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Andi facing the camera with progress pride face mask
December 14, 2020
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The question

“How do you know?” the question that every trans person has been asked and asked of themselves over and over. How can you know, how can you be sure? What is often not asked is the more nuanced question of “What does that mean to you?”

I can answer your first question easily “I’ve always known” “It just clicked” “I found the right words to describe what I have always felt inside” but what does that really mean? Well how do you know you are a man or a woman or any other deep aspect of your identity? For most people there’s not much thought in this. You know, you’ve always known and because you are part of the accepted majority you never need to question how you know. You adapt and develop your gender identity in alignment with the gender you were assigned at birth and with your developing body and that’s all OK.

But what does your gender identity really mean to you? Have you stopped and thought about it? Have you asked yourself who you are, have you studied yourself, have you practiced being yourself and then gone out and tested that self, consciously, out in the world? That’s risky, the new you is fragile, just forming, trying to put together an inside and an outside and make it work so that the world sees the person on the inside and so that you can finally be “free to be me!”

In today’s blog I’m thinking about the power of support and therapy when you are trans, I’ll be drawing on my years of experience as a therapist and also remembering the many, many words of group members and others who have allowed me the privilege of sharing their journey of self-discovery. As always I’m speaking from my perspective and my experience and in no way can I explain the totality of experience. There will be some generalisations and I would caution you to always approach this with an open mind, because everyone, and everyone’s transition, is different.

The feeling

The word “incongruence”, as originally defined by Carl Rogers, means out of alignment, of something not fitting or not being suitable, of knowing that there is a difference between the self you view and your ideal self. Being incongruent can hurt, your true self is fighting against the conditions imposed upon it and the more those conditions are forced down the harder it is for you to grow and become. Rogers used the analogy of the life force of a plant, to show that everything strives to grow past the obstacles and to become more authentic but as with everything in life becoming authentic is something that we do in relation to others. If there is one thing that this lockdown has really shown to all of us it’s the power of human contact. We need it, even the most introverted of us, needs to exist in relation to, not in isolation.


When you are trans you are defined as living with gender incongruence (ICD-11), those people who come to Chrysalis come to explore that incongruence, to find their authentic selves. For some that pressure of being out of alignment, of not being able to be their authentic self has forced dramatic events, an explosion of coming out, an urgency to transition, for others the sense of incongruence is more intangible, they know there is something not right but they don’t know exactly what. Many will have come to us because they have reached rock bottom, realised that transition is their final option if they are to go on living. For some they come to us to find out how they can reach a place of compromise so they they don’t have to transition, so they can hold everything in balance because life is always more complicated than a binary choice. Being trans is only an aspect of who we are and whilst transition is a focal point, it is not always the answer.


I’d like to give you three examples of what happens when someone is supported in their discovery of self at Chrysalis. (All names and identifying aspects have been changed)

When Isaac came to us he had already paid for a double mastectomy, a quite person and one who “knew he was not a woman, but did not feel he had the right to call himself a man either”, we had quite a discussion at the start of our time together about pronouns and settled on “just don’t use she'”. Isaac wanted to be confident, he wanted to be himself but he did not know how to get there. He would often talk about fear of being “found out” and of being read. He was scared of going out, of interacting with people and talked about his family’s lack of acceptance and deliberate misgendering. Isaac and I worked together for nearly two years, he was also a regular attendee of the support group and enjoyed getting to know other trans people and meeting some of our trans masculine speakers, for Isaac seeing trans masculine role models was a true eye opener, and after one memorable speaker we had a breakthrough session when he talked about his fear of taking hormones and yet how he desperately wanted the changes to his body. At our next session Isaac proudly affirmed to the group that he was claiming the pronouns “he/him” and that he had spoken to his doctor about a referral to the gender clinic. He stayed with us another year and just recently got back in touch to talk about volunteering. I can’t wait to have Isaac come and speak at the groups so that he too can be a role model for those who know but need help to find their way.

Elsa was in her 40s when I met her, she’d tried to transition years ago but it had gone very wrong, she had been shunned by her family and friends and at the time there was no Chrysalis to help her. Being totally isolated nearly drove her to suicide and in the end she decided to put Elsa back in the box and to get on with her life. She went to university and after graduation started her own business. She married and had two children who were her world. Elsa was referred to Chrysalis by her GP when she finally sought help after another severe period of depression. Her GP recognised the gender incongruence in Elsa and suggested that she speak with us to see if we could help. At first Elsa only ever presented in what she called “male mode”, she was incredibly wary of anyone finding out she was attending Chrysalis. She feared taking any action as to her that would be like stepping into the roller coaster, that she would have no control over what happened next. A fear that this woman who had been locked inside for so long would burst out and whilst Elsa knew she was trans she didn’t know this woman at all and she was scared of her. In her time at the group Elsa gradually came forward, she has a wicked sense of humour and a love of fine clothes and elegance that Elsa’s male mode had never experienced. Elsa often talked of herself as two separate people. There was him (with a sneer of dislike) and there was Elsa (with a soft smile). In our work together Elsa gradually came forward but not at the expense of him, he (and I never did know his name) was gradually allowed back in, he was respected, he was the person who had got Elsa to this point and he was still lovable. Elsa transitioned and in doing so she was able to come out quietly and to stay with her wife, Elsa integrated both aspects of her personality and became a fully formed person with a history and a beautiful future as mumdi to her children

Michael/Michelle came to Chrysalis several times, he/she was deeply in love with his wife and his wife did not know Michelle existed. Michael would alternate between hiding Michelle, buying her lots of clothes, eating too much and generally spinning around with no clear way out. Michelle would become a pressure that couldn’t be relieved in any other way than getting a hotel room and spending the weekend with room service. From the outside it looked like Michael was having an affair and in the end things came to a head and his wife confronted him. She insisted he come to Chrysalis. Michael spent most of our sessions talking about his wife, about their love, their hopes and dreams for the future, how his career wouldn’t allow him to be openly trans and in the end he came to realise that whilst Michelle would always be a part of him he didn’t need to transition. He left Chrysalis after a few months, having met lots of other trans people and realised that transition was not for him. He went away holding Michelle by the hand, she was not going to be shut back in her box, they had reached a healthy compromise and in acknowledging Michelle, in really looking into her eyes during our therapy Michael was able to see himself, as a proud, confident man.

Informed choice

Coming to Chrysalis means being given the space, the time and the tools to make your own informed choice about who you are and most importantly what you want to do about it. Being supported through your transition, being given the safe space to question, to find out from others how it has gone for them and being able to explore both the what if and the what if not without judgement means that you will make the best possible decisions for yourself. The papers have been full of the sad cases where people have made choices they regret, as if being trans is a black and white space when our very existence shows that being trans is part of an incredible spectrum of existence.

Take care and here is hoping that soon we will be able to get back to living our lives in relation to others, and in so doing we are able to relate authentically.

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