The International Foundation for Gender Education

Originally appeared in Transgender Tapestry #105, Spring 2004.



by Kathleen L. Farrell, Ph.D.





It has been more than two months since I experienced one of my most embarrassing moments as a therapist, and the memory still stings. In group therapy, I made the mistake of using the wrong pronoun. Strangely, I didn?t hear myself do it, but I noticed her retreat. Since it was her first time in the group, after trying unsuccessfully to pull her into the discussion, I decided it was related to a low comfort level and let it go.



After the meeting, she asked to speak to me. She seemed angry. I was tired after a long day, but I tried to listen. Despite years of experience in dealing with every kind of emotion aimed at me, including anger and disappointment, I felt myself become defensive. At first I couldn?t believe I had used ?him? instead of ?her.? I was in denial. I said, ?Are you sure that was what you heard? I am extremely sensitive to this issue. I don?t think of you as male. I think of you as female.?
Later, I would analyze this and recall what I noticed when Margaret came in. The seating was such that I saw her primarily in profile. For the first time, I noted she was right about her nose. Many times in individual therapy, she expressed the desire to have a nose job, and she thought her jaw line could be improved surgically. That evening, as
the group gathered, I studied her, silently agreeing with her about her nose and
disagreeing about her jaw line. I don?t remember exactly how I phrased my thought, but it was something like, ?She?s right, her nose is detracting from a more feminine appearance.?



In retrospect I?m 99% certain my thoughts matched her presentation. I thought of her as she.
From time to time, when seeing a male-to-female who is pre-op and dressed en femme, I?ve been struck by the thought: ?She still has male body parts!? I stay focused on the gender presentation of the person. As a genetic, right-brained female, it?s easy for me to relate to other female brains. This is not to say I don?t notice when someone misses the mark. When Grizzly Adams is sitting in front of me and tells me he is planning to transition, I find myself pondering the improbability and thinking, ?Perhaps I could refer this person to a colleague.?



Sitting across from Margaret and feeling bad about being confronted, I found myself zeroing in on my feelings rather than concentrating on hers. Lost in denying my culpability, I could neither comfort her nor relate to how upset she was by what she believed she had heard. Then something in her certainty gave me pause. I struggled out of my denial, and, flushed with embarrassment, I began a feeble apology. I was so flattened by my own error, I didn?t process her emotional distress. She left, and I was in shock. Then I noticed she had left the book behind that she had intended to borrow. I grabbed it and ran to the parking lot. She was at her car some distance away. I called her name and indicated the book. She shook her head in refusal and quickly drove off. I was left holding the tangible thing that could have brought her back.



A greater sense of disappointment in myself and a lesser concern for Margaret followed as I went through the motions of closing the office and driving home.



I answered the telephone calls that were waiting on my voice mail, all the while thinking about how I had reacted to Margaret.



It was not until the next morning, after a sleepless night, that I began separating my feelings and assessing the clinical damage. My thinking became focused on the emotional toll it had cost Margaret, really looking at what I might have taken away from her and how this would affect her self-esteem in her battle to become herself. I hoped this would become an opportunity, since ideally the therapeutic process provides a safe environment in which to open up all emotions and examine them. While I hoped she would make her next appointment, I had a sinking feeling that she would not?that when her therapist slapped her by calling her ?him,? that was the end.



I wonder how often pronoun mishaps happen in gender therapy. I?ve had transwomen tell me about former therapists, who didn?t specialize in gender issues, who refused to address them by their female names and even insisted on using Mr. I help the battered move beyond these negative experiences. It?s my job to help the emerging woman or man cope and move on when strangers and unsupportive relatives and friends are unkind. I assist them with perspective when goofs are made by supportive relatives and friends?gently helping them understand the period of adjustment everybody is going through and the difficulty of reversing a lifetime of referring to a father, son, or brother as he and him.



In gender therapy, more often than not, a transwoman initially presents in guy mode. After the gender shift, I always use her name. In individual sessions, when the person is sitting right in front of me, there is rarely a reason to use a personal pronoun. When family members or important others join us for a
session, their struggle to use the correct gender name and pronoun is often so obvious it makes it easy for me to avoid misspeaking a pronoun.



Actually, this was my second pronoun faux pas. The first occurred more than a year ago at a Halloween party for StarBurst, the Tampa Bay support group I founded in 1988. As an advisor, I attend meetings from time to time, and last year I volunteered to host a game of Halloween Charades.
It was the first time at StarBurst for Gina, an attractive woman who I was
seeing in individual therapy. Gina had a defensive posture that I perceived as a vestige of the years she practiced hiding Gina behind Gene.



With both teams close in points, we were in the final round and the game was opened up so both teams had the opportunity to guess. The room was charged with energy and merriment. One of Gina?s teammates was acting out the film ?Night of The Living Dead.? Guesses were coming at me from both sides of the room. Gina, in a voice barely above
a whisper, gave the correct answer. I pointed at her and said, ?He got it.?



If it had been a Hollywood movie, everyone would have gone dead quiet and stopped in mid-motion. In fact, what happened is no one except Gina heard ?He got it.? Finally I yelled above the crowd, ?Gina got it!?
Gina experienced a truly bittersweet moment?crushed by my words, and congratulated by her teammates for winning the game for them. Gina confronted me about it, I listened and we worked through it.



After the unresolved incident with Margaret, I did what I hope every therapist does when something like this happens?I made an appointment to see my therapist. ?Is there something about me and my feelings toward Gina, and now Margaret?? I try to examine all the possibilities. Gina was raised in the same Midwestern city where I grew up, and
she is the same age as my younger brother. I spent many years in the same North-eastern city where Margaret grew up,
and I finished my education there. Gina and Margaret also share some personality traits?they are bright, generally mistrusting, and have difficulty in relationships.



I tell my therapist that I?ve abused their trust and feel responsible for their fragility. I?m especially concerned that Margaret will use this as the sign she
has been looking for to discontinue her pursuit of her true self, her happy self. I complain that she cannot understand the real significance of this blunder. ?And
you can?? my therapist asks. I make a weak comparison about how the young people I see talk about their parents and then look at me and go, ?Whoops.?
My therapist and I talk about everything, and we spar?actually, mostly I spar and she watches. Sometimes she intervenes, sometimes she is patient until I figure out what I need to figure out. She asks if I were hoping for a therapeutic relationship with Margaret like she and
I have, like I have developed with Gina.



I probe what I believe is the common link?the masculinity I observed in both these women who were in the early stages of transitioning. I say, ?I?m not shifting the responsibility away from me, but I?m certain this was a factor.? Finally she gently tells me I need to let this go. I know she is right, but I?m saddened that I have no way to reach out to Margaret, to bring her back into therapy and work this through with her. And I anguish over Margaret and others who are damaged by what may seem a small thing.
This lesson is not just for me?it?s for all therapists who work with transgendered individuals and for all society. When will we learn how destructive words can be? In the case of Margaret, the course of her life may hang in the balance?that is the power of one little pronoun.



Note: Margaret (not her real name) has not returned to therapy with Dr. Farrell; Gina (not her real name), continues to see Dr. Farrell and is successfully transitioning.





Kathleen L. Farrell, Ph.D. is a gender therapist
who lives in St. Petersburg, where she works
exclusively with individuals who are experiencing gender identity issues and their families
and important others.