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Earlier this year I had the honor to be the mental health expert at a panel discussion at Westside Presbyterian Church (Ridgewood, New Jersey). We discussed the intersection of sexuality, gender and religion. We focused on how places of worship can become more welcoming to members of the LGBTQIA+ community, and you can watch the recording of the event here - https://youtu.be/xRrIQ7duyj0 Let me know what you think! Chris Warren-Dickins LLB MA LPC Psychotherapist, (Licensed Professional Counselor), Ridgewood NJ 07450 www.exploretransform.com 201-779-6917 chris@exploretransform.com  Earlier this year the American Counseling Association published another one of my articles. This time I wrote about how counselors can help people who are in an intimate relationship. This has traditionally been called 'couples counseling', but I find this term unhelpful because it communicates an assumption that the intimate relationship can only involve two people, and therefore excludes polyamorous relationships. Such an assumption can reveal a counselor's personal values, and this can hinder the therapeutic work. In the article I also mention how members of the LGBTQ community may be carrying wounds of discrimination, and this can have an impact on the intimate relationship between the clients, but also the therapeutic relationship (between counselor and the clients). Read the full article here - https://ct.counseling.org/2019/04/how-can-we-truly-help-clients-in-a-relationship/ Chris Warren-Dickins LLB MA LPC Psychotherapist, (Licensed Professional Counselor), Ridgewood NJ 07450 www.exploretransform.com 201-779-6917 chris@exploretransform.com  If your true identity is not the identity you were given at birth, you may identify in some other way, including transgender, gender non-confirming, gender queer, or non-binary (TGNC for ease of reference.) In all cases, you do not identify as cis gender. Cis gender means you identify as the gender identity you were given at birth. To identify as cis gender means that you live with cis gender privilege, whether you are aware of this or not. Cis gender privilege means that you do not have to endure the overt and covert discrimination experienced by many people who are TGNC. Cis gender privilege means you can assume you will not be denied work, a home, healthcare, a place to worship, a family to love, or your personal safety, because of your gender identity. Cis gender privilege means that you don’t have to remind people (even your loved ones) of your pronouns, and/or your name (for example, you are not deadnamed). Seemingly innocuous moments in everyday life can symbolize cis gender privilege, which basically assumes a binary construct of gender identity. Examples of these everyday moments are set out below: · You fill out a form and it asks you to tick the box ‘male’ or ‘female’. There is no box for people who identify as TGNC · Your friend is pregnant and holds a gender reveal party with ‘Pink or Blue?’ on every single decoration, including the cake and balloons · There are only two bathrooms, one labelled ‘male’ and one labelled ‘female’ · The same goes for other public facilities including locker rooms in gyms and changing rooms in clothes stores · Waiting to board a plane, the airline announces that only women and young children can board first · There are role models in the media and in the political arena who are cis gender · There are rites of passage, public ceremonies, and other traditions based around the binary concept of male and female · You register your child for a sports class and the instructor asks your child to get changed in the girl’s locker room, and join the girls group · You go to a high school graduation where everyone is told to sit in two sections: The male section and the female section To pretend that there are only cis gender males and cis gender females in society is to pretend that parts of our population, the GNC community, do not exist. To do this is offensive, and it can leave a lasting impact on someone’s mental health. “40% of transgender adults reported having made a suicide attempt, and 92% of these having attempted suicide before the age of 25” (Trevor Project). In addition, 86% of transgender individuals reported sexual or physical assault. Here are some accounts from a Human Rights Watch report: “Alexander S., a 16-year-old transgender boy in Texas, said: I started getting a lot of anonymous people telling me to kill myself, that it wasn’t worth living. I called the school and told them what was going on and they didn’t do anything.” and “It was “like a little mental pinch” when teachers used the wrong pronouns. “It doesn’t seem like a big deal, but eventually you bruise”, 17-year-old transgender student in Utah.” So the biggest cis gender privilege is to live a life where you are less likely to commit suicide, and less likely to experience