The Right Size Shoes: A Conversation on Gender and Healing

Gender affirming therapist Dillon Mathew-Gilmore, LMSW (they/them) joins The Lavender Lounge to talk about what it really means to heal through community. Dillon shares their journey into gender affirming care, the systemic barriers facing gender expansive people, and why curiosity is the foundation of meaningful support. We get into the relationship between transphobia and misogyny, and how small moments of connection can create real change. This is a personal and hopeful conversation you don't want to miss.

Affirming You Therapy

Come as You Are

Spectrum Medical Care Centre
Maricopa County Community Resources
LGBTQ+ Healthcare Directory
Vitalyst Health Foundation

Mental health resources:

Crisis & Suicide Prevention

• 988 Suicide & Crisis Lifeline — Call or text 988, available 24/7. LGBTQ+ individuals can still call 988 and receive caring, confidential support, though the specialized "Press 3" option is no longer available. EveryMind
• The Trevor Project (LGBTQ+ youth ages 24 and under) — TrevorLifeline: 1-866-488-7386 (24/7) | TrevorText: Text START to 678-678 (24/7) | TrevorChat available at thetrevorproject.org/get-help AFSP
• Trans Lifeline (by and for trans people) — 1-877-565-8860 (US), available 24/7 AFSP
• Crisis Text Line — Text HOME to 741741, available 24/7 Human Rights Campaign
• RAINN National Sexual Assault ...

Transcript

SPEAKER_01 0:03

When people feel seen, safe, supported, connected to their community, they go on to do incredible things. Right. So I think remembering in the moment-to-moment interactions with one another, that's the greatest potential for change.

SPEAKER_00 0:18

Hello and welcome to the Lavender Lounge, your podcast about LGBTQ health and wellness. I'm Anna, and today we will be talking with Dylan Matthew Gilmore, a therapist with Affirming You Therapy. Before we get started, I do want to let you know this episode contains open discussions about trauma. Please prioritize your mental health first. And if you or someone you know needs support, we've linked mental health resources to the topics we cover today. And a reminder that this podcast is for informational and educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with any questions about your health. Dylan, thank you so much for being with me today. Thank you for having me. How are you doing? I'm good. I'm excited. Yeah. My first podcast ever. So I would love to know about how you got into providing therapy. Do you mind sharing about your personal journey and the experiences that led you to choose this path?

SPEAKER_01 1:23

Yeah, absolutely. So as far as therapy goes, I actually did not choose this path. I very insistently did not want to be a therapist, ironically. But I have been on and off in behavioral health care since 2017. I have my bachelor's degree in psychology and my master's in social work. And that was a very intentional choice because with social work, you can operate at different levels. So you can do the individual side, which is therapy or things like that, case management. And then you can also work in different systems. So building programs or impacting change in government, those types of things. But gosh, how did I get into it? So I grew up in a really small town on the big island of Hawaii. And there are a lot of challenges in that community, just due to the colonization of the islands, the lasting impacts in poverty and mental health care and lack of access to resources. And I think people don't know that piece of Hawaii. So when I moved away, my goal was to go into a career where I could really help my community, whatever that meant. I did not know it would lead me to where I'm at now, for sure.

SPEAKER_00 2:29

Would you say it's correct to say your practice is rooted in the belief that we heal through community? Oh, absolutely. So, what does that mean to you? And how did you come to center this in your work?

SPEAKER_01 2:42

I think I could do a whole dissertation on that. But um I know it's a very broad question. Yeah, no, it's good. I mean, I think we all inherently have that drive for connection and community. I think that's what motivates us as human beings, right? And we want to be seen and valued as a member of our collective. And I was reflecting on this as we prepared for the podcast and like how I ended up here. And I think time and time again, especially with LGBT healthcare, I ran into situations where people would come to me and say, Hey, I need help accessing this thing. Like you're someone in the community I trust. Like well before I got into healthcare, behavioral health, I'd say, Hey, I have a kiddo who is exploring their gender identity and I want to support them and they're asking me about hormones and I don't know what to do. Like, can you help me? And time and again I'd say, you know, I don't know, but I should. I don't know. But let's get curious. Let's find out what does this mean? So even if I had my own internal biases or things that came up for me in that process, my first choice there, at least I try to, is to just be curious. Let's get curious about this. How do I support you as a community member? Even if I have no understanding of what that looks like, that is my ultimate role and for me as a community member. So I think offering that space of whoever you are, wherever you're at in your journey, I can create that space for you to feel seen and figure out what's going on for you and know that it's not permanent. Like where you are today is not going to be where you are tomorrow. So let's throw things against the wall and see what sticks for you.

SPEAKER_00 4:13

I love that. What are some other ways that you invite your clients and the people around you to stay curious? Do you have any concrete examples?

SPEAKER_01 4:25

I think I come back a lot to what does work, right? When people are like, I'm so frustrated with this person or this situation or my job or this disconnection in my life. What is working is what I try to help people see because there's often that multifaceted piece of it, like you said, the dark and the light, or some balance therein. So what are you noticing that does work for you, or or what's the hope here? So when people come to me and they're saying something doesn't feel right, I have this disconnect. My job is to figure out, okay, what is the goal? Like what does feel good for you, and how do we get there?

SPEAKER_00 5:01

And what type of community do you primarily work with in your practice?

SPEAKER_01 5:06

Currently I'm a therapist at Affirming You Therapy, and we specialize in gender-affirming, neurodivergent affirming, trauma-informed care. And of course, the things that I share today are not representative of my practices beliefs. They're just my personal and professional opinions as a social worker and therapist. But we specialize in those intersections for a lot of different reasons, but I specialize in gender-affirming care specifically. So trans folks, gender expansive folks, anybody in the LGBTQ plus community, people who are exploring their relationship styles as far as polyamory, multi-amory, and anyone going through like a big life transition, I think is kind of my specialty, whatever that looks like. It just happens to be that my passion is gender-affirming care. And it shouldn't be such a specialized thing, but it is so hard for people to find someone who's knowledgeable. Because it's not enough to just be like, well, yeah, whatever you're doing is fine. You have to have a little bit of knowledge to really support someone. Has to be an area, I think, where you've been curious. Even if you're not an expert, you're like, you've done the work to educate yourself about where someone might be coming from.

