Monika: Today it is my pleasure and honour to interview Jessie Jacobson, an inspirational woman from New York & Los Angeles, now living in London, United Kingdom, a specialist in psychotherapy and private counseling with a focus on transsexual, transgender, intersex and other gender-variant individuals; in addition to lesbian, gay, bisexual and heterosexual clients. Jessie also lectures on trans issues and therapy and has taught graduate psychology courses in Human Sexuality. Hello Jessie!
Jessie: Hello Monika. I’ve seen your site and have found the interviews both educational and enjoyable. I really appreciate what you’re doing and am honoured to participate.
Monika: Could you say a few words about yourself?
Jessie: I identify as a woman or a transwoman. I’m not too bothered about specific terminologies although there are certainly names and terms I would prefer not to have applied to me. I believe all of us should be free to choose the terminology for ourselves that we believe is most suitable, and that none of us should attempt to assign terminology to others. I transitioned somewhat late in life despite knowing since as far back as I can remember that I identified as female rather than male.
I have been very fortunate in my transition in that every aspect of my life has improved post-transition. The process wasn’t easy but very fulfilling and unexpected in just about every way. My now-wife and I had to move away from my home country, the U.S,. twice owing to discriminatory anti-same-sex marriage policies and anti-gender-identity recognition policies, which have fortunately changed over the past few years, at least in the U.K. and U.S.
Monika: What is the average person coming to you for help?
Jessie: When I began my training in 2002 in L.A. at the L.A. Gay & Lesbian Center, it would have been difficult to describe an average client, because when starting out as a trainee intern at a non-profit, especially at an organization (the largest LGBT, etc center in the world) that so values diversity, you work with an incredibly wide-range of clients.
I have seen clients that have ticked one or more of the boxes that make up LGBTQITSLFAA, and more, not to mention hetero/cisgender clients that come to LAGLC simply because of their reputation as a respected mental health clinic with sliding scales on a pay-what-you-can basis. The diversity continued in terms of ethnicities, religious/agnostic/atheistic backgrounds, age, political beliefs and beyond.
|Jessie at Windsor Castle.|
And, while in no way would I ever suggest that a non-trans therapist cannot work effectively with trans clients; I think it would be equally true to say that in terms of shared experiences and seeing the world through a “trans” lens, an effective, experienced trans therapist will have some advantages in terms of working with trans and gender-variant clients. So my average client in recent years would tend to be trans or gender-variant though I remain open to working with all clients and continue to do so.
Again, factors such as age, ethnicity, etc. vary greatly from client to client as the trans/gender-variant community is incredibly diverse with often the only common experiences being the fact that the clients are trans and in most cases must confront not only their own self-image and beliefs during their process of self-discovery and self-realization, but those of the people around them, both known and unknown; the latter whether they would prefer to or not.
Monika: Which diagnostic framework do you apply during your therapies?
Jessie: I am a confirmed eclectic in this regard. The nice thing about studying at Antioch University, Los Angeles (psychology graduate school) and doing my traineeship, interning and eventually working at LAGLC, is that there was/is no one framework stressed over any other.
Certainly, when working in limited time therapeutic relationships (when I was there, LAGLC limited the course of therapy to 6 months except for up to 20% of the clients, who at the therapist’s and supervisor’s discretion were allowed to be seen for a longer period depending upon need and circumstances), elements of Brief Therapy, Cognitive-Behavioural and the like (Rational-Emotive) inevitably come into play owing to those very time considerations.
Long-term psychoanalysis or working with floridly psychotic patients is not within the purview of the Center’s mission statement but that does not prevent individual therapists from incorporating aspects of psychodynamic, family systems or dialectical behaviour therapy along with other systems such as humanistic, transpersonal and one of my personal favourites, narrative therapy.
When working with such a marginalized, misunderstood and often ignored social group, I do feel it is central to look deeply at the role of the individual in society and focus upon the challenges the constructs of the overarching patriarchal, cisgendered, hetero-normative social narrative place upon those who are different in terms of both their gender identity, gender presentation, and, often, their sexual orientation(s). I do not believe there is any one type of therapy that works for everybody and I feel this is particularly true in terms of trans and gender-variant individuals as well as LGB-identified people.
Monika: As both a transsexual woman and a psychotherapist, you are probably more aware of the many issues surrounding gender identity, sexual orientation, coming out, transition and related concerns…
Jessie: Having experienced all these issues in the course of my own life and transition, being married to another transwoman and having trans friends and associates has certainly added a level of experience and empathy that most non-trans therapists are not exposed to. After working with hundreds of trans clients in diverse settings, as well as experiencing the therapeutic dyad from both sides of the relationship, I think I’ve been fortunate to reach a rarified level of both personal and professional experience in this regard. I think this applies equally to group, couples and family therapy.
Group therapy for both trans men and trans women, in my opinion, is an essential part of the process, and while there is more resistance initially to joining a therapy group, many of my clients have continued with group long after individual therapy concluded. Having been in a trans group myself in the early stages of transition, I felt fortunate to be involved in starting the first transwomen’s therapy group at LAGLC in 2002.
While I do feel qualified to speak on most LGBT, etc.-themed topics, certainly my specialization is with trans and gender-variant clients, and it is in this area that I focus my lecturing and consulting work. I’ve also taught graduate psychology courses in Human Sexuality, which has been a remarkably educational and emotional privilege for me, and I certainly hope a consciousness-expanding experience for the students.
|Jesse and her wife, Sonja.|
Jessie: I’m not sure that there are specifically any new trends given that trans and gender-variant oriented programs remain few and far between and the community continues to be marginalized and under-represented in terms of research or direct input in terms of the governing bodies of psychology and psychiatry.