sexual or physical assault. Less obvious forms of discrimination include microaggressions, which are everyday slights, snubs or insults that communicate hostility (whether or not they are intentional). GLAAD ran a photo campaign to highlight this issue. Here are some examples from that campaign – · Seven, a transgender man, was asked “Did you transition because you thought you were an ugly girl?” · Jacob, who is gender queer, was asked “When are you going to really transition?” · Tyler, who is agender/queer, was told “you need to shave if you’re trying to look like a girl” · Tiq, a trans man, was told “I would never have known you used to be a girl” · Shane, a trans man, was told “You understand what it’s like to be a woman” To acknowledge all of this, and the privilege of a cis gender man, is not to deny the suffering that cis gender men may experience as a result of another aspect of their identity. For example, if a cis gender man is also a gay man, it is likely that he would have endured his own experiences of overt and covert discrimination, including microaggressions, verbal abuse, and assault. But to acknowledge the suffering of one group of people does not take anything away from the suffering of another group. If we are to truly understand the concept of privilege, we cannot stop at gender identity. For example, a white transgender man will experience white privilege that a black transgender man will not. As the American Psychological Association points out, each of our “social identities contributes uniquely and in intersecting ways to shape” how we experience and perform our lives (APA Guidelines, 2018). In turn, this has an impact on “relational, psychological, and behavioural health outcomes in both positive and negative ways”. In the next article in this series, we will look at other forms of privilege, including white privilege. In the meantime, we will close with some tips on how to address cis gender privilege – · Raise awareness about the privilege of being cis gender · Stop making assumptions about people’s gender identity. If in doubt, and it seems appropriate, ask. If not, use ‘they’ rather than ‘him’ or ‘her’ · Normalize the concept of identifying gender, including a person’s pronouns, and include your own pronouns in your email signoff · Gender identity is a personal matter. How you identify, and how much you share that with another person, is up to you · Challenge the overly simplistic division of the human race into the binary fiction of ‘men or women’. We really can do better. Gender is a spectrum as varied as any other components to a person’s identity. The binary ‘man or women’ option has never, ever reflected reality, so isn’t it high time we caught up? Chris Warren-Dickins LLB MA LPC Pronouns: (they/them/theirs)  So what about gender identity and young children? The wonderful organization Gender Spectrum suggests using 'insistence, consistence and persistence to help determine if a child is truly gender-expansive or transgender': 'If a boy likes to play with dolls or likes the color pink, this doesn’t mean they will grow up to be transgender. If a girl wants to be called “John” for a couple of weeks, this doesn’t mean she will always feel like a boy. The longer and more insistently that a child has identified as the opposite gender, a combination of genders, or neither gender, the easier it becomes for a parent to know.' Gender Spectrum encourages parents to adopt Affirming Parenting Practices, and this includes allowing your child 'to choose, without pressure or unspoken messages, the clothes they wish to wear, how and with whom they play, their favorite toys, the accessories they favor, the manner in which they wear their hair, and the decorations and images with which they surround themselves'. You also need to help your child to 'prepare for any negative reactions they may encounter outside the home by practicing their responses with them and making sure, when appropriate, that there is a safe adult for them to turn to in case they need assistance'. It also means 'discussing any negative or conflicting feelings you are struggling with over their gender with other adults, not with your child'. No matter what, the most important point is that the 'self-esteem, mental well-being, and overall health of a child relies heavily on receiving love, support and compassion from their parents no matter where they are on their gender path.' Read more here https://www.genderspectrum.org/explore-topics/parenting-and-family/?fbclid=IwAR1BGGmBZcem7SxSQ60ch7yHyJO8eCfQdXI6c9W1IhDD9-yhfqt1s2ru5Bo#more-340 Chris Warren-Dickins LLB MA LPC Psychotherapist, (Licensed Professional Counselor), Ridgewood NJ 07450 www.exploretransform.com 201-779-6917 chris@exploretransform.com  So what exactly is Gender Identity? In the words of Gender Spectrum, gender identity is 'our internal experience and naming of our gender. It can correspond to or differ from the sex we were assigned at birth'. Gender identity is not a binary concept, this is simply how we have understood (or oversimplified) gender. The reality is that gender identity exists on a spectrum, and this can include people who are transgender, cis gender, non-binary, gender queer, and other gender identities. 