SPEAKER_00 6:13

What is some of the specific knowledge that you bring to your practice that you feel like benefits the community that you work with?

SPEAKER_01 6:21

I have had the privilege to work in gender-affirming care specifically for the past few years. Again, really unexpectedly for me. I had a friend of mine in 2020 come to me and say, Hey, my kiddos exploring their gender. What do I do? Like, how do I support them? And I said, you know, I don't know, but I should. And that inspired me to go back to grad school and to re-engage with the behavioral health field. And I was a case manager for SMI community. So seriously mentally ill is a designation here. And I worked with that community for a while and I knew just a little bit about how to be affirming. And I was suddenly handed like 200 gender expansive clients and put in charge of all these trainings. And I didn't know the first thing about gender affirming healthcare, like on a medical sense. And that sent me on my journey. And I had the privilege and the opportunity to be a gender-affirming navigator for a while through Prisma community care previously, Southwest Center. And then I was a case manager specializing in that and now a therapist throughout my program. So having that opportunity to meet with so many gender-expansive folks and from so many different backgrounds and perspectives in the community, I think has been really just such an honor, honestly. They've taught me so much. I learn more from my clients than I do from any educational program I've engaged in.

SPEAKER_00 7:43

Do you have any stories that you like to share about some ones that really impacted you?

SPEAKER_01 7:48

I mean, I've had tons of clients who have really impacted me in their perspective. And just I tend to stay away from the word bravery just because I think that gets thrown around a lot. But it is a really brave and courageous thing to be who you are, to be who you are in a way that just is celebratory and exploratory because I think for all of us, the world can be a really stifling place. I think if we all take a moment to think of some aspect of ourselves that feels like shameful to share, right? So for a lot of adults is play. Like we have a really hard time being playful, being silly, or it could be dressing the way you want, like wearing something sparkly or whatever. Adults have a hard time doing that. So if there's something you can think about where like sharing that feels really vulnerable and scary, trans folks, gender-expensive folks, members of the community, the LGBT community, like we do this, we have to explore who we are. We have to explore our identity and deep dive into things in a way that most folks don't. And I think it's the most beautiful thing. And so we get to come to terms with these parts that we are scared to share. And in the face of a world and a society and a time in our culture where it's so controversial to just be a human and be curious about yourself. So it's a not a direct answer to that. But anytime I see someone come into their own and they're just audacious and they're just like, this is me, and you're gonna deal with it or not, like it that's okay. People who aren't afraid to take up space, I think is my goal is helping people get there, whatever that looks like for them.

SPEAKER_00 9:17

That sounds really inspiring. I'm inspired, honestly, just listening to that. I can hear so much passion in your voice to help people take up space and be who they are because that's so hard, especially in this world that tries to put people in really specific boxes and labels. What kind of challenges have you observed with navigating these kind of issues with your clients?

SPEAKER_01 9:42

Gosh, on which level? I mean, there's the systemic challenges, obviously, is the biggest one, and I think we'll get into that. And there's the personal challenges because we want that connection with people. So I think that's the thing people forget. Like when you have a family member come out to you, what I see often for anyone who's trying to work on being an ally or learning about these things is when we come into these conversations, there's something we'll talk about in therapy called a bid for connection. So in a relationship that can be, hey, would you mind putting down your phone when we're at dinner together? Right? That's a bid for connection. So if that's ignored, it feels like rejection and it creates distance and potentially conflict and such. So to me, when someone shares something so deep and personal about themselves, that's a bid for connection. You're saying, hey, I'm gonna share something that's a little scary for me because I trust you. And I think people forget that. So when you, when someone is sharing something about themselves where I think a lot of times the expectation is to be rejected, right? People often respond immediately with their perspectives and their experiences around it. So if someone's kid comes out or or adult, like their friend, even says, hey, actually, these are my pronouns, or I'm kind of exploring transition for me. The first response I see from a lot of people who aren't familiar with gender-affirming care and transition is they immediately want to talk about children and medical stuff. So children and hormones, children and surgery, et cetera. They'll talk about hormones in sports and they'll talk about their own experiences, primarily if they've had anyone be defensive with them, then immediately they're like, well, people just attack me, so I don't even want to try with pronouns. And that is also a bid for connection, right? This person is potentially scared, potentially embarrassed about their like lack of knowledge, lack of ability to support this person, right? Just complete discomfort. And I think as a culture where you're struggling with that right now, like it's okay to be uncomfortable. That's where the growth is. But you have two people seeking to connect and not knowing how on a very challenging topic, challenging on one side for someone in a way that's really deeply personal and intimate and related to their identity. And the other person, it can be whatever, it can be social, it can be cultural, it can be their own personal experiences with gender. I think we don't talk enough about the fact that we all have a relationship to gender and sexuality, whether or not you've had to talk about or think about it. I mean, how many people do you know that have said, like, well, I do this because I'm a man, that's what men do all the time. Right. So, like, we all have an experience with gender. It's not a trans thing. We all have gender experiences, whether that's at the forefront of our minds all the time. So I know that's a very tangential answer, but to come back to it, the biggest barrier I think is in that reaction, right? So if it's whoever you're interacting with, a client, a friend, a coworker, a stranger, if they're sharing something with you or if they're asking you to respect them in a certain way, trying to let the discomfort be there, trying to honor their perspective and get curious rather than immediately talking about your perspective or opinions or whatever, because it's personal for this person and they're trusting you and they're sharing that. And I think it's okay to make space the other way. I have a lot of hard conversations with a lot of people about their fears, especially if it's a parent, right? They have, and that's so valid, right? To have your fears and your concerns and this big change that someone you care about is going through. But that person maybe doesn't need to be the person you emotionally process with. Same with providers if you're running into something you don't understand or anyone in the community, right? I mean, I know people of all different gender identities and sexual orientations that will come across another sector of the community that they're unfamiliar with. And the first thing is like defensiveness, fear, othering, right? Just being like, what is the strange thing in front of me rather than curiosity?

SPEAKER_00 13:33

I think it's so interesting that you have this perspective that if someone's uncomfortable with pronouns and vocalizes that, that that's also a bid for connection. I haven't heard that before. It's hard to say, I will say. Yeah. How did you come to that perspective?

