Becca Gerlach, LCSW discusses working with transgender clients as a cisgender therapist, and working with parents of kids or teens in this process. She shares how to offer support, space for parents to grieve if that’s part of their process while supporting the client, how to help clients who have non-supportive parents, and finding supportive resources.
Becca is a Licensed Clinical Social Worker with over 10 years of experience in the mental health field. Her work has focused on helping those who struggle the most; those with significant trauma. Becca is currently working toward her Ph.D. in Clinical Social Work. Becca has also completed additional training and is an advanced alcohol and drug counselor, sensory-based trauma therapy, psychedelic integration therapy, and is WPATH certified. After four years as a clinical director for a non-profit program, she took a turn away from the behavioral focus and now owns her own practice working primarily with young adults.
Becca offers parent coaching for parents of transgender, questioning, and gender non-conforming kids and teens.
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Portugal Marketing Retreat October 2-7, 2023
Becca Gerlach, LCSW discusses working with transgender clients as a cisgender therapist, and working with parents of kids or teens in this process. She shares how to offer support, space for parents to grieve if that’s part of their process while supporting the client, how to help clients who have non-supportive parents, and finding supportive resources.
Becca is a Licensed Clinical Social Worker with over 10 years of experience in the mental health field. Her work has focused on helping those who struggle the most; those with significant trauma. Becca is currently working toward her Ph.D. in Clinical Social Work. Becca has also completed additional training and is an advanced alcohol and drug counselor, sensory-based trauma therapy, psychedelic integration therapy, and is WPATH certified. After four years as a clinical director for a non-profit program, she took a turn away from the behavioral focus and now owns her own practice working primarily with young adults.
Becca offers parent coaching for parents of transgender, questioning, and gender non-conforming kids and teens.
OFFERS & HELPFUL LINKS:
Portugal Marketing Retreat October 2-7, 2023
Jennifer Agee: Hello. Hello. And welcome to Sh*t You Wish You Learned in Grad School. I'm your host, Jennifer Agee, licensed clinical professional counselor. And with me today is Becca Gerlach, licensed clinical social worker. So welcome to the show.
Becca Gerlach: Thank you for having me. I'm excited to be here.
Jennifer Agee: Yeah. So, Becca, um, you and I today are going to be talking about working with transgender clients and their pa-, and their parents. So, tell me, what are some things you wish you learned in grad school about working with this population?
Becca Gerlach: I wish that I had learned how to write letters for hormone replacement therapy for surgery. I wish that I had learned where resources and additional training were. Um, 'cause I got out of grad school, and I was working, um, after I left an agency between a group practice and kind of a crisis-style outpatient setting, trying to figure out what I was gonna do with my life. Um, and you're randomly assigned clients in both those spaces. Um, and so, I was working with some trans teenagers, um, and I felt awful and talked about this in supervision 'cause I felt like I was learning with them, um, which is not great. And so, I started looking for trainings for additional resources because I just felt really outta my depth. Um, you know, I had clients wanting letters and wanting referrals for things, and I didn't know how to provide that. Um, and so, when I finally did find some training, I had just missed the WPATH training, and so, it was like another year before I could get in there. Um, and so, I started looking for other things, and at that time there—it's better now—but at that time, there wasn't a whole lot. Um, and so, I got lucky and was able to find a colleague working at University of Michigan in the gender clinic there who was able to provide me some guidance in the meantime. Um, and since then I've learned a lot, um, and, you know, really enjoy working with this population. Um, because the other thing that then happened kind of accidentally is I work primarily with this population. Um, and I think in part because I did do the work to learn and, you know, became a good referral source, became a good, um, you know, person to do this work. Um, but that's definitely not where I started. Um, and I think that's true for a lot of people coming outta grad school. Um, and again, you know, resources are better now, but, you know, 10 years ago there just wasn't a lot of training opportunities. Um, and so WPATH is really the standards of care. That's the World Association... the World Professional Association for Trans Healthcare. Um, and so, there's both a medical focus, um, as well as a mental health focus. Um, and so, that's been really, really helpful to know that and have that, um...
Jennifer Agee: Oh, that's great. Okay. Yeah, I didn't know what, I didn't know what that was when you, when you said that I was gonna ask 'cause I, I'd never heard of it, so.
Becca Gerlach: Yeah.
