New Press Contribution in AskMen on Masculinity
Recently I was asked to share some thoughts on modern masculinity with AskMen. In the post we explore what contemporary masculinity is, can be, and how men can work towards owning their personal sense of masculine identity.
Read the article at this link.
Should You Be the Same Race or Gender as Your Therapist?
One of the things that I am most often asked in my phone consultations with folks is about matching between client and therapist along gender or race lines. That is, should you be the same gender or race as your therapist? As with most answers in psychology...it depends!
Finding the right therapist to work with is no easy feat. First, there is the research. You scour search results of sites like Google or sort through results on directory sites like Psychology Today in order to find a mental health professional in your area (with payment terms that you're comfortable with). You may not even know what you're supposed to be looking for! Should you have someone of your own race or should you not care? Does it matter? What about gender? Then, you make a quick call or schedule your first session and anxiety sets in. Now, you actually have to go.
It takes a lot out of you.
Research exists on the topic of matching between client and therapist along racial and/or gender lines, and the results are mixed. Based on the research that I've seen, there doesn't seem to be much difference in terms of treatment outcomes as it relates to therapist/client matching. That is, you are likely to gain similar outcomes if you are Black man meeting with a Black male therapist or a While male therapist. Are you surprised? Me too.
Of course, this all starts with the basis that there is no, or very limited, bias on the part of the therapist. The research indicates that therapists of all races, who are comfortable with their own racial identity and competent in working with clients of difference racial groups, are equally efficient. That's particularly good news if you live in an area where you are not able to find a therapist of your own race, if that is your preference.
When it comes to race, it seems that you can be sure a therapist of any race that is competent in working with your racial group can be effective at helping you work through your biggest concerns.
Another idea that I found interesting about the research is that the length of treatment IS affected by therapist, client match. Specifically with regards to race, there is research that indicates that while match doesn't so much matter for White folks, Black folks are more likely to stay in therapy longer when matched with Black therapists.
The research on gender (or sex) matching between therapist and client is also mixed. There is some research that indicates that, similar to race, gender matching makes no significant difference in terms of treatment outcomes. However, there is research that indicates that women tend to stay in treatment longer when matched with women therapists. Inversely, men may be more likely to drop out of therapy, and sooner, when matched with male therapists. Go figure.
It should be noted that all research attempts to explain trends that are able to be generalized about the population at large. Some research does a much better job at this than others. So take all of this information with a grain of salt.
At the end of the day, what matters most is who are you most comfortable sitting across from. When you're empowered with an answer to that question, you will be much more comfortable and prepared to work through your concerns with a therapist than you can grow to trust and lean on.
Additional suggested reading on the topic: Your Therapist is White. You're not. Is this a problem?
Sources:
Cabral, R. R., Smith, T. B. (2011, October 11). Racial/Ethnic Matching of Clients and Therapists in Mental Health Services: A Meta-Analytic Review of Preferences, Perceptions, and Outcomes. Retrieved April 4, 2017, from http://scholarsarchive.byu.edu/cgi/viewcontent.cgi?article=1079&context=facpub
Flaherty, J. A., MD, & Adams, S., PhD. (1998, January 01). Therapist-Patient Race and Sex Matching: Predictors of Treatment Duration. Retrieved April 04, 2017, from http://www.psychiatrictimes.com/articles/therapist-patient-race-and-sex-matching-predictors-treatment-duration
Jones, E. E. (1978, January 01). Effects Of Race On Psychotherapy Process And Outcome: An Exploratory Investigation. Retrieved April 04, 2017, from http://insights.ovid.com/psychotherapy-theory-research-practice/psytr/1978/10/000/effects-race-psychotherapy-process-outcome/4/01437416
Sterling, R. C., Gottheil, E., Weinstein, S. P., & Serota, R. (1998, July). Therapist/patient race and sex matching: treatment retention and 9-month follow-up outcome. Retrieved April 04, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/9744135
What does it mean to be transgender?
According to the Transgender Law and Policy Institute, up to 5% of the United States population identifies as transgender. For many, this term and identity represents a new facet of the LGBT community in the mainstream as trans people have only recently publicly gained the attention of the masses. The truth is that trans people have long been an important and integral part of the social and political movements to garner support for LGBT people.
And with Caitlyn Jenner most recently and courageously sharing her authentic self with the world through her Diane Sawyer interview, the mainstream media and many American households are buzzing with the question, what does it mean to be transgender? And if you're reading this, you might even be asking yourself, "Am I transgender?" As someone who has worked with and came to care for many trans or gender non-confirming folks, my hope is that this brief post will help provide you with some insight and answers along on your journey.
First, a little context. Up until 1973, the psychological community still sanctioned homosexuality as a mental disorder. While it was removed from the Diagnostic and Statistical Manual (the DSM) that year, the psychological community is still conflicted about how to best support people who self-identify as gay. Thankfully, there are many professionals (gay and heterosexual) who acknowledge and promote the mental and emotional health of gay folks by adopting supportive and gay affirmative practices. Sadly, however, there is still a large segment of the population who advocates for the use of conversion therapy, which aims to rid gay people of their same-sex desires in order to make them "straight". Too often the practice of conversion therapy is both emotionally and physically damaging and inappropriate, leaving the clients more emotionally damaged, confused and isolated from their families and loved ones. Now that transgender people are being more widely recognized in the public sphere, our culture is faced with the same questions and barriers as a society on how to best support trans folks.
For better or for worse, gender dysphoria is still listed in the DSM as a mental disorder. Many counselors like myself, don't consider identifying as trans as a mental health disorder, however, this often presents a conundrum for trans advocates as many states require a person to carry a diagnosis of gender dysphoria in order to begin gender affirmative treatment such as hormone replacement therapy and what has previously been known as sexual reassignment surgery, which is more colloquially referred to as "top" and "bottom" surgeries in the community. Given the restrictions on treatment, you can see how in order to live in accordance with your gender identity, some have to be stigmatized in order to receive the appropriate, supportive, and necessary medical interventions that are gender affirming. More plainly put, trans people must admit to being "sick" before receiving what is often life saving treatment.
Despite trans visibility increasing in the past few years, many folks still have questions and concerns about what it means to be trans. There are a lot of online resources that often feature the voices of trans people themselves such as Laura's Playground, TransAdvocate and PFLAG National. These are all great resources if you yourself think you may be trans or need insight about a friend or loved one. As a mental health professional, I will share with you the criteria of gender dysphoria which might help you gain some insight and clarity into what trans people might be experiencing. Here is an abbreviated list of that criteria:
Feelings that your internal gender identity does not match your physical characteristics
A desire for the sex characteristics of another gender (ex. sex organs such as penis, vagina, testicles or things like amount of body hair, tone of voice, waist to hip ratio, etc.)
Feeling that you should be treated as a different gender (than what you were assigned at birth)
Strong and persistent internal feelings that you are of a different gender or sex that you were assigned at birth
Again, this is a list based on heteronormative ideals and standards which see a trans identity as being "disordered".
There are histories of cultures with two-spirited, or third genders which haven't described or treated trans folks in the same way. I hope that this can serve as a starting point to form questions, invite discussion and ultimately garner understanding and compassion for people who all identify as trans like Caitlyn Jenner, Leelah Alcorn, Chaz Bono or Laverne Cox. All too often the health and livelihood of trans folks depends on our willingness to develop empathy and compassion, irrespective of our cultural or religious backgrounds. The truth of the matter is, lives are at stake.
And if you think that you might be trans, I invite you to seek out support in a trusted friend, loved one or affirmative counselor who can help guide you and support you on your journey of being your most authentic self.
You deserve that ability to do so. We all do.