Using Pronouns in Therapy

A major concern of mine at the beginning of the school year was how to introduce my pronouns into a therapeutic setting.  I’ve had more than enough experience doing this as a client (probably with three different therapists), but I suddenly found myself unsure of how to approach this with clients of my own.  As with all things in life I decided to come up with a game plan.

I chose to present my pronouns in a way that would be most beneficial to my clients.

I looked at it from the perspective of having been a client for about 4.5 years.  I thought to myself, “If I were seeing a therapist for the first time, how would I like them to talk about pronouns?  What would I want them to say?  What would sound too preachy, or what would sound professional enough that it wouldn’t bother me?”

My general script goes something like this:

“Hi, my name is [insert name here], and I tell all my new clients that I use they/them/their/themself pronouns.  I tell you this to let you know that if you ever come in and want me to use a different name or pronouns, I’m more than comfortable doing so, and this is a safe place to have that discussion.”

I’ve had a range of reactions to this.  With my transgender clients they seem to warm up to me immediately, which is pretty fantastic.  For other clients I’ve received head nods, moving on to the next subject, or else confused stares and questions.  When a client seems particularly confused and asks a number of questions, I tell them that it really has nothing to do with our work together, it won’t effect our working relationship, and it’s just for general information as some clients really like to know about pronoun usage.  This seems to help assuage the more concerned and confused clients.

Overall this seems to be a good strategy when interacting with clients, particularly with transgender clients.  If I know for sure that my client is transgender I sometimes add a bit where I ask them for their name and pronouns, and I assure them that I’ll make a note of these in their file.  I’m still working on figuring out how to change names in our filing system, but all in good time.

Toilet Training

Whilst in the loo today during class I happened upon a lovely torn up sticker that I realized was advocating for mindful use of restrooms.  And not in a, “Please clean up after your nasty selves” type of way, but rather in this way:

Thank you Censored Lexicon!

Which was a pretty awesome way to start off my day.  Read the resource I found about the importance of this here, and I hope you have a lovely day too after reading it.

Non-Binary Hormone Doses

So I hit the three year mark on hormones in…one hour.  Huzzah!  Here’s a video talking about a few things, including but not limited to: the doses I’ve been on, why I dropped doses, and changes (both physical and mental) that I’ve experienced.

Too long, didn’t watch?

  1. I started on 400 mg/ml every month, basically 200 mg/ml biweekly, along with Arimidex (an estrogen blocker).
  2. I dropped down to a half dose maybe 1.5-2 years into hormones.  I wanted to equalize my estrogen production and my testosterone intake as much as possible.
  3. I dropped down to 200 mg/ml every month and started doing my injections on the 15th and 30th of each month (except for February).
  4. I’m now on 100 mg/ml and no longer on Arimidex.  I decided to drop this low because I want to be on the minimal amount of testosterone possible without getting my periods back.
  5. Changes, in order:
    1. Body hair started exploding and body odor changed
    2. Voice started dropping
    3. Genital growth
    4. Acne
    5. Fat redistribution
  6. For acne I started with Doxycyline, but after about 1-2 years of taking it I built up a tolerance, became photosensitive, and now am on Azythromycin in conjuction with a Tretinoin cream and Cetaphil moisturizer.
  7. Changes since dropping doses:
    1. Acne is SO much better!
    2. Body hair that I shave (i.e. face and armpits) is growing back a little slower
    3. My emotions seem to be following a cyclical pattern.  I think this coincides with my menstrual cycle and the surge of estrogen.  I’m following this closely to see if I need to get my hormone levels checked, or if I need to increase my dose or get my ovaries removed in the future.  I would only to the latter if they became cancerous OR I determined the mood fluctuations were unbearable.

Ciao for now, brown cow!

The Gadfly

My hometown’s weekly publication, the High Plains Reader (HPR), is locally known as an alternative and well-researched paper.  Or at least, that’s always been my understanding of the paper.  One of the opinion columns is called Gadfly and written by Mr. Ed Raymond, and this has always been one of the highlights of HPR for myself and my family.  It has always been an informed critique of the goings on in society, and has focused on a wide number of issues both commonly seen in the public eye as well as those issues we’d all rather ignore.

My father has this adorable habit of cutting out newspaper articles, sticking them in an envelope, and mailing them to me to show his support of me.  Where other families might say, “Wow Brannen, you’re living such an authentic life and I couldn’t be prouder to have you as a child,” my family sends academic articles, newspaper clippings, and links to news reports or well-written blog posts.

And so imagine my pleasure when I opened my envelope to find a recent Gadfly article entitled “Bruce and Caitlyn and Friends”.  Knowing HPR, I thought it would be both informational as well as, you know, informed.  I read in horror as the first paragraph contained the phrase

Although he felt the pressures of the female brain as early as age six, it took him 59 years to transgender to female to satisfy those yearnings.

This was unfortunately not the end of the errors contained within the article, and so I decided to write Mr. Raymond an email delineating the points I felt were most salient:

“Mr. Raymond,

I’m a grad student at UW-Madison, but a Moorhead native, and my father sent me your article “Bruce and Caitlyn and Friends” to read.  I did enjoy the sentiments you expressed, especially regarding theology, but I did take issue with a few of your overlying themes.  I wanted to clear up a few points that you might not have been to clear about.

In your first paragraph you described Caitlyn Jenner as “transgendering from male to female.”  I wanted to bring to your attention that the word “transgender” is not a verb — for example, as a transgender person I cannot “transgender” from one sex or gender to another — but the term is an adjective.  So I am a gender neutral, non-binary transgender person.