Jennifer Agee: Yeah. I mean, I think when I was in grad school, honestly, um, it my, it was transgender was, I don't know, it was probably a line in a book somewhere, but it wasn't even a discussion. I graduated in '99. I mean, so that was a hot minute ago, but I don't remember a single conversation about it.
Becca Gerlach: Yeah. I mean, and I graduated. 12, 13 years ago. And I took the human sexuality class. It was like one of those one-credit weekend electives, you know? Um, and they had, you know, a group of people come in present to us, but it was very, this is my experience now in the world. It's not, you know, this is what it was like working with my therapist, or this is how the mental health system gets in the way, or this wasn't any of that. Um, you know, it wasn't here's the barriers that insurance creates. Um, it was very much just this, hey, we're people you might work with. Here we are. Um, and so, which I mean is fine, but that's not really helpful. Um, and I've also learned in working with this population that sometimes other therapists say really weird stuff to people, um, and so, that's not okay. Um, I had a kid one time, like 15-year-old kid, found me himself because mom had taken him to therapy somewhere and just doing her best, trying to help him, you know, and the therapist said something to him like, you know, Jesus wouldn't want you to alter your body.
Jennifer Agee: Whoa.
Becca Gerlach: Right. And so, the kid, good for him, got up and walked out of the room. I mean, good for him, you know, for, for advocating for himself and being like, nope, this isn't it.
Jennifer Agee: Right.
Becca Gerlach: Um, and he's like, I found you later that day. I just started Googling and found you. Um, but, but that's the thing, you know, like, I think therapists aren't offered enough support and training, and so, sometimes do say strange things to people, um, you know, or are working outside of their scope without necessarily realizing it. Um, and so, we do wanna be mindful about that.
Jennifer Agee: Yeah. So, as you started your own process of learning and understanding, kind of walk me through what are some of the things that you have learned, like, obviously the hard way, and what are some of the things that you've learned through classes and trainings and things like that? Just walk us through what this might look like.
Becca Gerlach: Sure. Um, so, I learned, um, what the, you know, resources are in my area. Um, so who, you know, are the good doctors, who are, you know, um, other professional, other helping professionals that do this work, um, and kind of have a resource list for our area. Um, you know, I learned, you know, who's maybe like– University of Michigan, um, has a very large gender clinic and has a great program, but they have a super long waiting list. Um, and so then I was learning, okay, who else is doing this? You know, who else, where else can we go to? Um, and so, I've learned about, um, Folx Health, which is an online telehealth platform, um, for hormone replacement, um, for young adult, you know, 18 and up. Um, but for people who don't have access, you know, I mean, I'm working with clients sometimes who are in Northern Michigan, eight hours away from me, and that's more accessible than having to drive downstate to see somebody because there's just not enough providers in their area. Um, and so, there are services like that that really provide more access, which is great. Um, I've also learned that insurance companies, um—I mean, I already kind of knew this 'cause insurance companies are a pain—but, um, I also learned that sometimes insurance companies require two letters, um, both from a treating therapist and from a non-treating therapist. Um, and so, I partnered with someone that I work with, um, to be able to provide both of those to, again, reduce those barriers for clients if that's something that's required. Um...
Jennifer Agee: What would a non... Can we pause here? What would a non-, what would a non-treating therapist have to do with, um, someone's care? That, that doesn't make sense to me. So, explain, explain that a little bit.
Becca Gerlach: So, some insurance companies, um, like for, for top surgery, for instance, may require for that to be approved, two letters. Um, so, both from someone that the client is seeing, which is sometimes problematic too because you're assuming that somebody needs to be in therapy, um, just because they're trans and that's not necessarily the case. Um, I mean, surgery is a big thing, and you know, support is always good, but it's also not necessarily true that we need to be in therapy. But then they also sometimes need to see a non-treating clinician to double-check the treating clinician, um, to make sure that this is really true. Um, because we don't just trust people and their experience and what they wanna do, um, which is not okay.
Jennifer Agee: Yeah.
Becca Gerlach: Um, yeah.
Jennifer Agee: That just seems, that just seems, um, odd to me. I understand wanting more than one opinion. Okay. This is a major life alteration to your body. Uh, I get that. Okay. But a non-treating clinician that, someone who doesn't then have a relationship with the client, that, that doesn't necessarily make sense to me, but okay.