Pathologization seems to remain the dominant mode of the medical and psychiatric governing bodies when it comes to categorizing and “treating” trans/gender-variant clients/patients. Yes, the DSM-V has finally jettisoned the demeaning, dehumanizing Gender Identity Disorder diagnosis and replaced it with the medically-approved Gender Dysphoria, yet it is still categorized as a disorder and continues the systemic stigmatization of “non-normative” gender identification and gender presentation.
Additionally, Transvestic Disorder is still included in the DSM-V under the category of Paraphilic Disorders, alongside such other diagnoses as Pedophilic Disorder, Exhibitionistic Disorder, Frotteuristic Disorder, Sexual Sadism Disorder, Fetishistic Disorder and Sexual Masochism Disorder, all of which impact upon others with the exception of Transvestic Disorder (and certain aspects of S/M & Fetishistic) – precisely what sort of message does this impart to the world-at-large, let alone the clients?
Fortunately there is a growing body of trans/GV-positive literature emerging in the field of psychology and the internet has had a strong impact on education and awareness. Things have certainly improved as regards treatment for trans/gender-variant clients in the medical, psychological and psychiatric fields but they also still have a very long way to go.
Monika: Do you assist transgender persons how to come out to family, friends, and at work?
Jessie: Yes, coming out is an essential focus in all types of therapy – individual, couples, group and family. Everybody’s process differs in numerous ways so it is important to personalize it according to both the client’s belief system(s) and often the other people in the client’s personal and professional life. It is always so valuable to find both trans and non-trans allies that can offer support and understanding during the coming out period, and while therapy should absolutely never be a required process, I do believe it can alleviate a large part of the burden inherent in many transitions.
A non-trans but trans-allied therapist I know, Christine Milrod once said that instead of the term GID (Gender Identity Disorder), the official diagnosis for trans/gender-variant people coming out should be OPD, or Other People’s Disorder, in the sense that most of the negative input that impacts the coming out process comes not from the trans/GV individual but from those around them, many of whom prefer to “blame the victim” rather than take responsibility for their own prejudices and negative reactions. Non-trans/GV folks often have no understanding of how long the trans/GV person coming out has struggled with their own internal fears, beliefs and prejudices before revealing their true selves to others.
So in some ways, each person one comes out to can, particularly in the early days, feel like one is going through the entire process all over again, almost in a Groundhog’s Day manner. Often in work situations, the best way to come out can be to inform the Human Resources department and one’s immediate superiors prior to coming out to the workplace staff as a whole, in order to assure that the overall process is handled appropriately.
Also, when coming out, I always try to discuss with clients the potential pitfalls of making assumptions about the reactions of family, friends, co-workers or the general public. It’s important to allow for both pleasant and unpleasant surprises from individuals that differ from one’s assumed understanding of that person. You don’t want to be pre-judging their reactions while asking them not to pre-judge your revelations, not only for fear of self-fulfilling prophecies but also so as not to come off too defensively in your sharing and revealing.
|Jessie near the Thames in London.|
My first television appearance was with Calpernia Addams and she was quite supportive and articulate so that left a big impression on me. As for other trans folks I’ve never had the privilege to meet in person, I hold the utmost respect for Wendy Carlos, Patrick Califia, Kate Bornstein, Jayne County, Jamison Green, Jan Morris, Sylvia Rivera, April Ashley, Shannon Minter, Leslie Feinberg, Candy Darling, Caroline Cosey, and too many others to remember here!
Well, so much for assumptions. While I was immediately able to find a clinical placement following grad school, at LAGLC, and subsequently a job there; with the notable exception of my paternal aunt, my step-brother and step-nephew, it was my family that proved the much more difficult challenge. However, most of the damaged relationships were repaired over time with a lot of work and even more education. My friends were generally very accepting.
However, the old guard will have to hand over the baton sooner or later to doctors and administrators with a more normalized and diversified perspective on what defines gender, sex and identity, meaning stereotyping and “gatekeeping” methodology will be replaced by something more fluid and individualistic. I’m a big supporter overall of the NHS and am therefore very acutely aware of its failings in this area though there have been some improvements. They can certainly learn something from the politicians and legal system in this regard.
Monika: Could transgenderism be the new frontier for human rights?
Jessie: Absolutely and it has been for a long while, although admittedly overshadowed by the larger LGB communities. The past decade has seen a remarkable amount of change although it’s really only the tip of the iceberg.
Some of the changes have been as part of the LGBT, etc. umbrella (same-sex marriage) but others, and I’m thinking of things like the changes in passports in the U.S., U.K. and some European countries and the effects those have had on immigration and travel concerns. The U.S. has a long way to go in terms of states’ (and further federal) rights for trans/gender-variant people, and when we look outside of parts of South America and Europe, the picture still appears very grim.
Monika: Are you active in politics? Do you participate in any lobbying campaigns? Do you think transgender women can make a difference in politics?
While I sign petitions and sometimes contribute to the debate in terms of political issues and campaigns, my primary interest has been focused on educating the psychological, psychiatric and medical professions in terms of trans awareness. I’ve lectured at universities, high schools, mental health facilities and non-profits as well as in the press, and on radio and television. Working at LAGLC opened me a lot to the sociopolitical aspects of my chosen field and I hope to more actively participate in the future.
Seeing a psychologist or psychiatrist is not an admission of there being something wrong with being transgender, simply a practical and direct means of dealing with the difficulties, both internal and external, that come with coming out and transitioning. Obviously, a trans-aware therapist is always going to be the way to go if you can find one where you live.
Also, the internet, if utilized correctly, can be a remarkable tool and there is a lot more high quality literature on the subject out there now than there was a decade or two ago.