SPEAKER_01 13:52

Honestly, I have a lot of close people in my life who really struggle with these things. And I have a lot of friends or clients who just won't interact with folks who are struggling with that. And I think that's totally fair and valid. Like you have to know what your capacity is. And when you are just trying to survive and when you're being treated differently on a day-to-day basis, it's really hard to ongoing have these conversations. I just think like, I don't know, if you're teased all the time for something, right? If someone's like, oh my gosh, haha, you're short, or like your name's funny, or whatever, and you're teased about it all the time, then the next person who comes up to you and is like, well, haha, I think your name's funny, or you're really short. Like they don't know all the experiences you've had about it. So you might be snappy, you might be defensive. And I don't think it's necessarily that person's job to educate you on their whole history of the way that they've been impacted and struggle on a day-to-day basis. So I think there is a lot of pressure for trans and non-binary folks to educate people on pronouns and this and that. And I don't think that's fair. I think you're putting the emotional labor back on people who have had to do that emotional labor for themselves already. And they do it for their providers and they do it for their family members. Like it's so draining. But I have the opportunity as a member of the community to have these hard conversations. I don't face the same barriers in some ways. And so if I want to keep these people in my life and I have the personal emotional capacity to have these conversations, I had to humanize them and empathize with them. And when someone immediately comes to me with defensiveness, as a therapist and just as a human, I try to hear them out first. Because then when those walls drop, they can hear me. And that's super challenging to do. I will be so honest there are days. I cannot have those conversations because if I'm saying, hey, this is important to me, and the first response is, well, what about me? You know. But if both people are doing that, you don't get anywhere. So just trying to create space for that because I think that's how we make change. And I have the capacity for that. I don't expect all my clients to do that or every genderqueer person I know to do that because that's exhausting. But if I can do it with this one conversation with this one friend, I will. And that is when you see the change, right? It's like the first person I knew who came out to me, my best friend growing up, came out to me at like age nine as a lesbian, and then later in high school as trans. And both times I was like, I don't know what that means, but I should know. And I all I know is I want to support my friend. So what does that look like? So I had no idea what I was doing with pronouns, but I switched as hard as it was, right? Like I switched because other people in his life weren't supportive in that way. And all that mattered to me was like, I need you to know you're not alone. And I think if people would remember that, like it's it's really not about what a person chooses to do for their transition, but isolating them immediately when they're trying to share something vulnerable with you is what creates all these disparities. It what's, in my perspective, it it exacerbates, if not creates, a lot of the mental health struggles that people face, right? We just want to know we're not alone. That's so beautiful. Really, really beautifully said. Thanks for following my tangents. It all comes together. I'm a big storyteller.

SPEAKER_00 17:05

How do you identify when you have the emotional capacity to engage in this connection or when you should take time to self-care or something like that?

SPEAKER_01 17:18

That's a good question. And it's a big one I'm sitting with lately. I think I just am always in the practice of getting to know myself better. So it's figuring out what does work, right? Like I said earlier. So I know that I have the capacity to have these conversations professionally. So I'll make time for the client work that I do or to sit on a panel or to be on a podcast and to share in that way. I'm also a drag artist, and I think that is a really lovely space to show up. But I know that I'm not at a point right now where I want to speak out politically, maybe, right, in a political setting. Like just learning myself and knowing that this is important for me, right? This is a value or this is something I want to change in the world, right? I love this perspective of when you think of the future and the future world you want to live in, and then you think of how you want to be a part of creating that, right? We can't do it all. We can't do everything. We can't be involved in every aspect of things. And I think if we care about any of these issues, we, especially queer folks, I think we take on a lot of responsibility of trying to do the right thing in every moment and we put all of this pressure on ourselves. So I guess I try to give myself a break and know that I can come back to things I care about in the future. I can always shift what that looks like. So right now it's gender-affirming care. And if in 10 years it's climate change stuff, making the space for that. And I know it sounds so cheesy, but like first and foremost, pouring into yourself. I don't think I knew until very recently why that's so key. But making sure that I, for me, dance every week and I spend time with my friends and I do the things that fill me up because if you're not meeting your own needs, then you have nothing else to give. I don't like the empty cup thing, right? You can't pour from an empty cup. I'm not a big fan of that metaphor. But why it just we're not a vessel to pour from endlessly. And I think it's hard to conceptualize. And I think it's unrealistic for a lot of folks. Like as a therapist, there are days where I don't have a lot to offer, but it's still my job. If you're a parent, you may be perpetually at an empty cup and you still have to give because that's what you signed up for in that way. You don't have to, but a lot of people do. So I just don't know that I love that metaphor. It doesn't make sense for me, but I love this idea that I'm creating a garden. I want to be able to help feed my community, right? So I have to water and tend to the garden. And even in the sharing of whatever I create, I can't give away all the food or I won't be there to continue tending to the garden. So I need to make sure I'm eating so I have the energy to go and weed the garden or whatever. I love the garden metaphor way more than the cup metaphor. So I I agree with you there.

SPEAKER_00 19:58

Yeah. Do you like the cup metaphor in general? Well, now that you've brought up the garden metaphor, I would much rather use that because that sounds more aesthetic too. Yeah, yeah. It's cute.

SPEAKER_01 20:08

I I'm have not a green thumb at all. I can't grow anything. Metaphorically, just metaphorically. Yeah.

SPEAKER_00 20:20

I've loved hearing your personal experience, but I'd love to transition now to talk more about these systemic external systems that transgender health and mental health finds itself in. What are some of the biggest systemic issues that you've observed currently impacting transgender health?

SPEAKER_01 20:40

Well, I can speak a little bit to both mental health and medical, because I've worked in both realms, but there are a lot of barriers right now. I think obviously politically, the fear that it's causing and the uncertainty, the changes in funding. So I think that's a big one. And I'll come back to that. But at the basis, a lot of this I think is rooted in bigger systemic issues as far as racism and misogyny, and obviously transphobia and homophobia and just fear, right? It comes down to fear. But the way that those things show up are so integrated into healthcare and behavioral health because even mental health, even the DSM V is inherently rooted in colonization and pathologizing folks, right? Like mental health and disquote disorders. A lot of it comes from trying to control women, people of color, and the LGBTQ community. And I can link references to folks who speak more in depth about that. I'm I'm still learning about this, but there's inherently like privilege and power as a therapist, as a clinician, as a provider that we hold. And so the barriers are integrated into the system. Like we say it's healthcare and and we're trying to help people, but there's so much historical trauma and oppression. Rooted in the systems. So I think that's the biggest barrier that keeps people from accessing care and having continuous care. Yeah. So lots of things there wherever you want to start.