Becca Gerlach: Right. Which is where, I mean, I've been lucky to be able to partner with somebody in my practice to be able to help with that in case that happens, to be able to like kind of warm handoff, say, you know, this is, this is Gabby. She's gonna talk to you. It's gonna be much the same as what we just talked about. You know, she's gonna write you your second letter. It's not, you know, she's not gonna get in the weeds with you. Like, it's not gonna be like that. Um, and that's worked well. Um, but for therapists who maybe don't have those relationships, you know, that's maybe something to think about. You know, if you're providing letters and you know that somebody needs a secondary one, um, you know, having those relationships with other therapists that can help is really important.
Jennifer Agee: Okay. Um, and in working with the parents, so what age, what population do you work with?
Becca Gerlach: So, I see kids 12 and up.
Jennifer Agee: Mm-hmm.
Becca Gerlach: Yep.
Jennifer Agee: Okay.
Becca Gerlach: Um, and so, sometimes with kids, you know, parents kind of respond one of two ways, and I get, like, it's a, it's a huge thing and parents have their own grief process and need to have a space to do that. Um, and then, so I do, I do parent work sometimes as well, um, if I'm not treating the kiddo, um, and to help them kind of process through that. But sometimes kids just want them, you know, their parents to use their name and pronouns. They're not ready to do anything else. Um, and sometimes parents get, you know, 20 steps ahead and are thinking of all these other things, and it's like, no, no, they, they're just asking you to do this right now. Let's just listen to what we wanna do, um, and, you know, just, just do this for right this moment. Um, we don't need to get ahead, too far ahead. Um, whereas other kids do really know that they want to do puberty blockers, um, you know, and want to be working, you know, with their doctor to do that. And so, then I'm working with parents to talk about, you know, that and, um, you know, really framing it as it's buying your kid time. You know, it's just, it's buying them time. Um, you know, there's not any real harm in it. It's just delaying puberty. It's not, you know, causing any life-altering anything else? It's just buying them some time, which kids need sometimes. Um, and kids know themselves. You know, kids, kids know who they are, and, you know, we have to be able to, to trust them. Um...
Jennifer Agee: That's hard though, because, because I've been a teenager, and I was very sure about a lot of things that I was absolutely wrong about, or I got to know myself better, understood where some of those things were. So, you know, I can only imagine if I were a parent in that situation that, I mean, those would, those would be the things I would be thinking is I don't want to remove your breasts, I don't want to cut off your penis because I, you are still in a developmental phase with, with so many things, you know? And, and having been through that phase of life myself, you know, understanding that, that things that you're a hundred percent sure of, you may not forever be a hundred percent sure of at 12 or 13.
Becca Gerlach: Yeah.
Jennifer Agee: How do you help navigate that and balance those things?
Becca Gerlach: So, with kids that young, it's not about making those big changes. It's, it is about, you know, name and pronouns. It's about maybe puberty, maybe puberty blockers, you know, depending on the kid. Um, it's, it's really about buying time, you know, to be able to sort through, and, and understand, you know, and come, come to, you know, whatever conclusion we're gonna come to. Um, and, you know, when I'm working with kids that are a bit older, you know, 16, 17, they tend to be a little more certain. They tend to really want to be doing hormone replacement therapy. They're not necessarily ready to do anything else, um, but they are oftentimes ready to do that. Um, and so, again, it's talking with parents about what's permanent changes versus what's not, but it's also talking with kids about what's permanent and what isn't. Um, because some things are, and some things aren't. Um, and so, you know, really weighing those things out and really working together to come up with a plan. Um, and talking with a doctor and talking with, you know, having kind of more of a team approach to it. Um, but the thing is, you know, for these teenagers, you know, their suicide risk is so, so high. Um, and so, when we don't provide services, when we don't do the things, you know, we're really putting them at risk. Um, and so, that's sometimes something I'm saying to parents too, is like, look, you know, sometimes this is more serious than, than you wanna believe it is or than you think it is. Um, and oftentimes, you know, starting more affirming care alleviates a lot of that underlying depression. Um, because it's really about things not being right, you know, not being authentic, not anything else.
Jennifer Agee: Mm-hmm. How, tell me a little bit about, kind of, um, your thinking about how to help the teen navigate both, um, their own exploration of what this means for them and healthy, kind of, challenging and that, like, where, how do you draw those lines? Because I, I can imagine that that could be difficult sometimes because you wanna be extremely affirming. This is a very, uh, high-risk population, like you said, for suicidality and, and stuff. Um, but also, you know, giving them space to explore and not necessarily have to double-down that it's okay to be in an exploratory phase, which, which I, I think our society is driving people towards definitive answers at a very young age–
Becca Gerlach: Yes.
