Piper’s fi rst therapist had used a


combination of narrative therapy and, ostensibly, person-centred therapy, yet she had failed to identify Piper’s experiences of cisgenderism as suffi cient to constitute trauma. Instead, the therapist had focused on get ing Piper to build their preferred story of their situation. T is achieved only a limited form of ‘person-centred’ practice, partly because the therapist’s limited understanding of people’s cisgenderist experiences meant she could not adequately grasp the systemic consequences to Piper. In contrast, during our therapeutic work together, Piper and I focused on helping them to recognise the magnitude of cisgenderism in their daily life and the resultant magnitude of their systemic-trauma response. Over time, partly by increasing Piper’s insight into the nature of their past and ongoing systemic trauma and by encouraging Piper to treat their own systemic trauma as a legitimate injury worthy of our joint therapeutic at ention, Piper was able to redefi ne their boundaries and insist on a higher standard of treatment in their interpersonal relationships. For several months, Piper had been involved with a woman who paid lip service to respecting Piper’s gender and constantly expected Piper to help in her life, but who refused to provide any actual support or assistance with Piper’s eff orts to respond to serial misgenderers in their life. During the course of our work together, Piper was able to recognise this partner was neither ‘safe’ nor ‘affi rming’ and take action to distance themselves from the relationship. Piper’s experience is far from rare. From 1 August 2013, Australia’s Sex Discrimination Act (1984) has provided federal anti-discrimination protection that specifi cally includes both non-binary people and the provision of healthcare services. Yet, many non-binary people coming to me for therapy continue to report almost universal denial they even exist. T is non-binary erasure is enacted not only by people in most or all areas of their personal lives, but oſt en by their previous therapists and their current healthcare providers. Non-binary people coming to me for therapy oſt en disclose prior misdiagnosis with borderline personality disorder, in the absence of any symptoms associated with this diagnosis, solely or primarily due to a previous therapist’s failure to acknowledge their


26


gender as valid rather than inherently pathological. Another non-binary person was recently denied the approval let er typically required to obtain hormones in Australia, because they have epilepsy and their psychiatrist told them their gender identity was a kind of ‘brain damage’ that would resolve with proper treatment. Another non-binary person was recently refused psychiatric care by the clinical director of a nominally ‘LGBTQI-friendly’ clinic in Sydney, aſt er they requested this psychiatrist not continue to misgender them. Given that cisgenderist incidents like


those Asma, Piper, and Jaysen faced can lead to systemic trauma, how can we be therapeutically helpful to people who may have diffi culty imagining a life free from daily cisgenderism? Non-cisgenderist clinical practice begins by therapists acknowledging the presence and impact of cisgenderism. We need to identify cisgenderism across diverse systemic contexts and understand exposure to cisgenderism can result in systemic trauma. T ese key realisations can help people of trans and/or non-binary experience to bet er identify cisgenderism. Once identifi ed, we can work to reduce exposure to cisgenderism, help people to heal from its impact, and build eff ective self-care and self- protective responses. T e systemic nature of both cisgenderism and its consequent trauma places systemic family therapists in a unique position to help people who experience cisgenderist trauma. Beyond the management of cisgenderist


trauma, how do we guide people to unlock the unique skills and insights that are possible from a strengths-based perspective? One of the best articles I’ve read on affi rmative practice, Richmond et al. (2012), described a core therapeutic goal with trans and/or non-binary people: help people learn to trust themselves. Several of the non-binary people coming to me for therapy have unlocked unique strengths of being non-binary – what we sometimes refer to in therapy as ‘non- binary superpowers’. T ese non-binary strengths apply in aspects of life beyond gender. For example, several non-binary people discovered during our therapy sessions that they could shiſt from a rigid, ‘black and white’ approach to problem- solving toward a non-binary one. T is non- binary problem-solving approach allowed them to identify more than two ‘sides’ and


more than two options to dilemmas they faced, both in the workplace and with their partners. T is benefi cial transformation occurred as a direct result of their increasing public expression of their non- binary gender. ‘Tolerance’, ‘acceptance’, and being ‘trans-friendly’ may be steps along the way to affi rmative practice, but they will ultimately be insuffi cient to counteract the extreme defi cit-perspective to which many people are exposed in their everyday lives. As systemic therapists, we need to do more than merely validate people’s experiences of stigma, loss, and oppression. In addition to validating people’s traumatic experiences, we also need to celebrate the unique potential benefi ts of trans and/or non-binary lived-experiences in the form of insights, strengths, and skills. We need to stop asking only defi cit questions like “What’s wrong with non-binary people?” and instead start asking celebratory questions like “What’s fabulous about being non- binary?”


References Ansara, Y.G. (2010) Beyond cisgenderism: Counselling people with non-assigned gender identities. In L. Moon (ed.) Counselling Ideologies: Queer Challenges To Heteronormativity.Aldershot: Ashgate. Ansara, Y.G. (2012) Cisgenderism in medical settings: How collaborative partnerships can challenge structural violence. In I. Rivers & R. Ward (eds.) Out Of The Ordinary: LGBT Lives. Cambridge: Cambridge Scholars Press. Ansara, Y.G. (2015) Challenging cisgenderism in the ageing and aged care sector: Meeting the needs of older people of trans and/or non‐binary experience. Australasian Journal on Ageing, 34(S2), 14-18. Ansara, Y.G., & Hegarty, P. (2012) Cisgenderism in psychology: Pathologising and misgendering children from 1999 to 2008. Psychology and Sexuality, 3(2): 137-160. Australian Human Rights Commission. (n.d.) Complaints under the Sex Discrimination Act: Gender identity. Retrieved 17 October 2017 from https:// www.humanrights.gov.au/complaints-under-sex- discrimination-act-gender-identity Blumer, M.L., Gavriel Ansara, Y. & Watson, C.M. (2013) Cisgenderism in family therapy: How everyday clinical practices can delegitimize people’s gender self-designations. Journal of Family Psychotherapy, 24(4), 267-285. Goldsmith, R.E., Gamache-Martin, C. & Smith, C.P. (2014) Systemic trauma. Journal of Trauma and Dissociation, 15: 117–132. Richmond, K.A., Burnes, T. & Carroll, K. (2012) Lost in trans-lation: Interpreting systems of trauma for transgender clients. Traumatology, 18: 45-57. Riggs, D.W., Ansara, G.Y., & Treharne, G.J. (2015) An evidence‐based model for understanding the mental health experiences of transgender Australians. Australian Psychologist, 50: 32-39. Rogers, M. (2017) Challenging cisgenderism through trans people’s narratives of domestic violence and abuse. Sexualities, Advance online publication. doi: 10.1177/1363460716681475.” Shelton, J. (2015) Transgender youth homelessness: Understanding programmatic barriers through the lens of cisgenderism. Children and Youth Services Review, 59: 10-18.


Context 155, February 2018


‘What’s fabulous about being non-binary?’: Non-cisgenderist clinical responses to systemic trauma


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