SPEAKER_00 22:10

So many things. I'm interested in the relationship between transphobia and misogyny. Yeah. Can you tell me about that?

SPEAKER_01 22:21

Or what are your thoughts on that relationship? Yeah. I mean, again, I think a lot of it is also based in racism. I think that's where a lot of these challenges are. There's so many things that we can be taught in this field that further the biases of like of things of like women in hysteria and just like the different stereotypes that are embedded in this. And so a lot of the studies that are done, right? So all of the interventions, not all of a majority of the popular interventions for therapy, for psychology is based in white men stuff and the studies that have been done. So if you look at research, what communities are being researched, how are these things being applied? If you look at the quote unquote evidence, who's included in that? What were the ethics behind it? I think that's a big piece of it because if you look at hormones for people assigned female at birth, cisgender women, right? People who still identify as female and were assigned female at birth, if you access hormones, whether that is birth control, whether that is due to a hormonal imbalance, whether that is for menopause, there's not a lot of research done on this and like the long-term impacts on your body. People want to be up in arms about trans folks accessing care and they compare it to other forms of hormone care, including like sports and testosterone and all this stuff. Gender-affirming care, especially around hormones, it just exists. It wasn't even specific for trans folks. It exists for anybody who is experiencing a hormonal imbalance and it's understudied and really difficult for cis women to access and get an understanding of the difference between bioidentical hormones versus synthetic and what like the education is around when you get your blood work done, right? In your typical cycle before you start hormones, things like that. Like just people don't know enough. And I would say providers as well. A lot of providers receive very limited education, to my understanding, around sex education, hormones, different things like that. So you have to see all these specialists. And even if you see an endocrinologist, right, like they may not know everything about trans-related care. So it's just a very nuanced system. And I think it's not integrated enough into what we're taught, right? You have to seek out LGBTQ specific training modules as a therapist, right? You're not, it's not just integrated. It's getting there, at least for social work, it's getting there. I think for a lot of folks it is. But if our goal as providers and clinicians is just to be able to help anyone who comes to us, right? We're our goal is to do no harm and to help anyone who comes to our door. So I'm not particularly religious, but if I have someone who comes in of a very specific religion, I'm gonna do my research for that, right? Again, it comes back to this. Ooh, I don't know, but I should. That is my responsibility as a therapist, as a clinician, as a social worker. If I don't know, let me go find out. Let me do the work. That's what to me, culturally competent care means. Yeah. Right. And clients not going to come in and say, well, I haven't been able to access this because of misogyny in my life. They might, but it's our job to know what those barriers are and to meet people where they're at.

SPEAKER_00 25:29

Yeah. So that everyone can hopefully get to a place where we understand or make space for understanding each other. You use this term gender expansiveness. Can you just break down what does gender expansiveness mean to you? And how do you feel like it fits in this framework of misogyny and yeah, transphobia?

SPEAKER_01 25:53

Yeah, that's a good question. A lot of the way that misogyny shows up in our current society is that we have our specific roles and they're so inherently tied to gender. When I'm talking to someone, it's it's really easy to get a sense of how much this is in ingrained in them. And so we're taught all of the shoulds, right? The things we're supposed to do. And so if you vary from that at all, there's this social repercussion. So if you watch anything from, I don't know, the 70s, 80s, 90s around lesbian culture and like butch folks. Or if you look at kink communities or poly communities, or just anything that's like on the outskirts of quote unquote normal, you'll see a lot of discussion around this, right? So I've seen a lot of videos and documentaries around butch women who were ousted even from the lesbian communities for wanting to be too much like a man. Seriously, I don't think we remember this. And it's that stuff still happens. And just even within our own community, shaming people for whoever they are. So if you vary from that at all, I mean, even just walking through one of the spaces we walked through today, getting kind of that double take because I'm wearing like a button up and all these fun colors and whatever. Like people just fantastic. Thank you. Yes, I'm wearing these purple pants and a white shirt with pink collars and got gold jewelry on. And I've got purple, I've got short purple hair. It's just fun, right? Clothing's just fun. But the different spaces we're in, I know if I walk through, and I know that certain places, if I show up for a job interview at a bank, the way that I look, I'm gonna get some questions. But thankfully, I have the opportunity to live in spaces where people don't bite an eye at that. They might question other things. So any any way that you vary from the norm and like men who want to wear skirts, like that's a huge thing. Um why is that such an issue? I know. Why is that such a problem? I I really wonder, I want to ask people like, why does it matter to you? Like, what harm is it causing you? And I I really want people to get curious around these things we're taught to believe. I highly recommend the documentary, Disclosure. It's really well done and it addresses a lot of the media stigma around transphobia and misogyny and gender roles. And specifically, it talks about that inherent fear that is in the media about men and gender variance, right? Like doing anything different is a huge deal. So I just think that it's all geared to keep us in the sameness. And I will give like two little examples. When I'm talking to anyone about gender, I tell them to imagine a closet, right? Filled with all the clothes, all of the possible options. And if you were taught that you had to wear something specific every day, right? So if you are a cis woman, very comfortable in your femininity, but you were forced every day to wear this like scratchy suit that made you feel uncomfortable. And then someone offered you this closet that has all of these options and you could just go play, like think back to your child self and you just pick whatever. Kids don't know anything about all the societal nonsense, but they develop their gender from a really young age and their understanding of it. But if you just let yourself be that kid's self and go pick something, like who cares what you're wearing to the grocery store?

SPEAKER_00 29:09

Right? That's actually really helpful for me just thinking about that right now.

SPEAKER_01 29:13

So that's a really good example. I love metaphors and storytelling and conceptualizing for people.

SPEAKER_00 29:20

Yeah. What would you tell someone that hears that metaphor and says, well, you should just be uncomfortable because gender is just your sex? Yeah. How would you address that?