Jennifer Agee: When developmentally we just may not be at definitive answer phases yet.
Becca Gerlach: Right. No, it's definitely letting them know, like, what's your truth today is your truth today. And whatever your truth is tomorrow is your truth tomorrow. You know, we're gonna operate out of that. And you're allowed to change your mind. You're allowed to do things differently. You're allowed to think about this differently. It doesn't have to be totally binary. It doesn't have to be any way that you don't want it to be. And we also talk a lot about safety, like who is it safe to be out to and who is it not safe to be out to. Um, I think that's the other thing sometimes with therapists we need to be cautious of, you know, of course, we want kids to be honest with their parents, but if it's not safe for them to do that or they're not ready to do that, we shouldn't be pushing that either. Um, and so, we need to recognize, like, where is this safe for them to be themselves and to be out, and where is that maybe not really ready yet? Or are they not really ready yet? You know, you wanna be able to be confident and kind of own yourself and who you are, and if you're not at that point yet, if you're still figuring it out, it's okay. And it's okay to keep that, you know, more to yourself. It's totally up to you and where you're at. Um, and so, with teenagers especially, we talk a lot about that. Um, you know, where are you at today? Who's a safe person in your life that you can talk to? Um, you know, and who are people that maybe aren't, and you have to be a little more careful? You know, which isn't okay, but it is what it is. Um, cause ultimately, we want everybody to be safe.
Jennifer Agee: Mm-hmm. What is that like for you to navigate that relationship with parents? Let's say a kiddo has come out to you and said, this is what I think's going on, I, I think I was maybe born in the wrong body, and you start having that conversation, and they say, don't tell my parent. Like, how, how does, how does that work out? Where do you draw the line? How long does that go on? Because I can see both perspectives. You know, as a parent, if you knew your kid was really hurting and not knowing what was going on, that would be a really painful place to be. And as a therapist, I also understand having to hold confidentiality. So, tell me a little bit of how you've learned to navigate that dusty water. Yeah.
Becca Gerlach: Yeah. Um, so, I talk with the client about, okay, at what point do we want to bring mom and dad into this? Um, you know, what do you need for me, what do you need for yourself to be able to do that? Because eventually, we do wanna be able to bring them in. And most, most of the time, you know, kids will make that decision, um, you know, and bring them in. And there's plenty of times where that's happening, you know, in my therapy room. Um, you know, sometimes with the client and sometimes without. That same client that found me, um, Online, um, after the negative experience with the other therapist, he was like, you have to talk to my dad without me, because my dad, like, stresses me out. I can't, I can't do it.
Jennifer Agee: Mm-hmm.
Becca Gerlach: I was like, ok, that's okay. You know, and, and so I told him, I said, this is what I'm gonna say. This is, you know, making sure that he knew, like, what I was gonna be talking about and what I was gonna say so that he felt comfortable. And he was like, that's, that's on you. You gotta, you gotta do that. And I was like, okay, I can do that. But we also have to be able to talk to dad together at some point too.
Jennifer Agee: Yeah.
Becca Gerlach: Um, because this is your relationship with him, and, you know, you're not gonna be with me forever. You, you're gonna have dad for long, lot longer. And so, let's, let's work on that relationship. But he was so worried how dad was gonna respond, um, that he didn't even want to be in the room for that initial part. Um, and so, I'm okay doing that. That's not the ideal, by any means, but, but it is okay. Um, and there's other times, you know, I have a, a session that's coming up where kiddo's gonna bring parents in and, and she's 20, um, but is worried about what if I, what if they don't get it? Um, and so, you know, you're gonna be here and you're gonna support, right? Yeah, absolutely. Like, that's completely fine. You're gonna say the things. And so, we've been working the last couple sessions, like roleplaying, how that's gonna go. Um, but yeah, I mean, absolutely, we want parents included and we want them involved, but it does need to be kind of at the kid's pace.
Jennifer Agee: Mm-hmm. Um, yeah. I, yeah. And that's true really with any issue, insert issue here with kids, a lot of times, especially if they're unsure if the parent is going to judge them or look, look at them in a different way.
Becca Gerlach: Yeah.
Jennifer Agee: That emotional vulnerability of knowing I could look in their eyes and see them disappointed in me or see rejection. That is too much for a lot of people to handle and they– You know, I've had people ask me to be in the room or to be the one that starts the conversation on a lot of different topics over the years for that.
