Gender Affirming Care
What is Gender Affirming Care?
Gender affirming care (GAC) is an umbrella term to describe any kind of approach that helps someone feel affirmed in their gender identity. GAC is for everyone, not just trans people. Even people who identify with the sex they were assigned at birth do things every day to feel affirmed in their gender, it just goes unnoticed because it fits in with social norms. For example, women who shave their legs to be perceived as different from men. It’s perfectly natural to have body hair as a woman, no matter your sex, and yet in our culture to have body hair is more often seen as masculine.
GAC is also completely subjective from person to person. For example, someone may be assigned male at birth (AMAB), but identify as a woman, and yet for her, being affirmed in her gender, may not mean keeping up with present day gender norms. In this example, this person may like punk, queer expressions of feminitiy for how she wants to express her gender identity, and that may include hairy legs.
So, gender affirming care is really about accessing and acting on self expression of your gender identity. It’s subjective to what that means for each person. The most involved interventions are medical options like surgery to change sex organs or hormone therapy. And again, people who aren’t trans also do this.
This is why I love working with people of all gender identities and experiences, trans or cis. Whether you’re someone going through a mastectomy because of breast cancer or a trans person firuguring out who you want to be versus how other people perceive you, we are all going through a life time of gender exploration of what it means to be a woman or man, or neither (etc.). What we thought womanhood or manhood was as child versus a teenage versus as a mother or a middle aged adult, it is very normal for our conception of self within our gender identity to change over time.
Acceptance and Commitment Therapy (ACT) with GAC
I like using ACT for folks exploring their gender because of it’s focus on values based living. By defining what it is we value in being whatever gender identity we take on, we can better move towards how it is we want to be. Values based living is also great because it’s very focused on the journey versus the outcome. We can live by our values and refocus our attention on savouring the process instead of acceptance being contingent on reaching our end goal. It’s what makes the imbetween stages of life meaningful, which is important because a lot of our life is spent in a state of being inbetween our goals.
When it comes to enjoying our gender identity, it’s also important we start practicing some relationship that isn’t just critical of our bodies before we get to our outcome goals. Otherwise, we run the risk of not feeling at home within ourselves even when we get the changes we wanted. If we don’t know what it’s like to appreciate our bodies because we’ve spent so much time locking into gender dysphoria, our dysmorphia can get really rigid and become all that we see. Sometimes, we make a lot of changes to the exterior, but struggle to appreciate or find familiarity afterwards because we’ve spent so much time in the habit of seeing what we don’t like. HRT and surgeries can shift our gender presentation, but the body that we have is still the blue print from which these changes are going to grow out of.
I’m not suggesting the pursuit of body transformations is futile. Many trans people that I know who go through body transitions experience gender dysphoria going down, and statistically this is the case with less than 1% of people detransitioning. An approach in the meantime to find greater grounding in the meantime is appreciation for neutral body parts like our lungs that help us breath. Or, strating to reframe and notice one’s self within the gender identity that you wish you saw more on the outside, with inspiration from people within the gender identity that you hold reverence for. This exploration can look like adopting styles you like and starting to wearing them for yourself in private and/or with people you know will celebrate or respond with acceptance to your presentation. It can also look like exploring people you appreciate not for what they look like but who they are, how they explify who you want to be in your own gender identity, and where you can start to notice and savour these qualities in yourself. I also explore with folks what experiences within their body can be still felt as aligned with their gender identity. I’m someone who identifies as bi-gender and over time different parts of myself that would be seen as feminine to others, feels more masculine to me and vice versa. There is playfulness in exploring what is masculine versus feminine or androgynous or neutral.
Overall, what I use as a guide with folks is not so much an emphasis on gender dysphoria but gender euphoria, and where we can build out more and more of that safety by developing a sense of self that is more than our our pain. This gender euphoria as the northern start we’re moving towards, in combination with consideration for your wants, needs, and overall wellbeing, can be a far more sustainable and workable approach.
If you’re looking to explore gender identity further or have gone through a major transition in your life that has reshaped how you see yourself in your gender identity, please feel free to reach out for a free consultation here.