'Because we are provided with limited language for gender, it may take a person quite some time to discover, or create, the language that best communicates their internal experience. Likewise, as language evolves, a person’s name for their gender may also evolve. This does not mean their gender has changed, but rather that the words for it are shifting.' 'Each dimension of gender is informed by our unique intersection of identities, experiences, and personal characteristics. We are more than our body, gender identity and gender expression: we are also our race, ethnicity, class, faith, sense of geographic place, family history, and more. Our gender is personal because, while we share some of these aspects of self with others, the way that all of these identities, influences and characteristics come together is unique to each of us'. Read more here https://www.genderspectrum.org/quick-…/understanding-gender/ Chris Warren-Dickins LLB MA LPC Psychotherapist, (Licensed Professional Counselor), Ridgewood NJ 07450 www.exploretransform.com 201-779-6917 chris@exploretransform.com  For some, it is easier to believe there is not a problem, than to have to face the full onslaught of someone else’s distress. If someone believes they are not directly impacted by an issue, they choose to close their eyes and ears. The trouble is, one person’s distress is rarely relevant to just that one person. We need to take responsibility for every person in society, because their distress could be caused by us, and their distress could, eventually, become our problem. “I go to a Catholic school, where I’ve heard that my counselor has made some racist comments in class. Unless I 110 percent trusted and were close to my counselor, I wouldn’t feel comfortable confiding in them.” This is just one account in the ‘LGBTQ Youth Report’, published last year by the Human Rights Campaign. The report highlighted the multi-layered difficulties experienced by LGBTQ youth. I have set out just some of these findings, and if you are at all concerned about living in a healthy society, you will find these disturbing – ‘Only 25% of LGBTQ youth have families who show support for them by getting involved in the larger LGBTQ and ally community.’ ‘Trans youth are over 2x more likely to be taunted or mocked by family for their LGBTQ identity than cisgender LGBQ youth.’ ‘LGBTQ youth of color report hearing family express negativity about LGBTQ people more frequently than their white peers.’ ‘Only 27% of LGBTQ youth can “definitely” be themselves in school as an LGBTQ person.’ Only 26% of LGBTQ youth report that they always feel safe in the classroom.’ ‘Seventy-seven percent of LGBTQ youth surveyed report that on average they had felt down or depressed in the past week. Alarmingly, only 41 percent had received psychological or emotional counseling to address these issues in the past 12 months. LGBTQ youth of color face even greater challenges in accessing counseling services, with large disparities and an average of 37 percent of respondents having received psychological or emotional counseling in the past 12 months.Importantly, youth who had received counseling reported better mental health outcomes.’ Who is going to be ‘family’ to the 75% of LGBTQ youth who have no support from their own family, or the ‘trans youth’ who are being ‘taunted or mocked by family for their LGBTQ identity’? You? If you are willing to open your eyes and ears, and to help with this societal issue, here are the Human Rights Campaign’s suggestions - ‘School Administrators & Teachers
‘Mental Health & Medical Professionals
‘Parents & Family Members
Full report available here - https://www.hrc.org/resources/2018-lgbtq-youth-report Chris Warren-Dickins LLB MA LPC Psychotherapist, (Licensed Professional Counselor), Ridgewood NJ 07450 www.exploretransform.com 201-779-6917 chris@exploretransform.com 
