Transgender Emergence: Therapeutic Guidelines for Working with Gender-Variant People and Their Families

Lev compiles a terrific anthology on working with transgender clients. Whether you are a health professional or mental health professional, Transgender Emergence offers the information and skills to be successful with transgender clients. This is a must-have if you work directly with this population. -Brad Baranowski Counseling Intern

Are you - or a family member - considering or beginning male-to-female or female-to-male transition? You should study this book. Transgender Emergence was written to fill the huge hole in the theory and practice of care for all gender-variant people and their families. It is a superb resource. Originally intended for professionals in psychiatry, psychology, family therapy, and social work, Transgender Emergence is also an excellent guide for clients to use in evaluating and choosing members of their support network. Arlene Lev is a family therapist with over 20 years of experience addressing the unique therapeutic needs of LGBT people. She is a member of the Harry Benjamin International Gender Dysphoria Association - and is at odds with those who would use the Standards of Care to act as gatekeepers rather than guidelines to serve the needs of transsexuals. She postulates that much of the pathology experienced by gender-variant people is due to their experience with our cultural and sociological demands, rather than their gender variance. Ms. Lev stresses that the transgender's/transsexual's personal identity is real, and cannot be changed. All clinical efforts should be geared toward helping the client and their family accept and adjust to their gender variance. The goal of the therapeutic relationship must be empowerment of the client and their family to rewrite their lives in a meaningful way. She believes that transgender is nothing more (or less) than a normal, healthy variation of human expression. There are three parts to the book. Part I discusses transgender/transsexual throughout history, outlining various attempts at understanding sex, gender, and their relationship to each other. The historical premise is that anything other than the polar opposites of male and female is deviant - and must be punished or fixed. As most transgendered people know, "fixing" often meant behavior modification by punishment. Part II discusses diagnosis, evaluation, and treatment philosophy developed during the past century. Lev finds that "The diagnosis of Gender Identity Dysphoria is part of a long historical process of labeling and pathologizing sexual and gender differences." She criticizes this diagnosis as a mixture of unscientific clinical assumptions that are inappropriate as the basis of treatment. Part III examines potential treatment philosophies and recommends those treatments that honor diversity. The "disorder" or psychopathology found in transgender/transsexual clients is most often the result of gender suppression by family members and society rather than being the cause of their gender variance. Unique to Lev's recommendations is the idea of providing therapy to the entire family throughout - and even after - transition. No family can absorb the announcement that a member is not what they seem without disturbing the established family dynamics. One chapter is devoted to discussion of the stresses imposed on other family membe

"A MARVELOUS RESOURCE. . . . Well-written and well-researched. . . . . Provides enough information to give even the most inexperienced psychologist or counselor an understanding of the issues involved in working with the target population-but even counselors who have treated many gender-variant individuals should read this book." Reviewd By: Dallas Denny, MA, Editor, Transgender Tapestry Journal

"FINALLY, a book that does justice to the life-changing power of psychotherapy in the transgender coming-out process. I recommend this book to any psychotherapist called to work with transgender clients. I also recommend it to transgender individuals who might benefit from understanding how psychotherapy can play an invaluable role. COMPREHENSIVE AND PASSIONATE. . . . TERRIFIC. . . . LONG OVERDUE." Reviewed By:Walter Bockting, PhD, Co-editor, Transgender and HIV: Risks, Prevention, and Care; Assistant Professor and Coordinator, Transgender Health Services, Program in Human Sexuality, University of Minnesota Medical School

"The information contained in this book is SO IMPORTANT THAT NO CLINICIAN CAN AFFORD TO MISS IT. The book offers a clear, comprehensive, and cogent review of the history of the mental health field's thinking about sexuality and gender, and an extraordinarily thoughtful and extensive exploration of assessment and intervention issues with gender-variant people and their families. Lev's knowledge of the subject is phenomenal, and the breadth and clarity of her writing are brilliant. This book lays out an enormous amount of complex material in a highly readable and useful text. . . . BELONGS IN THE LIBRARY OF EVERY PSYCHOTHERAPIST, COUNSELOR, AND HEALTH CARE PROFESSIONAL." Reviewed By: Monica McGoldrick, MSW, Director, Multicultural Family Institute, Highland Park, New Jersey