Becca Gerlach: Yes. Yeah. Yeah. Yeah. And one of the things I say to parents too, you know, like you're, you're deciding what your relationship with your kid looks like when they're an adult, you know? So, your reaction matters, and you're gonna have your own feelings about this. I mean, that's totally allowed, and that's okay because there is a grief process that happens a lot of the time because you imagined your kid one way and, and they're not.
Jennifer Agee: Mm-hmm.
Becca Gerlach: But I think that's true in parenting a lot of the time. Like, we imagine our kids in one way, and that's not how they are. Um, you know, they're their own people. Um, and it's, it's often not our fantasy. And I think sometimes parents have an easier time with that, and sometimes parents have a harder time with the, you know, fantasy of what, what it was supposed to be like, um, and, and working through that and letting that go. Um, but it is a whole process, and I'll say that to clients too, that like your, your parent is allowed to have their feelings about this.
Jennifer Agee: Mm-hmm.
Becca Gerlach: You know, you've been thinking about this for, you know, however long. They're just learning about it. So, like, you are, you know, 10 steps ahead of them in a lot of ways. And so, we do have to give them some time to catch up. Um, and so, we do talk a lot about that too, that like, let's give our parents some time to catch up because they're just getting clued into something, you know, you've been talking about for, you know, maybe a couple years.
Jennifer Agee: Yeah, 'cause, ultimately, if there's a way to preserve the family, the family support around this individual, that's best. So–
Becca Gerlach: Yes.
Jennifer Agee: Yeah. Preparing them in advance so that if you don't receive the feedback that you wish you would, right, it's not a TikTok video, right? This is your, this is your unique mom and dad or your–
Becca Gerlach: Yes, yes.
Jennifer Agee: Caregiver or whatever. Um, and you want to have a, likely, a relationship with them for a lifetime and so, if we can give some grace and, and have some understanding, that would be, that would be nice. Yeah.
Becca Gerlach: Yep. Yep. And we also talk about too, like, you know, once parents are more, you know, with them in it, you know, letting parents help with extended family because sometimes then it's worry about grandparents, or worry about aunts and uncles, or worry about, you know, somebody else. And it's like, okay, well, that's where parents have a role. You know, like, parents need to help with that part, and that's their job. Um, and so, we have a lot of conversations about that as well, that this isn't all on you. You know, we learned your parents are supportive, we learned they're good, like everything is okay, like we're working through these things. And now, you know, that's for them to help you with. This isn't all on you as, you know, 16-year-old you. Um, they're there for you. Yeah.
Jennifer Agee: The biggest pushback I have seen is more people concerned about what grandparents will think.
Becca Gerlach: Yes. Yep. Yeah.
Jennifer Agee: On that too.
Becca Gerlach: There is– Yes. There is always that concern. I'm working with a kid right now who has a, such a beautiful relationship with his grandma, um, and is so, so worried. But then the more he's told me about grandma, I'm like, I don't think, I think grandma probably knows, right? You know, the more he's said, and the more he's talked, I'm like, I think this grandma probably is like really with it. Um, but there's just so much worry that, because this is such an important relationship, this is such a beautiful relationship, like what if it changes?
Jennifer Agee: Mm-hmm.
Becca Gerlach: And I say, you know, grandparents love you. They may not understand. You know, they may need more education than your parents do. They may not really get it, but they don't have the same stakes as your parents either. And so, sometimes it is a little bit easier with grandparents than, than kids think, um, not always, but sometimes. They just don't know.
Jennifer Agee: You know, um, I have never walked with a client through transition. So, I've had clients explore their feelings around it and, you know, all that kind of stuff. But there hits a point where I don't have resources, expertise, and, and I, in Kansas City, there are amazing groups and organizations and practices that do. And so, if they are really hitting that level, I know that I don't have what I need to be able to provide. I don't know how to navigate it. Um, so, what is that process like? And what do you see, what do you notice, what do you wish clinicians would know or understand about what it's like to actually walk through someone through transition?