SPEAKER_01 29:33

Well, I would talk about the difference between sex and gender. And again, I'm not a medical provider of any sort, but if I do like gender 101 training, we'll talk about the difference between the two. So when people talk about gender, well, they think they're talking about gender, but they're talking about sex. So you have internal and external sex characteristics. So the way that we perceive other people's gender is often based on the secondary sex characteristics. So we're looking at hair length, body hair. Do they have an Adam's apple, jawline definition, muscle definition, and body fat distribution? That's where we get our perception of gender. People get really fixated on sex. So sex and what determines that, there's a couple of different things, right? But you have genitalia, which people are super fixated on, which I think is a little strange because I don't know you. Take me to dinner first before you're asking me the interesting questions. So if we think about sex, right, we're talking about sex assigned at birth, which is often based on your genitalia. The funny thing with that is like we all have the same parts, just organized differently. I'm quoting the book Come as You Are by Emily Nagoski with that. Love that book. So I think we are treated differently depending on our gender presentation, primarily. Gender can be a variety of things depending on the culture you're in, but it can be the way that you present yourself, right? So clothing, makeup, what you choose to do with your hair, and can be the roles that you choose to take on or forced into depending on your society, right? There are cultures that have three designated genders already. So we have these really specific beliefs about what it means to be a man and a woman. And we can talk about sex and sexual characteristics, so that again, genitalia chromosomes, which there are many different chromosomal makeups. And I think people forget that. So it's not just XX and XY. There's so much more to it than that. So if you want to base it off of just the quote-unquote science and like the biology behind it, we can do that, but there's gender variance there as well. It's not just man and woman. And then the, I think this is where it gets controversial because there are certain traits and behaviors and things that we see that come from right nature versus nurture, right? So what is inherent in us based on our biology? But even there's there are so many factors to that for your personal makeup. That's where we say gender is a social construct. It's everything else that comes with it. And so it's like when people say men are more logical and women are more emotional. Like, what does that mean? What does that even mean? Right. What are you even saying? Yeah. But also what purpose does that serve? Right. Because when I work with my cis male clients who are afraid to cry, what messages are we taking? What are we internalizing? Why is that so important? I want to ask folks, why is that important to you? What is your relationship to gender? Why does this threaten the foundation of your identity to see someone who presents differently?

SPEAKER_00 32:29

It sounds so artificial when you put it that way. It sounds like there's so many artificial societal expectations that don't align with how we actually feel. And I'm just like, how did we get here? I'm sure there's a whole bunch of history to that too. Have you had any personal experiences? Like how is this conflict artificial or not between gender and sex impacted you personally? Or has it in any way? So much there.

SPEAKER_01 32:57

Yeah. It's actually something I don't talk about often on a personal basis. Just because I do it professionally, I've kind of compartmentalized that. And I think that that's something I'll have to address eventually. So I think because most of the world through the binary lens is going to view me as a woman, right? The way that they see me is going to be based on their understanding of gender. And because I'm perceived that way, I am treated as such, right? So I experience what a lot of our community experiences would a lot of cis women or people who present that way experience. I think it's shown up a lot for me in my romantic relationships. I've had some very complex ones. So I use they, them pronouns. You know, I was in college when I started using those pronouns. I didn't know it was an option. And I didn't change anything about my appearance. I wasn't thinking about medical transition. I didn't know anything about any of that. I just, I felt like I had been wearing shoes that were too small for me my whole life. And someone gave me the right size shoes.

SPEAKER_00 34:00

Yeah.

SPEAKER_01 34:00

So I can't go into depth about why and where in my history and whatever. I just know it feels right for me. And so the people in my life who respect that like really mean a lot to me. And the ones who don't, it's a learning curve. And I respect their perspective as much as I can. But so when it comes to dating and romantic partnership, hopefully your partner respects you. And I've dated, I date women primarily. So I would, I would say identify as a lesbian. But I've dated a lot of cisgender women with their own perspectives on my gender and my gender presentation and what that means in our relationship. And last year I went on a first date with somebody, and I said, you know, I have a tendency to date cisgender women who don't respect my pronouns. And this person was also a cisgender woman. That's surprising. And I right. She said, Why? Why are you doing that? I said, I don't know. I didn't know that there were other options, which sounds so silly. Like I've been in this work for so long, and then personally I'm allowing people to be close to me and allowing their comfort levels to come above like who I am, I guess. It's probably one of the few regrets I have in my life, is not, well, maybe not regrets. It's something I'm learning because I wasn't as assertive or let me think how to say it. Yeah, I I just I've chosen to be with and around people who don't see that part of who I am. And just I allow space for their growth and having empathy in that. But the thing is, one of the people that I dated had a non-binary child as well. So when we'd have these challenging conversations and these conversations that, you know, inherently were isolating or othering or just weren't kind about it, weren't curious on both ends, and then that was viewed by this kiddo. I wish that had been different. I think about that often. And so I try to move about the world that way. So even with all the politics, and even with I have a lot of older friends who are lesbians and have their own experience with gender, again, because of the discrimination about different gender presentations in the lesbian community. So there's like a lot of dialogue there we could go into. But and I respect where they're coming from. And I respect that they don't get the pronouns thing. And I make space for that because I can. But with my intimate relationships, I've realized that I can't hold the space for that anymore. You know? So even today coming on the podcast and saying that is scary, which is wild. I've been out forever. But I don't have those conversations all the time because I'd rather do it in an advocacy sense, right? I'd rather do it here than say to someone I want to be close to, like, hey, this is important to me, because that comes with so much emotional labor on my part. So I'm learning to trust my people to be kind when they ask me things and to do their own work. I've had a lot of hard conversations around that recently. So I've seen it a lot in my relationships, and I've had a lot of really crappy responses that I just think when anyone is sharing something with you, but when your partner is sharing something with you, I don't understand why those responses happen. I had a partner when I was probably 18. I had the fortune to be in London for a study abroad program. And we were on a bus, and she was going to meet my friends for the first time. And I was nervous, and there were some cultural differences there. We're from different backgrounds. I'm also a dancer and I like Latin dance and I engage in different communities. So different spaces with very different beliefs around gender. So respecting some cultural differences. I try to be mindful of that. But again, this was my partner at the time. And we were on this bus and I said, hey, just so you know, these are the pronouns my friends are going to use. So I didn't even say it as I need you to do this or anything. Like I didn't even really bring myself into the conversation. I was like, just so you know, just as an aside. And she said some pretty terrible things about, I guess, just harm to trans people in the world. And I it was not great. But she inappropriately went to basically she said, Well, what do you have down there? was kind of her first response. And she touched me inappropriately on this bus in public as a partner, as someone I had been with for, you know, casually dating. I it didn't even feel like a big thing at the time. I mean, it felt terrible, but it was like, that's why I didn't tell her in the first place. I didn't know what the response was going to be. Well, that's a pretty bad response. Yeah, true. That's not honestly the worst, but I do think I've been very fortunate in this. And I think I think this is where the change can occur, and I hope it does, right? Like I've shared that story. I shared that story on a panel between different, I don't know, just if with different public officials and different things like that to normalize it. Because I think when people interact with me, because of the way that I present and my background and the way that I speak, right? I've I've learned through education to speak in a way that offers me a seat at the table. And that can be really frustrating. But because I can do that, because I can take up this space and people will listen to me, I try to have these conversations and normalize it because they wouldn't expect that from me. They look at me and they think immediately, oh, you're one of us. Actually, not quite. And they know that there's something like a little different, but I have the that opportunity. And it is very challenging to have discussions with lesbian women who have their own experience with gender and like I want to make space for that. And also, also, I'm here and I am a person in this conversation and I matter too. And so trying to teach that to my clients and then also apply that in my own life. But it does feel like handing someone this very fragile thing, and you're like, please don't drop it. Please, I'm barely certain about what this means for me. Please just be careful with this. That's so scary. Yeah. Honestly.

