The question often arises, how to best support transgender people? How to best support autistic people? People with ADHD? People who are otherwise neurodivergent? To answer this question, I draw from my experiences in these communities and from my education as a therapist. When I was working on the coursework for my master’s degree, I explored many counseling theories, and one that stood out to me is person-centered therapy. This asks a different question: What if we trusted people to be the experts on their own experience?
My clients often have stories of being invalidated regarding their experiences, whether they are talking about gender identity, neurodivergence, chronic pain, or any of the myriad reasons people seek therapy. When I was seeking medical transition, I was relieved to find the informed consent model. I had blood drawn for analysis, I signed papers informing me of pros and cons of hormone replacement therapy, and my doctor screened me to ensure I was making a decision of my own free will. This felt affirming and respectful, and I was relieved that I didn’t have to have two mental health professionals, at least one with a PhD., sign off that I am who I say that I am, per outdated standards of care for medical transition.
I do my best to discourage respectability politics, or using “respectability” as a litmus test for what someone deserves. I do not deserve medical care because I have achieved certain things or because I present myself or speak a certain way, or because I have certain privileges, but because I am a human being. And, I find it telling when I share my successes, for example when presenting at conferences, that I commonly receive responses minimizing the impacts of my neurodivergences. I have taken to pointing out in a facetious manner that nobody who attends my presentations sees a picture of my messy apartment.
I grew up hearing how capable I am, how articulate I am, how I could achieve anything I wanted to. I grew up hearing “inspirational” stories of people who “had it worse” than I did, showing that little things like my ADHD and my scoliosis, which required me to wear a back brace 23 hours a day for years of my life, shouldn’t inhibit or prohibit me from achieving my goals. How this felt, however, was far from inspirational. Rather, I felt like I had to perform exceptionally above my peers in order to count.
Where this really hurt, however, was after I came out as transgender at the age of 22. I brought my parents to a meeting with my therapist to help clear the air around my transition. At that time, I still thought I could get my parents to be on board with my medical transition – an aspect of my life they still ignore nine years later. I was receiving healthcare from an organization in Boston known in the trans community as a flagship of competent care. I received fully integrated healthcare; my therapist and my doctor worked in the same building and actively communicated.
Deciding her and my father’s discomfort with my transition was more important than my right to self-determination, my mother attempted to email my therapist with the intention to interrupt my care. What I found the most hurtful about that email was her specifically citing my ADHD as a reason I was not competent to seek my own healthcare. The same woman who had told me my whole life that I could do anything I sought to achieve, who encouraged me to seek my own healthcare, who told me that my disability was more of a difference, then weaponized that against me.
Luckily, she emailed a wholly different organization in error. They forwarded the email to my therapist, who brought it to my attention. I was lucky that I was seen as competent, lucky that I was a legal adult with my autonomy fully respected, or this may have gone badly for me.
Around the same time, my parents picked up my testosterone prescription at the pharmacy and refused to give it to me. It was in that moment that I knew I could never trust my parents with big life news or changes again, and I still keep them at arm’s length. This kind of medical abuse is common – more common than people may want to acknowledge. I have never felt more betrayed in my life, and even at the age of 31, still feel the ramifications of that decision. It took me nearly a decade and intentionally learning what characterizes abuse and neglect to realize what it was for myself.
All this to say, I am a highly achieving person, and my parents, who are excellent at looking like wholesome, supportive people to those on the outside, still weaponized my neurodivergence against my transition.
I encourage healthcare providers to trust their clients, their patients. When people come out as transgender, it is often after a period of questioning and exploration. Most experience questioning and challenging from important people. Many are still thrown out of parents’ homes and lives, or are emotionally pushed away. Receiving supportive healthcare, both physical and mental, is life saving, and I encourage providers to take down as many barriers as possible.
Kendrick is a DBT therapist in Minnesota currently working towards LPCC licensure. He experiences the world from the intersecting lenses of whiteness, transness, neurodivergence, and invisible disability. He is motivated by his beloved dog, Star, and the LGBTQIA+ community.