Michelle gave us a very moving talk on gender dysphoria: unhappiness with gender identity, which leads many thousands of males and females in the UK every year to consider and in many cases change their gender.  Surprisingly to me about half of surgical reassignments are female to male and half male to female.


When changing gender entails the surgical changing of genitalia, this is a considerable and very invasive surgical procedure.  It is often accompanied by the taking of hormones and even facial surgery.


Someone considering gender change may come to a psychotherapist/counsellor for help in exploring the issue of gender identity and what is involved physically, socially and psychologically in such a change.


Michelle’s excellent website, http://genderidentity.co.uk/ has a wealth of information and there is even a free book of hers available, “Transgender, a guide to Transgender in the UK.”


She says on the website that “Many people with Gender Dysphoria and who are exploring their gender identity issues are struggling to make a decision about their futures. Others may have made a decision to transition from one gender role to another or indeed may actually be transitioning. Whatever the situation, it is often helpful to get support via Psychotherapy and Counselling.”


Children considering a new gender can receive puberty blockers to slow down the process of puberty.  For a boy, once testosterone kicks in, the voice breaks, the adam’s apple forms, and the body and face begin to change shape. Facial and other body hair also begins to grow.


For a physically mature man, changing gender to female involves the problem of passability.   It is very unlikely he will look and sound exactly like a woman when he has transitioned and this can be very disappointing and stressful. Female to male transition can often be more convincing. Testosterone is a very powerful hormone, more powerful that oestrogen.






Psychologically the loss of the familiar gender identity can be surprising and difficult, and requiring a period of adjustment.  Michelle talked about her experience of the loss of “male privileges.”  She finds it more difficult to be heard than she did as a man for example.  It takes longer for her to be noticed by the waiter at a restaurant!


I liked Michelle’s humour – she has also been a stand-up comic.  She was asked if we should call her Shelley or Michelle and replied, “My friends call me Shelley so you can call me Michelle,” and when she talked us through the process of gender change and sexual re-assignment surgery, she finished by saying “Bob’s your aunt!”


She shared with us a case study where a man was considering changing gender and Michelle made it clear that she was by no means encouraging the man to do so even though he did change gender in the end.  Michelle explained that her task as psychotherapist was rather to support and challenge the client and help him or her to explore gender identity and consequences of any changes, allowing the client to make the decisions.


Michelle’s main point is that we all have to be true to ourselves, comfortable in our own skins, and that for some this means the difficult journey of transitioning from one gender to another.  The therapist, in transgender work, as in all work with clients, can help the client to explore what is true for himself or herself and what is needed to live that truth.


Thank you Michelle for a remarkable talk. It left all of us at the end of the evening with a lot to process.


David Brown