Becca Gerlach: Um, that it's a long process. Um, and helping clients, kind of, know that it, it can be a long process. Um, again, if clients want to utilize their insurance for services, they typically need to be on hormones for a year, um, before surgery can even be on the table. Um, there's some change with that, like that's getting a little bit better. Um, but for, but for some, that's still going to be kind of the standard, standard, you know, practice. Um, it does, sort of, you know, make some decisions for the client. You know, because maybe, again, like, we're making very binary decisions in that. Like, that you have to be on hormones to do X, Y, or Z. Um, and again, there's some change with that. That's, that's shifting a little bit, um, but not entirely. Um, so, it's, it's doing that process for a year, then referring and getting, you know, consult with, with a surgeon if that's something that they wanna do. Um, for clients who are transitioning male to female, um, to start hormones, they, the, the doctor will make them consider sperm banking, um, because it will impact their fertility, whereas female to male, um, it's not necessarily going to impact fertility as much. And so, that's something, you know, that, that people have to make a decision about, um, usually right up front. And so, that's something we talk about in therapy as well. Um, you know, and, and the hard part about that is, like, that's not always accessible for people. There's, there's cost involved in that. Um, and so, sometimes, you know, it's, well, maybe I would want to, but I don't know that I can. Um, and, and this ultimately is more important, so that, that kind of, you know, gets in the way. And I haven't found great resources for that. That's definitely on my list of like, okay, where can people do this for not crazy amounts of money?
Jennifer Agee: Mm-hmm.
Becca Gerlach: Um, and so, that's, that's on my list to continue looking for. Um, but, you know, and it's also walking clients through, they're essentially gonna go through a second puberty, you know, starting hormones, um, with testosterone much faster than with estrogen and the androgen blockers. Um, but it is, it is gonna happen. Um, and we gotta kind of ride the waves of that. Um, and it does change, you know, kind of, mentally, emotionally, as well as physically. You know, there are changes that occur. Um, and so, helping clients, kind of, understand and, and anticipate those changes as best that we can. Um, you know, for most clients those are positive things because it's affirming and it, you know, it's, it's in the right direction. Um, but there's still some ups and downs in that because it's like, you know, I've had clients say, well, you know, I used to be able to cry, and now I can't. Like, and I know it's this like hormone thing in the way. Like, and I, and I know that I need to, but like I just can't. And, you know, and then for other clients, it's like I just feel so much more emotional, or I feel so much more sensitive, and like, that's not how it was before, and this is so weird. Um, and so, it's helping navigate that process as well. Um, and then getting to surgery, you know, let's say we're having, you know, top surgery or facial feminization surgery, um, you know, helping, you know, do we have good supports for recovery? Do we have everybody we need lined up, um, you know, to be able to help after, because you're gonna be outta commission for a minute? Um, and so, just making sure people have the support that they need and the ability to be off work and or out of school or, you know, whatever the, the case may be.
Jennifer Agee: Mm-hmm.
Becca Gerlach: Yeah.
Jennifer Agee: I can't begin to imagine if you have never experienced female hormones before, and sometimes the woo, you know, the hot mess expressed all of that can be, um, to ha-, to start to feel that surging through your body when it is such literally a foreign concept. Even when you explain it to men now, they're just like, huh? Like, they cannot conceptualize how much differently you think and you feel in your body and the way you see the world and interact with the world. I bet that's a fascinating journey to walk with people on.
Becca Gerlach: It, it absolutely is. And it's also an interesting shift that, you know, if you were previously moving through the world as male and now moving through the world as female, that's a big shift too. There's different, you know, interactions are different. People interact with you differently. You know, there's, there's different things that happen. Um, and so, it is, it is really interesting, you know, to kind of help navigate that and say, you know, but also normalize, too, that like, yep, that is, yep, sucks. That's, you know, um, and I think, you know, that's helpful. But also, you know, one of the things too, talking with clients about you know, none of us live, like, entirely in, like, feminine or masculine, you know?
Jennifer Agee: Mm-hmm.
Becca Gerlach: Like, we all kind of live a little more, you know, skewed one way or the other, kind of somewhere in the middle. And so, initially, like you might feel like you need to really swing one way or the other to kind of affirm and, you know, be, be solid in your identity. But as you kind of shift back a little, like, that's okay.
Jennifer Agee: Mm-hmm.
Becca Gerlach: You know, that's normal and that's okay. 'Cause it is sort of the second adolescence happening of like new identity, new development, exploration. Um, and so, all that's normal. So, really being able to normalize that and, you know, validate that experience, because it is, you're, you're finding yourself again and, you know, maybe you did that already when you were 16, 17, 18, but now you're doing it at 28. Um, you know, still that experience.
Jennifer Agee: Mm-hmm. Yeah. Just figure, you know, that it's a, it's a, a whole 'nother level of identity work, right, it's finding out what fits, fits for me in this new way I operate in the world.
