems like an egregious error. How could someone in our field ever respond in that way? But as I continue to navigate through this field, I am noticing it happens more than people would think.

This is why the Contextual Behavior Approaches for Working with Sexual Orientation & Gender Diversity conference is so important.

I attended this conference in 2017 while I was working with this particular supervisor. It felt like a safe haven of acceptance and a fountain of knowledge related to working with people who identify as gender and sexual minorities.

I learned about shame and race as they relate to this population from Yash Bhambhani and Kelly Wilson. I sat with my own discomfort in the service of values during experiential exercises led by Matthew Skinta and Aisling Curtin. I watched in awe as Colleen Sloan conceptualized and demonstrated Dialectical Behavioral Therapy skills for work with transgender and gender nonconforming people.

See also: How is RO-DBT different from DBT? 

When this year’s conference was announced, I felt a rush of excitement about the opportunity to continue to grow and learn.

Many clinicians will admit they do not feel competent to work with people who identify as gender and sexual minorities, even though these people continue to face mental health challenges. Further, gender and sexual minorities are less likely to seek services due to societal group stigma and worries related to therapist competency.

If we as a field truly value diversity, it is imperative that we continue to gain knowledge in this area. It is imperative that we recognize the gaps and blind spots in our training. Although I cannot say this conference will answer and solve all of those problems, it is a great place to start. ​

We Invite You to Learn Skills to Develop Powerful, Therapeutic Relationships With Your GSM Clients at Our Gender and Sexual Minorities Conference!