SPEAKER_00 39:38

That's a terrifying thing to do. And if you want connection, it's like you have to do that. I know.

SPEAKER_01 39:44

Yeah. So it's finding those people who are safe right now. I have people in my life who are lesbians or bisexual women or pansexual folks, or just anyone in the gender spectrum and sexuality spectrum that do support that. And it's not even a question, like, I'll share my pronouns or I'll share my perspective. And they're like, Yeah, of course. And people don't always want to see that. And that's their journey, right? So I would encourage, like, if you have people in your life that just refuse to do that, right? If you go to share this vulnerable piece and it's rejected, let that be okay. That does not a reflection on you. That's a reflection on their inability to show up. How do you deal with rejection?

SPEAKER_00 40:24

Well how do you how do you even start not super well, honestly?

SPEAKER_01 40:28

No, I'm just kidding. It's hard. I think it's hard for any of us. Even when I go to ask someone for a dance, right? And like not supposed to do that as an as someone assigned female at birth. I'm not supposed to approach people for a dance. But I don't want to sit out. I like this song. People won't always dance with me. I think partially because of the way that I dress or the way that I look. They're, you know, there's a lot of things. But if I go to ask someone for a dance and I'm denied, and if I'm denied twice, it hurts, right? Like rejection hurts if a client decides that we're not a good fit. It hurts, you know, even though I know it's not personal and I really want people to find whatever their best fit is. I still care. So there's a lot of DBT skills. Dialectic behavioral therapy has a lot of skills around things like riding the wave, like ride the wave of your emotions, just letting yourself feel, because it's okay to feel rejection, acknowledging what the good things are in that and what you need from that. And depending on how it came about, I try to take it as like a gift, honestly. Because if someone says, Yeah, yeah. Because if someone says, hey, I can't accept this, thank you for letting me know. Thank you for not having me like spend all this time and this energy, and I can let that go and then go be around people who do accept me, or just sit with myself until I find those people. That's so right. I'm like, take notes, take notes. I mean, I'm gonna cry in my car about it first for sure, because that still sucks. But you know, we think we want these things, but if it's something we're like, you can't be you, and again, please keep in mind this is coming from such a place of privilege with this, right? If I like when you talk about the workplace, if I am fired for being a member of the community because of where my background is, because of the opportunities I've had, I'm probably gonna find a job, right? Not true for everyone. So not everyone has the space to just be authentically themselves and to move through things differently. It affects people's housing, stability, all of this. So it's it's not accessible to everyone. But if it is, right, if you do have that privilege and opportunity to step away. And in your interpersonal relationships, especially, like letting go of folks who don't want to be there.

SPEAKER_00 42:29

That's so hard to do. It is.

SPEAKER_01 42:32

Yeah.

SPEAKER_00 42:37

So you mentioned the harm that can come from people not having access to this. What is something that you wish people understood about how harmful this lack of access can be?

SPEAKER_01 42:47

I have two thoughts on that. Primarily, I think the most impactful thing I've had a client tell me is that hormones have saved their life, that they were so distressed about not being able to be who they were, who they are, that they would rather not be here if they can't be themselves. So people talk about suicide in the community, suicidal ideation. And if you struggle with that, please contact your mental health professional, reach out to a crisis line, call 988 or the trans lifeline. But people talk about like the mental health disparities, but not the solutions and not the why. So I've had people come to me and say, I would rather live to be 65 and have my hormones than live to be 80 without them. This has saved my life. I would not have made it to next year. I would not have made it another decade without gender-affirming care. So who are we to stop that? Right? Like, if this is so needed for you, who am I to tell you otherwise? I have worked with people who have doubts about surgeries because of course you have doubts, but the incredible joy and the euphoria. We talk a lot about dysphoria, but not about the euphoria. So when I'm working with people who are exploring their gender, I think, okay, what makes you feel good in your body, in your mind, and your Everything. And not everyone feels uncomfortable in their body. I think that's a big misconception. Not everyone feels gender dysphoria in that way. And the definition of gender dysphoria these days has shifted. So it is distress over the fact that people don't view you the way you view yourself, right? Specifically around gender. So we get focused on the body stuff, which not everyone experiences. And then we don't talk about the euphoria. So what would make you feel good? What makes you feel good in your body? Like when you, I don't know about you, if I'm having a rough day, I will dress up super cute for work because it makes me feel better.

SPEAKER_00 44:33

Self-care, right?