As a member of the healthcare profession, I have a duty to ensure that my services are available for all members of society. Dr Wizdom Powell, lead author of a study in the journal Behavioral Medicine, points out that “medical mistrust is significantly contributing to delays in African American men utilizing the health care system”. The study refers to the need for ‘patient-centered interactions’ which are characterised by ‘mutually as well as supportive and responsive communication’. This ensures a higher likelihood of ‘patient to trust’. As the study points out: “For African-American men, who are disproportionately exposed to daily, racialized slights against their humanity, a little patient-centeredness could go a long way in restoring their medical organization trust, as well as improving timely detection and screening.” In addition, the study points out that I, as a clinician, need to remain aware of the “the more pernicious role of structural racism in policies, practices, and procedures impacting medically vulnerable and underserved populations”. https://www.tandfonline.com/doi/full/10.1080/08964289.2019.1585327 Chris Warren-Dickins LLB MA LPC Psychotherapist, (Licensed Professional Counselor), Ridgewood NJ 07450 www.exploretransform.com 201-779-6917 chris@exploretransform.com  The American Counseling Association (ACA) has issued a statement regarding gun violence. A link to the full statement can be found below. It is important to highlight that the ACA "strongly discourages attributing these atrocities to mental illness—rather than considering the complex interplay of the misuse of guns and targeted acts of gun violence". Included in the ACA statement are links to useful resources, should you need these. I have attached one of those useful documents, a factsheet on 'Helping Survivors with Stress Management Skills'. Chris Warren-Dickins LLB MA LPC Psychotherapist, (Licensed Professional Counselor), Ridgewood NJ 07450 www.exploretransform.com 201-779-6917 chris@exploretransform.com The label ‘toxic masculinity’ is unhelpful for the whole of society, no matter the gender identity. In this fascinating interview with Dr Wizdom Powell and Dr Ronald Levant (from minute mark 25:13 onwards) Dr Powell makes the important point that “we are complicit in maintaining this idea of masculinities that is mythic and difficult to achieve”, and “these messages start very early in the life course”. Dr Powell also makes the important point that, in order for boys and men to get the help they need, we “need to think about structural arrangements for particular racial and ethnic minority males like black men and boys that actually make it even more likely that men will push back from seeking the help they need, and these arrangements include structural disadvantages like racism that can interact with men’s beliefs about what it means to be a man to negatively impact their health. So we need systems change…to make it possible for boys and men to enact masculinities that really convey the dynamic broad range of emotions they are capable of displaying.’ Full interview (from minute mark 25:13 onwards) available from this link - https://www.kcur.org/post/seg-1-human-cost-reassessment-seg-2-toxic-humanity#stream/0 Chris Warren-Dickins LLB MA LPC Psychotherapist, (Licensed Professional Counselor), Ridgewood NJ 07450 www.exploretransform.com 201-779-6917 chris@exploretransform.com  At least one in six men have been sexually violated (1in6.org). That might seem higher than you expected, but experts say the number is probably even higher. Here are some of the reasons why -
This last point is a really important one to clarify. Sexual violation is not about sex or sexuality. Sexual violation is an act of violence inflicted by the perpetrator in an attempt to overpower, to control, or to punish the survivor. Sexual desire, and/or sexual orientation have nothing to do with sexual violation. I cannot express this point enough, and yet still I hear this confusion. Symptoms If you have experienced sexual violation, or you know someone who has, one of the most intense resulting symptoms is shame. Shame goes to the core of you, tricking you into the belief that there is something intrinsically wrong with you. This is distinguished from guilt, which is regret for an action you did or did not do. Shame is about you, whereas guilt is about the external action. Along with shame, you may also experience humiliation, rage, sadness and fear. You may be easily angered or easily upset, and you may have flashbacks, or become emotionally numb. There is no right or wrong way to feel about sexual violation, and you should be treated with enough respect to allow for these feelings. Experiencing an emotion is neither right nor wrong, it is what you do with it that is judged. So, for example, some people may judge you for feeling angry. You are entitled to feel angry, but you are not, of course, entitled, to use that anger to punch someone. It can help to understand a couple of these symptoms - Emotionally numb – The term for this is dissociation. To survive the experience of sexual violation, your brain might have shut down for a moment. It did what it needed to, otherwise the experience might have been overwhelming. The trouble is, the danger has now passed, so you need to reconnect with your emotions, your thoughts, and your body. With the help of a trained professional, such as a psychotherapist, you can learn some grounding exercises, to become aware of your whole self. It is important to know that you have not necessarily become emotionally numb forever. It was a survival mode that should, with the right help, become a