I have been asked by many people lately about Bruce Jenner and what I think about his/her story. To be honest with you, I have stayed out of it. What I can tell you is that Bruce Jenner is struggling with something. If Bruce were to email or phone my office inquiring about my services, that would be typical of what so many of my transgender or gender-variant patients would do. Many patients have told me that making that first call or first email to me was one of the hardest things they’ve ever done. They seemed so surprised that I would return their call or email pretty quickly.
By the time someone reaches out to me, they are at their wits end. Many of these people have done everything in their power to deal with their gender dysphoria by themselves and have not wanted to seek help from a professional. The person feels so much shame or embarrassment and isn’t sure if I will judge them or make them feel bad about themselves. It is my job to make the person feel comfortable, safe and assured that I can help them and that there is nothing wrong with how they feel. Many of the patients report putting off this call and dealing with their gender dysphoria for 20, 30, 40 or even 50 years themselves and hoped they would either die or grow out of it. Like I said, I get the call or the email when the individual has hit their breaking point. The person is either suicidal, unable to function professionally or personally or realize that their depression or anxiety isn’t going away no matter what they do. For many of the clients I see, they are married with children, have successful careers, good friends, appear happy on the outside but feel a very deep void inside. Many patients tell me that I am the first person in the entire world that they have told about themselves. Many transgender people who decide to do this later in life struggle to know how far to take the journey. If they are already in their late 40’s, 50’s, 60’s and 70’s, they might say, why bother? I always answer them with why not? Bruce Jenner fits right into the population of people that I have been treating in my practice for the past two decades.
A very common scenerio that clients will bring up during the early stages of treatment is, “Can you prescribe a pill for me that will cure me of being transgender”? I say it’s common because transitioning isn’t easy but for most of my clients, it ends up being the absolute right thing to do and it was something they should have done a long time ago but couldn’t for so many reasons. I believe it is up to me to give the patient reassurance that walking through these doors was the best thing they could have done for themselves. Transitioning can seem selfish to everyone else. Transitioning can seem out of character for everyone else. For the transgender person, it makes perfect sense. Having electrolysis, starting hormones, discussing facial feminization surgery, hair transplants, wigs, clothes, gender reconfirming surgeries, dating, voice lessons. It is all a part of the process. Their anxiety and depression could be caused by oppressing their gender identity. Their issues with anger, rage, unhappiness, drugs or alcohol could have a direct correlation to not dealing with their gender identity and/or sexual orientation issues. This usually puts the patient at ease.
I believe that Bruce Jenner has been pondering this for a very long time. I can only guess that he has tried to be happy as himself up until this point. Did he know he was transgender when he was young? He probably knew he was different. What made him decide he couldn’t live as male anymore? This can only be answered by him. Many people report that they wake up one day and say, enough is enough. I can’t take it anymore. I don’t want to admire women anymore, I want to be one. I don’t like my facial hair, I don’t like pretending to be someone that I’m not. For so many of my patients, the only time they have dressed and felt female is at home by themselves. Even if they told their partners before marriage, most spouses didn’t take them seriously. In Bruce Jenner’s case, we don’t know what he told his partners.
Psychotherapy helps with sorting out the whole picture. The first question I ask any new client is, What would you like me to call you? I also tell my clients, please feel free to come to session dressed any way you feel comfortable. We will discuss everything from how long you have had these feelings, how you think I can help you, what are your short term goals, what are your long term goals and what would you like to accomplish during our time together? I also explain that everything we talk about is confidential and that I would be happy to do family sessions. We talk about hormones, surgeries, providers, side effects and in time, things begin to make sense to the client and decisions are made and a plan of action takes place. What I have witnessed time and time again is that by the time a client leaves my office, they feel calmer, clearer and more confident that they know who they are and what they are with less anxiety, more direction and with a sense of purpose. I actually get to see smiles on their faces. During our time together, there will be losses and gains but overall the world did not come to an end as they believed it would. In many ways, they have begun living a new life with new possibilities, new challenges, and new opportunities. These clients also become more confident, less depressed, less anxious, happier, healthier and more confident to go out into the world and hold their head up high and be their true selves. I hope that Bruce will get the change to do this as well. I’m rooting for him.