SPEAKER_01 44:35

Yeah. It's all about self-care in like a sustainable long-term way, right? Self-care is not just a bubble bath. It's building a life where you feel healthy and sustained and like yourself, like your most authentic version of who you are. That's the goal for me as a clinician. Is my job is to help you figure out what the innermost feelings are, what you need. I have no agenda with it. People are going to pursue what they want. We don't have any control over that. I think people forget that.

SPEAKER_00 44:59

For parents with kids, like if you try to tell them no, it kind of goes either way.

SPEAKER_01 45:04

So yeah.

SPEAKER_00 45:05

But I'm also hearing the seriousness of what you're saying. Yeah. That gender-affirming care literally saves lives. It does. Like it is literally life-saving.

SPEAKER_01 45:15

And even just those safe conversations, even just having a safe provider to say, that's normal. It's normal to be confused, to be curious, to feel different than what you were told you should be. I feel personally, I feel very fortunate that I didn't have a strict upbringing in the way that some folks did. It came with its own challenges, but most of the clients I work with, there's some piece of them that just wants to follow the rules of like who they're told they should be. So whether that's your parents told you that you need to be a doctor or a lawyer, or society says you have to be whatever, this way or that way, you have to conform to things. They struggle with that. Doesn't matter their identity. When they come in my door, like people are like, Well, but I should be doing this. Why? Why should you? And I've had the freedom to do whatever. I used to wear the most ridiculous outfits to school because I did not care. I didn't have a lot of the shoulds. So I have that freedom of thinking, I think. And so many people are taught there are like there's a right and wrong way to do things about things that are so arbitrary.

SPEAKER_00 46:17

Yeah.

SPEAKER_01 46:18

You know, who why?

SPEAKER_00 46:20

Just why? Yeah.

SPEAKER_01 46:21

If it works for you, it works for you. And I think that's a big thing with working with neurodivergent folks too, is just like make it work for you.

SPEAKER_00 46:27

Yeah. That's so good.

SPEAKER_01 46:30

Yeah, it's it's very interesting. And I've learned a lot in this field. And my clients are just the coolest people ever, honestly. I love the people I get to work with. I think if we can look at all of this as an opportunity to look at ourselves and get curious with ourselves and why we think the way we do and why the stuff comes up for us.

SPEAKER_00 46:48

Maybe if we asked ourselves more questions, stay more curious, maybe we could have some good changes. Just be kind to ourselves about it. Where do you think change has to start for systems, or do you think it starts with individuals? Do you think it needs to be this community collective transformation? What are your thoughts on that? Both.

SPEAKER_01 47:12

I mean, I think it starts right here, right now, today. We're having this conversation, right? So both of us as individuals and what we choose to come together and do. Everybody can make a difference. I think it does start with kindness, but I do think it's a systems-wide thing. It needs to be the systems and the organizations that change. And I think there is power in the individual movement. So something I try to think about just as an example is when I have these challenging conversations with someone who doesn't understand trans identities, when I share my experiences with them and humanize it a little bit. Or if they have a friend or family member who comes to them with this, they won't be quite as defensive. And it potentially helps that person, doesn't isolate them. And that can have such a big impact. And I try to remember this. It's hard sometimes in this field to remember the impact we make. But when people feel seen, safe, supported, connected to their community, they go on to do incredible things. Right. Absolutely. So hopefully if I can create that space, this is why I like working with business professionals or professionals in the same field, like creating that safe space for them to have a moment for themselves, because they go on to do incredible things and they need support just as much as the next person. So I think remembering in the moment-to-moment interactions with one another, that's the greatest potential for change. Because if my client then goes to talk to their very conservative parent who is in politics and can influence those, and now it's a personal thing. That just made a systemic level change because I was curious and kind to someone. And I think we forget that. It's like the butterfly effect. Yeah. Yeah, exactly. So it's a little bit of both. It does need to be a systems change. I really encourage people to look at whatever field you're in, whatever spaces you engage with, how can you make it more accessible to people? So in every regard, right? So more accessible to folks with disabilities or immunocompromised people or whatever. If you imagine someone in front of you who is different from yourself who wants to access the same things you are, what is needed to make that happen? I don't think it's a huge ask to be considerate of others. So maybe it's not going around and asking pronouns from everyone you meet, but maybe it's just not making those assumptions and asking people again and being curious.

SPEAKER_00 49:43

So it can just be that small step.

SPEAKER_01 49:45

Yeah. So so I'm in the dance world, right? And that's a very binary system a lot of times, especially in traditional forms of dance. But, you know, if you're making an advertisement for that, just think about the language we're using. Do you want it to be a ladies' class or do you want it to be a heels class, right? Like what is the messaging there? And who does that include? Is it inclusive? And do you want that space to be inclusive? I hope so. But for me personally, even if I'm okay with some of the different terms, right? Like we say girl in a gay way. I don't mind that personally. I don't, I don't care. I'm pretty flexible with all of that stuff. I think you know people's intention a lot of the time. So I'm cool with that. But being a lady, I don't want to be called a lady. I just I don't like that. Even if I was a cis woman, I don't like that term. But personally. That's fair. Um also who uses the word lady anymore. Oh, all the time. Yeah. Really? Yes. Hi, ladies. I just personally, that bothers me.

SPEAKER_00 50:34

But it seems like it's from the 19 kind of term.

SPEAKER_01 50:39

But guys to me doesn't feel the same way. Guys feels gender neutral. Yeah. So I mean it shifts over time, like language shifts. But I I do think sometimes people get in their own way and get in their heads about like, oh no, I use this term, or I like they get so scared to make a mistake as opposed to just asking. So I I like it when people are like, hey, do you I use girl, but like in a gay way. Is that cool with you? Same thing with, I don't know, different terms that have been reclaimed in the community, right? There's terms that I like, but I'll ask someone before I use them. So even on this podcast, I've used the word queer. Not everyone loves that word. I do, and I'm always open to dialogue about that. I won't refer to a client that way unless they use the word, right? So I just don't think it's super difficult to ask and to be open to learning. And I personally get excited when I learn about new things. So as a provider or clinician, if you're walking into a room where there's a client, learning to like knock on the door first or like ask consent before you touch somebody, both in dance spaces and in clinical spaces, say, Hey, I'm gonna go ahead and put my hand on your back to listen to your heartbeat or to or and dance, right? I'm gonna, this is what we're doing next. I'm gonna correct your stance. Is that okay? Just offering people the option to say no and the autonomy. I think offering people autonomy is huge. It's a huge way to get people engaged and to feel safe, whether or not, and I think that's a trauma-informed lens, right? But it it someone doesn't have to have trauma to have different comfort levels with their body or like what's happening. So I think if we could give people more autonomy and make less assumptions about how people want to be referred to, how they want to be touched or interacted with, I mean, I think that would be a game changer, honestly. Yeah. Truly. Just asking for consent and everything. Just asking for permission and consent and being considerate in that way. I'll ask my clients, is the temperature in the room okay? Do you need a water? Right. Just like making sure they're comfortable and creating that space for people to like show up differently. So I really enjoy when my clients will get up to use the restroom in the middle of a session. Don't be uncomfortable. Don't worry about being polite. Like, go do that. And there's a balance, right? You can't, if you're on the phone the whole time during a session, I that's not super helpful.

