Lecture 3

Question 1

What is gender dysphoria?

Answer 1

A clinical term used to describe the symptoms of excessive pain, anguish, agitation, and restlessness that gender-variant people seeking therapy often express

_{Examples: Dissociation, suicidality, sexual dysfunction,<br></br>substance abuse, self-mutilation, intense hostility toward other differently gendered people, insomnia, isolation, dysthymia, anxiety, weight loss or gain, and work or school difficulties}

Question 2

What is transgender emergence?

Answer 2

Transgender emergence is a developmental process whereby gender variant people examine themselves and their identity, within a context of compassion and empowerment, in progress to an authentic and functional sex- and gender-identity congruence

Question 3

What are the stages of the emergence?

Answer 3

1. Awareness
2. Seeking information/reaching out
3. Disclosure to significant others
4. Exploration: identity and self-labeling
5. Exploration: transition issues/possible body modification
6. Integration: acceptance and post-transition issues

Question 4

What are the family emergence stages?

Answer 4

1. Discovery and disclosure - families are often shocked, even when they are aware of a gender issue, the realization of its importance can be emotionally devastating
2. Turmoil - Family members may become withdrawn or emotionally volatile, and can cause stress as the family struggles to accept the reality of gender variance
3. Negotiation - Partners realize that the gender issues will not vanish and must be adjusted to in some manner. A process of compromise, determining what each is comfortable living with.
4. Finding balance - balance does not necessarily mean permanent resolution, it means the transgenderism as is no longer a secret, the family no longer in turmoil. Usually family is ready at this point to integrate the transgender member back into the normal life of the family

Question 5

What is cultural humility?

Answer 5

• Cultural humility is about listening deeply to what our clients tell us
• Cultural humility is about being flexible and humble enough to:
  
  • Engage in self-reflection and critique
  • Understand our culture is no better than any other
  • Admit when we don’t know about the culture of our clients
  • Seek out resources
  • Recognize that only the client is the expert in their culture
  • Place assumptions aside

Question 6

What are the stages of the family life cycle and the emotional process that goes with each?

Answer 6

• Life stage: Leaving home/Single young adults
  
  • Emotional process: excepting emotional and financial responsibility for self
• Life stage: The joining of families through marriage
  
  • Emotional process: commitment to a new system
• Life stage: Families with young children
  
  • Emotional process: Accepting new members into the family system
• Life stage: Families with adolescents
  
  • Emotional process: increasing flexibility of family boundaries to permit a child’s independence and grandparents frailties
• Life stage: launching children and moving on
  
  • Emotional process: excepting a multitude of exits from and entries into the family system
• Life stage: families in later life
  
  • Emotional process: excepting the shifting generational roles

Question 7

Second-order changes in leaving home/single young adults

Answer 7

• Differentiation of self in relation to the family of origin
• Development of intimate peer relationships
  
  • New peers become more important
• Establishment of self in respect to work and financial independence

Question 8

Second-order changes in joining of family through marriage

Answer 8

• Formation of marital system
• Realignment of relationships with extended families and friends to include spouse

Question 9

Second-order changes in families with young children

Answer 9

• Adjusting the marital system to make space for children
• Joining in child rearing, financial and household tasks
• Realignment of relationships with extended family to include parenting and grandparenting roles

Question 10

Second-order changes in families with adolescents

Answer 10

• Shifting of parent/child relationship to permit adolescent to move into and out of system
• Refocus on midlife marital and career issues
• Beginning shift toward caring for older generation

Question 11

Second-order changes in launching children and moving on

Answer 11

• Renegotiation of marital system as dyad
• Development of adult to adult relationships
• Realignment of relationships to include in-laws and grandchildren
• Dealing with disabilities and death of parents (grandparents)

Question 12

Second-order changes in families in later life

Answer 12

• Maintaining your own and/or couple functioning and interests in the face of physiological decline
• Support for a more central role of middle generation
• Making room in the system for the wisdom and experience of the elderly, supporting the older generation without over-functioning for them
• Dealing with the loss of spouse, siblings, and other peers and preparation for death