Friday, 11 April 2014

Interview with Jessie Jacobson

Monika: Today it is my pleasure and honor to interview Jessie Jacobson, an inspirational woman from New York and 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 honored 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 certain 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.

Over the last couple of years at LAGLC, and after I transferred to private practice in 2008, first in Los Angeles and more recently in London, I focused more exclusively on working with trans clients, my reasoning being that there are a lot of LGB therapists out there these days but still relatively few trans therapists.
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 behavior therapy along with other systems such as humanistic, transpersonal, and one of my personal favorites, 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, cisgender, 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 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 a 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 the 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 for a consciousness-expanding experience for the students.

Jesse and her wife, Sonja.

Monika: What are the new trends in psychotherapy for transgender persons?
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.
Monika: What is the most challenging part of your job?
Jessie: I think any therapist has to constantly be vigilant about not projecting their own belief systems or personal history upon their clients and to never attempt to dictate an “appropriate” course of action rather than soliciting and/or teasing out the client’s own solutions. Transference and counter-transference also require constant scrutiny. I authored a pamphlet about a decade ago entitled Counter-Transference, for mental health professionals, that dealt specifically with this issue.

Jessie near the Thames in London.

Monika: At that time of your transition, did you have any transgender role models that you followed?
Jessie: I’m not sure I would call any of the transgender men or women who influenced me “role models” necessarily, only because I have a bit of an aversion to the term itself. When I was young, I was only aware of Christine Jorgensen and Renee Richards, both of whom I was so impressed by. When I began at LAGLC, Daniel Gould, a social worker who co-led the trans men’s group there was a big influence early on in my transition.
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!
Monika: What was the hardest thing about your coming out?
Jessie: When I made the decision to come out, while I anticipated shock and significant adjustment from family members, my big concern was how I would be perceived and treated in graduate school, the workplace, and the world-at-large. After all, most of my family members were fairly liberal and open-minded and I had mapped out a “textbook” coming out plan.
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.


All the photos: courtesy of Jessie Jacobson.
© 2014 - Monika Kowalska

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