temporary state. Hypervigilance, easy to become startled or get angered or upset – If you were sexually violated, your body probably went into fight or flight mode. Your sympathetic nervous system kicked in, sending the blood pumping around your body, and readying your body to fight or flee. The trouble is, you were not able to get away, and so your brain and body are still stuck in that fight or flight mode, stuck in hypervigilance. It is as if your brain and body have unfinished business, leaving your brain on edge, and causing you to jump at even the slightest sudden noise, smell, touch or thought. You are still ready for attack, long after the danger has gone. All of this can have an impact on your intimate relationships, your sense of trust of other people, the way you work, your concentration levels, your sleep, and your appetite. It is also a constant drain on your body. You may deal with it by isolating yourself, or trying to keep things under excessive control (which, in turn, leads others to tire of you, dismissing you unkindly as a ‘control freak’). You may even engage in substance abuse, as a way of escaping this constant sense of panic. What can help Talking to a trained professional, such as a psychotherapist, is an important step to take. With the help of a psychotherapist, you will do three things –
There are different types of psychotherapy available, and one particularly effective approach for trauma is Eye Movement Desensitization and Reprocessing therapy (EMDR). EMDR is recognized as an “A” level of treatment for trauma, recommended by the World Health Organization and the National Institute for Clinical Excellence. There are other types of therapy, and most will focus on your thoughts, emotions, and bodily sensations. It is important to include work on the body, as that acts as a bridge between your thoughts and emotions. You hold a great deal of your trauma in your body, causing all sorts of physical symptoms including stomach cramps, constipation, migraines, and nausea. No matter what approach your therapist takes, it is essential that you look out for your negative, self-critical voice. If you are the survivor of sexual violation, and you are carrying shame, this critical voice will be turned up to full volume. Work with your therapist to turn down the volume on this critical voice, replacing judgement with understanding. Understand that your thoughts, emotions and body may have done all sorts of things to survive the sexual violation. For example, you might have engaged in escapist behavior, such as denial or substance abuse, or you may have lashed out (at others or yourself) with the rage that you were feeling. Understand that this was what you had to do to survive. These might not have been constructive coping mechanisms, but they were all you had to survive, and now is the time to replace these with more helpful coping mechanisms. You can also talk to friends and family, but it is important that they give you the right type of help. Set out below are some thoughts on how they can help, and you might wish to show these to your friends and family –
You are not alone, and male survivors of sexual violation are not as rare as societal myths would have you believe. When you are ready to talk to someone, this might offer you an opportunity to experience a different way to relate to someone. For example, the clear and consistent boundaries offered by a psychotherapist can offer you the safety to learn how to trust someone else. This will take time, but remember that you are in control. You can decide how much you share, and when. This can teach you about other people, that not everyone poses a threat, but it can also teach you more about yourself. We can learn so much about ourselves through our interactions with other people. Having the hope of that safe space, where there are clear and consistent boundaries, can offer you a place to rest, at least for a little. It is a place where you do not have to remain alert for the potential of an attack. It is a place where you do not have to fight hard to be someone you are not. And it is a place where, eventually, you can show just a little bit of your vulnerability. Be kind to yourself Go gently, and be kind to yourself. Remember that the shame you carry is not yours, it is the perpetrator’s. The shame will intensify the negative, self-critical voice, but with a little bit of help, you can work hard to turn down the volume. This will give you time and space to replace the unhelpful coping mechanisms with more helpful ways to manage those symptoms. Start today, with a simple relaxation or grounding exercise, and see where you go from there. Let me know if you need anything. Chris Warren-Dickins LLB MA LPC Psychotherapist, (Licensed Professional Counselor), Ridgewood NJ 07450 www.exploretransform.com 201-779-6917 chris@exploretransform.com  |
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