4 Creating a safe space for trans clients
In the previous sections you learned about the discrimination that trans people face and what transitioning potentially involves. This section considers how we can make the space inside the therapy/consultation room safer for trans people than the space outside.
Creating a sense of safety for clients is clearly important. Trust is recognised as a key facet of successful therapy (Allen, 2021, Fonagy and Allison, 2014) with a question on the most widely used questionnaire to assess therapeutic alliance including: ‘My therapist and I trust each other’ (Hatcher and Gillapsy, 2006). Trust helps build the therapeutic relationship, and the therapeutic relationship is one of the key drivers of therapy outcomes (Norcross and Lambert, 2019). Trust is also especially critical for any population that is marginalised as the experience of discrimination is very likely to create barriers to trust (Luchenski et al., 2018).
To begin to consider what a ‘safe therapy space’ might mean for a trans client, try the next activity.
Activity 4.1: Beliefs about trans identities
The following questions are intended as a way to support you to look directly at what you think and believe. Your answers are anonymous and will not be shared. Alternatively, you can download the accessible PDF version below.
Discussion
Arguably, acceptance is the foundation of a good therapeutic relationship (Bu and Paré, 2018). However, a therapist can accept what trans people do, in a ‘live and let live’ way, whilst still denying the authenticity, the ‘realness’ of their identities. In that regard, a therapist can imagine they are holding space for trans people while still believing they know better than them. This bias against the authenticity and legitimacy of trans identity is very common, and it can be psychologically undermining for clients.