Secondly you seem to conflate sexuality, sex, and gender identity, although granted the concepts are closely connected.  Sex is what we’re designated at birth based on our genitalia — male, female, or intersex — although as you reference with Nicole, this can be a confusing area for religious reasons as well as medical and social reasons.  Sexuality is who you are or are not attracted to romantically or sexually.  And gender identity is your internal feeling of yourself and where you stand, or don’t stand, within a typically gendered society.

You ask, “What makes us think that when it comes to sexuality each human has received exactly just the right amount of testosterone and estrogen to put us in a narrow ‘normal’ heterosexual range?”  This question makes no sense; hormones point to our sex assigned at birth, but heterosexual is a sexual orientation, part of our sexuality, and I don’t know that hormones play any definitive role in determining our sexuality.

The last concern I had regards your section on non-binary individuals, which really hit close to home for me.  “Non-binary” and “agender” are two completely different gender identities.  Non-binary is more of an umbrella term for people who do not subscribe to the notion of only two genders (the man/woman dichotomy).  Thus a non-binary person would not necessarily say they are male/female, as this connotes more of a feel of being intersex than it has anything to do with gender.  Some non-binary people do identify as bigender, however, and might say they are both a man and a woman.  Being agender involves not identifying with any sort of gender at all, or having a neutral gender identity, or even just not having any proper terminology to describe their gender.  This does not mean androgyny, as this is defined as being in between masculinity and femininity on that binary scale I mentioned above, and typically involves gender presentation (i.e. how you dress, behave, etc.).

(As an aside, being non-binary or agender does not involve “not choos[ing] a gender.”  People under the transgender and non-binary umbrellas don’t “choose” their gender any more than cisgender people do.  By the way, thank you for including that term in your piece!)

This is a handy site I’ve found that helped me clear up a lot of questions four years ago, when I first started coming to terms with my own gender identity.  The link is  I eagerly anticipate your response.”

I will readily admit I censored myself when going into the sex≠gender≠sexuality bit.  I did not want to inundate the email with a description of exactly how sex is determined by the body, but simply described how doctors assign us a sex.  And perhaps I hadn’t been as eloquent as I would have liked, but I felt that I had composed an overall good commentary before clicking “send.”  I was excited that instead of writing musings on my blog I had taken a step farther–to actually educating someone in a profession which I greatly admire.  I waited on tenterhooks, excited to hear what Mr. Raymond might reply.  And the next day or two I found this in my inbox:

Continue reading

Gender Neutral Pokémon

Yes, I’m about to use Pokémon as a gigantic metaphor for my gender neutral, non-binary identity.  You have been warned.


Ralts used CONFUSE GENDER! It was super effective!

I always liked playing the Pokémon games on my ancient, beat up Gameboy Advance I bought off a middle school friend.  I was always partial to the core Pokémon (I’m a purist, what can I say?) but one Pokémon in particular always caught my eye, and it became a staple of my main team in every Green Leaf play-through.

Ralts and I were total buds.  From its cute high-pitched cry to its adorable green bangs, I knew we were meant to make a dynamic team together.  What’s not to love about a psychic fairy type, after all?  But it was about more than just having a psychic Pokémon for me.

I never had outlets for my gender identity or expression growing up, and most of the avenues I did find were highly monitored or criticised, either by my family or my peers at school.  Instead I buried myself in books and gaming, with Harry Potter and Pokémon becoming my main forms of self-expression and validation.

Ralts, like many Pokémon, looked fairly gender neutral.  But unlike most Pokémon it was able to evolve into two very distinct forms in its third evolution.  Gardevoir was also generation III, with a graceful dress-like body and flowing hair.  And yes, this Pokémon could be either a male or female.

In generation IV they introduced Gallade, which was solely a male evolution of Kirlia — Ralts’ second evolution which resembled a small ballerina with green pigtails.  But it was Ralts I always gravitated towards, and I always halted evolution because I couldn’t bear to see my tiny Pokémon counterpart change.

Ralts represented in the Pokémon world everything that I unconsciously felt about my own body and gender: that it was completely ambiguous and devoid of gendered presumptions.

For someone with no way to explain their gender neutral identity, is it any surprise this Pokémon caught my fancy?  Since then I’ve evolved into a grad student who plays more PC games and no Pokémon games to speak of, but I’m still the small, cute, gender neutral person I was back in middle school.  I imagine my Pokédex entry would look something like this:

Brannen: A small gender neutral, non-binary person who stores vast amounts of information inside their tiny head.  Will approach if offered tea and cookies.

My Life Without Gender

In reading a fantastic article by Tyler Ford I found, finally, a narrative that mirrors mine like no other trans narrative has before.  I’d never read about someone else who had never felt a connection to their body, who would instead retreat into their heads and become a “floating brain,” as I always liked to describe myself.  In their article, Tyler describes this more eloquently than I ever did:

I have always felt like a walking brain, living in my head while everyone around me seemed to have some innate understanding of their bodies: how they moved, what they desired.

Equally important is Tyler’s take on what it means for people to continually (and always inappropriately) inquire about their genitalia:

Strangers are often desperate to figure out what genitalia I have, in the hope that my body holds the key to some great secret and unavoidable truth about myself and my gender. It doesn’t. My words hold my truth. My body is simply the vehicle that gives me the opportunity to express myself.

I encourage you to read the full article, as it’s an incredibly eloquent account of an agender individual’s journey through and beyond the gender binary.  It’s a story that needs to be shared, just as all of our stories need to be shared, in order to challenge a society that tells us in effect, “You don’t exist.”