Transgender and Gender-Diverse Affirming EMDR
EMDR helps resolve and move past trauma that people have experienced throughout their lifetimes. We often think of childhood abuse, car wrecks, or war veterans in the context of EMDR, but there unfortunately almost limitless types of traumas. One of those broad categories is the trauma that many transgender and gender-diverse people experience culturally and from family. Regardless of the source, it’s important to provide gender affirming care.
For some context on the cultural situation, in 2024 there are hundreds of proposed transgender or gender related laws, which is also a significant uptick compared to the previous year. This cultural and political climate has affects on the mental health and wellbeing of transgender individuals regardless of the bill passing or not. At EMDR Therapy Nashville we acknowledge this impact and want to provide affirming care that supports individuals as well as creates safe spaces to be authentic, genuine, and protected.
Transgender individuals often face significant challenges in life satisfaction due to constant and wide spread discrimination and social stigma, especially depending on where they live. This discrimination can be things like social exclusion, harassment, and barriers to healthcare (e.g. Tennessee’s anti transgender health bill). The consistent exposure to can have a big impact senses of self-worth and well-being. Furthermore, these stressors can exacerbate existing mental health conditions, making it difficult for transgender individuals to access the support and care they need to thrive. With this difficulty or aversion, it’s important for therapists to learn and utilize significant cultural competency, not just lip-service to it. With appropriate and deep cultural competency therapists can support clients, avoid negative experiences like misgendering or deadnaming, and utilize validation of clients’ lived experiences.
Thankfully, EMDR therapy itself is neutral when it comes to conceptualizing gender. Some of the older therapy frameworks are not this way which requires navigating and adapting the model itself. But with EMDR, the intervention is a good basis to start from and allows the therapist to focus on affirmation and cultural competence in the relationship without the client having to worry about the intervention or tool that’s being used.
For therapists who are interested in providing gender-affirming care, the following tips could be helpful. Also for clients, know that at EMDR Therapy Nashville we are mindful of these tips and incorporate them in to our work.
Tips for Gender-Affirming Care
Utilize Gender-Affirming Guidelines: WPATH, APA, NASW, and other organizations provide guidelines for gender-affirming care that therapists can read and utilize with clients.
Use Affirming Language: Always use the client's chosen name and pronouns, and ask if you're unsure. Also lead by example by stating your pronouns on things like emails.
Support Identity Exploration: Allow clients the space to explore and affirm their gender identity at their own pace.
Address Intersectionality: Understand how factors like race, class, and sexual orientation intersect with gender identity.
Advocate for Your Clients: Help navigate barriers to accessing healthcare, legal rights, and social services.
Have Resources Available: Educate yourself so you can provide information on transgender-friendly services, support groups, and legal assistance. As therapists we often know of local information for other areas (e.g. domestic violence, eating disorders) so become educated on similar options for transgender or gender diverse clients.
Practice Cultural Humility: Recognize that each transgender person's experience is unique and avoid making assumptions. It’s ok and helpful to be knowledgeable about statistics and generalities, but that’s different than stereotypes. With that, address your own internal bias and beliefs around transgender or gender-diverse individuals.
Recognize the Social and Political Impacts: Be aware of the social and political environment, for example any pending or passed legislation, and its impact or potential impact.
In addition, it can be helpful with our work with clients to incorporate EMDR-specific tips. While EMDR is inherently neutral (and effective as a therapeutic tool), certain changes can help its effectiveness transgender and gender diverse clients. By integrating gender-affirming practices, addressing trauma related to gender identity, and being mindful of the unique challenges transgender clients face, therapists can create a more supportive and responsive EMDR experience. These adjustments not only affirm the client's identity but also help in addressing the specific sources of trauma they may encounter.
Tips for Gender Affirming EMDR
Be Aware of Body Reactivity: With a lot of transgender/gender-diverse clients having histories (or present day) body dysphoria there can be heightened or different dissociation from bodily sensations or processing.
Explore Trauma Specific to Gender Identity: With EMDR we find that trauma can tie in to other trauma. Be aware and open to exploring how any seemingly unrelated trauma (e.g. “not good enough” from a perfectionistic parent) can tie in with gender identity related trauma.
Empower Self-Advocacy: Integrate strategies within EMDR to strengthen the client’s ability to advocate for themselves in situations where their gender identity may be challenged or invalidated.
Incorporate Gender Awareness to Historical or Parts Work: Be aware of internal parts that have a gender and be open to what that gender is. Also establish a preference when referencing childhood or past trauma in relation to name and gender.
In summary, it is crucial to offer care tailored to the client’s specific needs in the context of EMDR therapy for transgender and gender diverse individuals facing distinct challenges. This can include societal biases, discrimination, past trauma related to gender, and familial or social support estrangement. By incorporating specific tips and education, for example using validating language addressing gender related trauma and promoting empowerment, therapists can establish a secure and beneficial therapeutic setting. These adaptations not only improve the effectiveness of EMDR treatment but also validate the clients sense of self. We strongly believe in showing up well for all of our clients regardless of gender identity (as well as race, spirituality, religion, socioeconomic status, political beliefs, etc., although that’s not the context of this article).
If you’re interested in starting gender-affirming and culturally competent EMDR therapy, reach out to us.