SPEAKER_00 52:39

But just offering the option to make people feel like, hey, I'm autonomous, I'm in control for as much control as we can have in this world. It's very out of control right now. Yeah.

SPEAKER_01 52:52

I yeah, not to be such a therapist about it, but I think boundaries come into this because I think people have a misconception of what a boundary is. People think that boundaries are so there's a difference between a boundary versus trying to control somebody else's actions versus a request. So if someone's yelling at you, right, if you're in an argument, someone's yelling and that doesn't work for you. You can say, hey, I don't really like it when you yell, you know, can we bring it down? That's a request. And then if you say, hey, if you continue to yell at me, I'm gonna step out and come back when we're both calm. If you follow through with that, right, then it's a boundary. You have to follow through. If you don't, it's just a request. Now, if you say, you can't yell at me, that's not fair. I'm trying to control your behavior. I can't do anything about that. And that's different from a rule, right? We have rules and stuff around, again, like not being on your cell phone during a session. That's a rule. But boundaries are very different. So deciding what your level of comfort is. So when you're talking about if you have the capacity to have a conversation, if someone is getting really aggressive and talking over you or things like that, you can say, hey, I am gonna excuse myself from this conversation for the time being. Let's revisit this or, you know, whatever. Here's some resources, whatever. You get to make choices about what you are doing and how you want to interact with people. You can't control what they do, but you can remove yourself from the situation or set a boundary. And there's a lot of really wonderful podcasts and articles and things on this. But I think that would help us a lot as the conversations around consent and boundaries and comfort levels. And I think people are really quick to say, like, oh, you're being sensitive or this or that. But it's it's so nice to be able to say, you know, hey, I want, I want to have a difficult conversation with you today, is like, are you up for that? Because I don't know. Maybe you've had a really hard day at work.

SPEAKER_03 54:37

Yeah.

SPEAKER_01 54:38

Maybe you didn't sleep well, maybe you're on a new medication, maybe whatever. And I'm giving you the opportunity to show up and to communicate what you want and need. And I just think there's so much respect in that. And I just, it's so challenging that with these conversations because then you'll talk to people who are on the other end of things who are very amped up and who want to fixate on one element of the conversation. And again, it's the bid for connection. Both sides want kindness and respect.

SPEAKER_03 55:00

Yeah.

SPEAKER_01 55:01

So if they have a very different viewpoint, they're like, well, you've got to respect my opinion. That is very true. That's very true. I need to treat you with respect. Maybe, maybe not the I have to respect your opinion, but I I need to treat you with respect. But are you doing that? Right. If you're saying respect me, respect me, like, are you also offering that respect? Yeah. Would be my Is that reciprocal? Yeah. You know? And again, when someone's sharing something personal, I do think there's a little bit I would love for people to create more space and opportunity for folks who are sharing their personal experiences versus just making it this opinionated thing. Like if you don't have a personal experience with something and you have someone coming to you saying, hey, this was my experience, listen to them. They have that firsthand experience. So if someone is saying, This makes me uncomfortable due to this experience, they're telling the truth, right? This isn't some objective thing that maybe they've researched or whatever. And then and then there can be follow-up discussions on media and this and that. But I'm not sitting here saying, This was my experience with gender, and you're saying, no, that's not true. Who are you to tell me? Right. So that would be what I would ask for people who are feeling that defensiveness come up or have really political views about it, but maybe not their own experience with gender or gender-affirming healthcare before you jump into action or these heavy conversations. Do some research, listen to the person in front of you who's telling you like that this is difficult for them. Take a moment and let them have that. Like, is this a relationship? Do you want to build into that? Do you want to do the community building, whether that's a friend or the politician next to you or whatever? Like, if someone is saying, This is my experience, please hear me. Please hear me, right? Can we prioritize that bid for connection based on their personal experience and then talk about ourselves secondary? Yeah. Right. If we if we don't want to be heard, I know. It's true. Yeah. And so I try to remember that when I get some very frustrated calls.

SPEAKER_00 56:56

Dylan, thank you so much for being on this podcast today. You brought such a wealth of expertise, and I really have enjoyed getting to know you and also your personal experiences. Thank you so much. Yeah. Thank you so much for having me.

SPEAKER_01 57:10

I really appreciate it. And opportunities like this remind me of the hope that I'm trying to remind other people of, right? Like this is an opportunity that we're being curious with one another and learning about each other, and that there's another person out there who's supportive and doing this work. So that's cool.

SPEAKER_00 57:24

It's like the how you have to find the ways to keep having hope, right?

SPEAKER_01 57:28

Yeah. And so genuinely, I it's so hard right now. And I really want to honor that. Yeah. So going out and finding what is good for you and the people who see you and value you and love you for who you are, it changes everything. I really believe that it shouldn't be that I am this like specialist in gender-affirming care. It should be everyone is knowledgeable about this, and but I am. And it's because it's not more widespread. So I'd really encourage like providers to go out and get your education, be curious about this and open yourself up to serving anyone who comes through your door. Right. And get curious about yourself. Make it personal for you. Yeah.

SPEAKER_00 58:05

Well, it sounds like you've done all of those things. I'm trying. I've so much to learn. Yeah. All right. Well, this has been Dylan and Anna at the Lavender Lounge Podcast. Have a wonderful day.