5.1 Co-occurring issues and how we view them

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A gender queer person in a hospital exam room sitting on a medical bed with medical equipment in the background.

There is empirical evidence of co-occurrence between being trans and having certain other differences and diagnoses and being diverse in other ways. To explore this further, try the next activity.

Activity 5.2: Reflecting on co-occurrence and causality

Timing: Allow 20 minutes

Part 1

A client comes into your therapy room. Over the course of the next hour, you discover five facts about him – for each fact, tick which statements you believe apply. Alternatively, you can download the accessible PDF version below.

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Discussion

This client profile is based on Alan Turing, arguably the greatest contributor to the modern computer age. You are invited to make note of the way you responded to each of Turing’s differences:

  • Did you think about what ‘caused’ Turing’s genius, or his left-handedness?
  • What assumptions are you making about what ‘caused’ his sexuality and his autism?
  • Do the answers reflect how positively or negatively society thinks about these differences?
  • When you saw all these differences together in one person, did you find yourself wondering about what linked them all?
  • If Turing had been trans, would that have changed any of your answers?

Turing is a good example of a cluster phenomenon that is just beginning to be observed – divergent people may be divergent in multiple ways. This cluster phenomenon is explored in the following reading.

To find out more about this issue of co-occurring traits, listen to this excerpt from Person-Centred Counselling for Trans and Gender Diverse People, read by author Sam Hope:

Download this audio clip.Audio player: sam_hope_book_excerpt_act5.2b.mp3
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Transcript

SAM HOPE:
This is Sam Hope reading from Chapter 5 of their book, Person-Centred Counselling for Trans and Gender Diverse People.
‘We like to connect things together. Traits that are divergent must have causes, even though nobody seeks for causes of more normative traits. It turns out that a lot of physical issues, such as migraines, ME, asthma, fibromyalgia, IBS, sleep cycle problems, coincide with the LGBTQ+ population. All these are easily dismissed as psychosomatic.
But provably, physical conditions such as joint hypermobility – being double-jointed – Postural Orthostatic Tachycardia Syndrome, or POTS, arachnid dactyl, or spider fingers, and Ehlers-Danlos Syndrome, EDS, all coincide with this population group.
In fact, many people diagnosed with fibromyalgia, ME, or simply medically unexplained symptoms have turned out to have one of these syndromes. It doesn't serve our clients if we collude with dismissive GPs in assuming, for instance, that our client's IBS is related to stress or unresolved anger rather than a genuine physical symptom.
Naturally, stress can aggravate any symptom. And as one GP once said to me, oh, well, this is psychosomatic. But when we work with trans people, we need to be prepared for a lot of divergent traits and learn to challenge the assumption we might make about them or causal links we might assume. It turns out that when human beings are divergent in one way, this increases the odds of them being divergent in another.
A number of divergent traits cluster together in the population – non-heterosexuality; left-handedness; joint hypermobility; genius; synesthesia; ME/CFS; fibromyalgia; physical conditions, like EDS and POTS; gender variance; certain facial features; dyslexia; ADHD; high sensitivity; autism; dyslexia; dyspraxia; and other body and brain quirks.
Why does this happen? We do not know. And I recoil at the idea of anyone trying to discover the cause because they might want to prevent divergent people from existing. And I believe divergence is important. Holistically speaking, even if some aspects of divergence can be difficult, I believe divergence overall benefits society.
What is important to me is to invite the reader to note their responses to each of these differences. We may not realise how we are harbouring inaccurate pet theories about many divergent traits, particularly when we see them occurring together and link them in our minds. I know I've spent a lot of time undoing my own assumptions and urges to link, for example, transness and autism together.’
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Pause for reflection

Although the reading discussed a number of different population overlaps, the autism/trans overlap is perhaps the most commonly discussed and researched (Glidden at al., 2015). Our ICTA research showed that autistic trans people often faced extra barriers to acceptance and diagnosis.

What extra accommodations might people who are both trans and autistic need in order for us to hold space for them? What does it say about how society views trans people, and autistic people, that the identities of people who are both face extra barriers and layers of invalidation?

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5 Working with the diversity of the trans community

5.2 Trans identity and sexuality