For this work we decided to present a conference that we attended a few days ago.
Entitled: gender awareness evening, this conference took place in the presence of several
speakers. First of all, two professionals: Mathilde Loarec, a psychologist in Nantes who has
been welcoming many LGBT patients for a few years and recently a lot of transgender
patients, and Mylène Hue, a speech therapist in Nantes who responds to requests for vocal
transitions and who is trained in hypnosis. This conference was initiated by a student in
Licence 3 at the University of Nantes, Eloïse Durand, very invested in this cause. Finally we
were lucky enough to have some testimonies from people who have lived this transition and
who were able to tell us about their journey. In total, there were nearly 70 of us at the ZOOM
meeting, including many psychology/speech therapy students from all over France,
professionals (especially psychologists) and people who were concerned and who were
present to testify.
We are now going to tell you about the main concepts we learned during this evening. First
of all, we took a quiz to review the essential terms of inclusiveness, and we will present
some of them to you. Then we will talk more specifically about transition and its impact on
the psychological level. Finally, we will discuss the ways in which inclusiveness can be
improved in our practice.
Part 1 : vocabulary
To start, what does LGBTQIA+ mean ? This acronym includes the members of the
community in a specific position : Lesbian, Gay, Bisexual, Transgender, Intersex, Queer and/
or Questionning, and Asexual and/ or Ally. The acronym has grown over the years and the
addition of the “+” at the end of it suggests the recognition of other identities not yet included.
Often the first terms are known by the general public, on the other hand, the further we
advance in the list, the less clear the concepts are for everyone. To better understand we
can start by defining the term transgender. Transgender is used to describe any person who
has a gender identity that is different from the gender that they were assigned at birth. Then
there is the general term : Queer, it refers to define all people with a sexuality or an idendity
of gender different from heteronormativity. Then, Questioning refers to someone who is not
sure how they identify. Someone can be questioning their sexual orientation and/ or their
gender identity. By the term “Asexual”, it is the individuals who have little or no sexual desire
who are designated. We will come back to the notion of ally later.
Now that the terms of the acronym are clearer, let’s move on to other vocabulary words we
learned on this evening. The non-binary term designates people who do not identify
themselves as strictly male or female but rather as a mixture of the 2 or neither of the 2, the
idea is to move away from the traditional gender model that governs our society. Other
expressions are important for our future practice such as the fact to attribute a gender to
someone in which he doesn’t recognize himself, in French it is called : “mégenrer”. In the
same way “morinommer” means in French the fact to call someone by a name while he is no
longer part of his identity, this old name assigned at birth is now considered his “deadname”.
Unfortunately we cannot expand on this part even though there are many other terms that
we need to know.
Part 2 : The transitioning process
Transition can take different forms, not everyone goes at the same pace and follows the
same transition steps. However, if we had to describe a trajectory of the transition, we would
first speak of the work of exploration. During this work, everyone finds what is comfortable
for them; this will be a step focused on acceptance. After acceptance, the transition can
begin and take different forms that we will present to you.
First, social transition takes place when the individual shares with others the identity in which
he recognizes himself (not necessarily in all social spheres).Then, the transition can be
administrative, that is to say that the person will try to change his identity, his first name on
the administrative documents and / or change the gender mention of the civil status. We can
also talk about vocal or communicational transition, the latter can be done in partnership with
a speech therapist or a singing teacher. It can take the form of a rather heavy surgical
operation which presents risks especially in terms of deglutition.
Finally, sometimes but not systematically, the transition can be made at the medical level,
the transition then includes hormonal treatments and / or surgical interventions (chest, face,
genitals). This latest transition aims to affirm a person’s social gender but this decision varies
from one person to another and it is important to respect it by not asking too intrusive
questions on this subject.
Part 3 : How to be inclusive in practice ?
What will particularly interest us in this part are the advice given to act in the best way in our
future profession.
These good intentions begin before the meeting, indeed we can already act during the
appointment setting. During this first contact, it is important to respect the choice that the
patient makes to contact us, whether he uses a telephone / email contact or even by text
message, it will be necessary to send him a response by this same means. By taking care to
respect this, we give the patient the possibility of having a choice, perhaps the patient is
more comfortable writing than orally and in this case he must be able to decide. Also, when
contact is made by phone, it is advisable not to use gendered adjectives (Madam, Sir). In
addition, to ask for the name and surname of the person, it is preferable to ask the following
question “Would you have a name, a first name so that I can fill in the appointment sheet?”.
This inclusive formulation avoids the person having to give the first name that is on their vital
card and therefore potentially their deadname. The person is then free to give the name they
want.
If we continue in the advice, before the appointment an important step would be the waiting
room. It is an often not inclusive environment made up of posters of all kinds, the idea is to
pay particular attention to what will be exhibited in this room. Finally, the content of the place
of care informs the patient of the subjects that he can then mention in peace or not.
Let’s now move on to the clinical consultation. First of all, the psychologist must accept being
in the dark and not knowing everything, often the patient wishes to keep a certain amount of
information to himself which can be frustrating for the psychologist but he has to deal with it.
In addition, it will be very important in the interview not to show heteronormativity and to
presuppose the sexual orientation of the person or his / her partner(s), it is the patient who
informs us. For this, the psychologist will have to accept that the patient can doubt, explore
…The psychotherapist should also pay attention to the use of the patient’s first and last
name, which may change during therapy. Finally, especially in this population, the
psychologist will have to question the consent before establishing physical contact with the
person (hypnosis session), it will be a question of establishing a proper physical distance.
Note that this list of recommendations is not exhaustive but constitutes an overview of what
can be done.
In conclusion, this evening allowed us to reflect on these emerging claims that carry a reality
we need to become aware of. We were surprised to learn so many new elements such as
the existence of a list of caregivers considered “Safe” by other members of the community
which allows individuals to feel safe in their choice of medical-psychological pathway. In
addition, hearing from people who have experienced the reality of this pathway has been a
real privilege for us. We know today more than ever the urgency of the training of the
professionals who take part in the course of care, it is essential to be constantly informed in
order not to participate in the possible exclusion of a community. Our future profession as
psychologists will bring us face to face with people presenting a certain psychological
malaise and without awareness of our patient’s difficulties it is difficult to get involved in
therapeutic care. To return to the vocabulary used by the community, we must define
ourselves as “allies”, that is, believing in social and legal equality for members of the
LGBTQIA+ community.
To know: during the year, other evenings will be organized to raise awareness and facilitate
the inclusion of members of the LGBTQIA + community. In the meantime, and for more
information, you can refer to the leaflet “For an inclusive health” intended for health
professionals that you will find below.
Words we have learned:
gender awareness = sensibilisation au genre
- inclusiveness = inclusivité
- heavy surgery = chirurgie lourde
- become aware of = prendre conscience
- speech therapist = orthophoniste
Reference:
- Pour une santé inclusive “Guide pour un meilleur accueil des minorités genrées,
sexuelles et sexuées à destination des professionnel·le·s de santé” (For inclusive
health “Guide for better reception of gender, sexual and sexed minorities for health
professionals”)
https://www.lecrips-idf.net/sites/default/files/2021-06/crips_guide-sante-lgbtqi_2021.p
df