Gender and sexual identity are two separate areas of human experience that are often conflated. The challenge in working effectively with these different domains requires an acknowledgement of both and how they play out in an individual's life.

Gender

One's gender is much more than what society informs us it should be. Gender primarily implies how one feels on the inside, whether this be primarily masculine, feminine, something in-between, or none of the above. The ability to cultivate a connection with who one is on the inside is a life-long process of individuation we each come to terms with in our own unique ways.

As a clinician, I am well aware of cultural notions of femininity and masculinity and the ways they serve as the background against which many of us live. Implicit in these notions of gender, however, is that femininity and masculinity are somehow discreet categories of experience. They are not. There is no essential quality to masculinity that does not contain qualities of femininity just as there is no essential quality of femininity that does not include masculinity. It is the relationship between the two that characterizes notions of gender that we have come to identify as such: femininity can only be known as it is contrasted with, and differentiated from, masculinity and vice-versa. The diversity and multiplicity of human experience characterizes the ambiguity of the many ways femininity and masculinity are actually lived out in the world. That they can only be considered in relation to one another, and that each contains parts of the other in itself, brings an implicit transgendered quality to each.

Some of the ways society propagates notions of femininity and masculinity (e.g., through educational institutions, religious institutions, civic institutions, etc.), can have deleterious effects upon those whose gender identity and expression fall outside cultural norms. The wounds left from such mistreatment leave scars that are often difficult to heal as they are continuously rewounded in such a person's routine interactions with the world. It may then be difficult to trust that others can accept, honor, and respect the expression of the person's truths. In therapy with those who have experienced such injury, I help tend the wounds that have been heedlessly inflicted by others and support the patient as they discover forms of self-expression that feel aligned with one's inner truths.

Sexual Identity

Sexual identity concerns itself with to whom a person is sexually attracted. Psychoanalysis informs us that at the level of the unconscious, there can be an experience of polymorphous sexuality. These potential forms of sexual expression in the psyche unconsciously inspire each of us to pleasure oneself in ways that feel right and give fuller expression to who one is: a person who expresses oneself sexually in private in ways that come naturally and who also participates in a larger human community.

Desire may be cultivated within an individual's body, mind, heart, and soul in such a way that the object of one's desire may be of another sex or gender, or one's own. While gender and sexuality may occupy separate domains of experience, the varied expression of each is in accord with, again, the diversity and multiplicity of human expression and desire. This means that for some, homosexuality may be the primary way they go about experiencing pleasure as well as relational coupling. For others, heterosexuality may be their primary path. And still for others, the objects of their sexual desire may shift from one sex or gender to another over the course of time. For our transgendered brothers and sisters, or other-gendered siblings, desire follows the inclinations and proclivities of, again, one's body, mind, heart, and soul.

In the consultation room, my primary focus and concern is how one identifies and the accumulation of experiences that have resulted in who the person is. The fundamental right of self-expression is a basic human right to which we are all granted and to which honor and respect is due. Who we are and how we have come to be who we are, is generally a cause for celebration, joy, and wonder. This focus and concern forms the basis of the psychotherapeutic inquiry and guides the therapy.