Becca Gerlach: Yeah. Yeah. Which is enjoyable in the therapy work. I mean, I, you know, it's, it's exciting and challenging and, you know, it's, it's fun to, to help people, you know, navigate that. Um, and sometimes it's incredibly hard and sad. You know, like when insurance companies deny things or when, you know, family members aren't supportive. Like, there's also that, that piece too. But on the flip side, like, there's so much, you know, happiness and, and joy that, you know, it's, it's totally worth it.
Jennifer Agee: Mm-hmm. Okay, so is there, if let, like, let's say newer clinicians are listening to this, is there terminology that people need to start to familiarize themselves with or things like that? What, what do you recommend? Where's a good place to start?
Becca Gerlach: Um, I think knowing the difference at, at a very ba-, this is very basic level, you know, sex, biological, gender, you know, identity, social construct, right? Like, we need to know the difference between those two. We need to kind of understand gender expression, you know, um, and somebody who's maybe just kind of, you know, maybe trying some things out versus somebody who is identifying as transgender. You know, those are two different things. Um, you know, somebody who's gender-nonconforming or non-binary, um, you know, who doesn't have a gender identity or says, you know, I'm not quite male, I'm not quite female, I'm somewhere in the middle, um, you know, and use they-them pronouns, it's really important, you know, for us to be using the pronouns that our clients are using, to use the language that they're using, you know, to be affirming in that way. Like, that, that part's really important, um, and that's what we need to know. Um, we need to know, you know, that, you know, gender affirmation can mean a lot of different things. It can mean using, you know, thing, it can mean, you know, medical stuff like hormone replacement therapy and surgery, but it can also just mean getting a new haircut and using new pronouns and getting a new outfit. Like, it doesn't have, it's all the things, right?
Jennifer Agee: Mm-hmm.
Becca Gerlach: We do need to know what the resources in our communities are. You know, and we need to know where, you know, affirming providers are, um, you know, and, and work together to find those. Um, in some areas they're more accessible than others, um, and that's, that's important. Um, we need to know, you know, puberty blockers are different than, you know, hormone replacement therapy. That's kind of a precursor. Um, you know, just stopping puberty, and so kids, you know, have to be young enough to be able to use those. Um, you know, whereas testosterone is going to be for someone that wants to transition to a more masculine presentation, and then estrogen and anti-androgens, um, are gonna be for somebody who wants to transition more feminine. So, those are the words that our clients might be saying to us, but often they're gonna say HRT, which is hormone replacement therapy. They'll say top surgery, they'll say bottom surgery. Um, you know, they're not using necessarily the really super medically terms, which, you know, we don't need to either. It's okay.
Jennifer Agee: Yeah. Yeah. But just even knowing what are the ba-, what are the basics I need to be familiar with so that I'm educated enough to have this conversation and not feel like the client is having to educate me the entire time.
Becca Gerlach: Right. Absolutely. Yeah.
Jennifer Agee: Mm-hmm.
Becca Gerlach: Yeah, and those, those are definitely the, the main, the main things. But it's really, it's, you know, it's using the client's language. You know, how do they identify? How do they want to be identified? You know, what name do they want to be using? You know, and if their parents know, you know, if it's kid underage or an adult, you know, putting that in the chart as their preferred name, not using their, you know, just making sure legal name is where a legal name needs to be if it's not changed yet, um, and otherwise using their preferred name. Um, and, you know, just making sure we're listening. Um, yeah.
Jennifer Agee: Yeah. Still just use your basic counseling skills.
Becca Gerlach: Yeah.
Jennifer Agee: Be a good listener, care for your client, you know, um, let them lead where, where needs to be gone, and, and support them in where they are, meet them where they are. Yeah. Well, thank you so much for coming on and, and talking about this. And if people wanna get in touch with you, what's the best way to do that?
Becca Gerlach: Um, probably through email. Um, so, it's Becca, becca@beinghuman.group. Um, or you can check out our website at www.beinghumangroup.com. Um, and I'd be happy to talk with you. Um, I do lots of consultation, um, and all that kind of stuff, so happy to talk with people. Yeah. Thank you so much, Jen. I really appreciate it.
Jennifer Agee: Yeah, thanks for being on. If you'd like to connect more with me, the podcast or upcoming retreats and trainings, counselingcommunity.com. And I hope you all get out there and live your best dang life. Have a good day.