I came to this work when a loved one came out in the early 1990s and began the long transition before most therapists understood gender dysphoria and Internet access to solid information did not yet exist. For her, the risk of career loss was high, the emphasis on “passing” and neatly disappearing anonymously into a binary, strict male or female world was deemed essential to avoid stigma, and no insurance plans paid for any of the huge medical costs or transgender care that could attain this.
My loved one was able to grasp the brass ring, affording medical costs by cashing in her retirement savings, while enduring a stressful ‘proving ground’ environment at work that demanded her complete ability to remain undetected, also called “going stealth.” She has the good fortune of ‘passing’. (but what she hadn’t during those repressive times?) Today she thrives, proving that gender dysphoria is not indicative of a character, psychotic, or sexual disorder, and that a civilized society must and can be taught to have compassion for those it has not understood.
Today more insurance plans cover the costs of genital surgery, and most cover hormone therapy and psychotherapy. In Colorado, the law forbids transphobic actions by employers and landlords. Two Colorado medical institutions offer gender-affirming surgeries: Denver Health and University of Colorado Health (UC Health).
Many gender dysphoric people need to make the transition but know they will never ‘pass’ even with expensive facial feminization surgery (FFS), state-of-the-art masculinizing genital surgery and decades of hormone therapy. They face the dilemma of living authentically and carrying themselves with dignity in the face of social stigma. Not everyone wants to or can live “out and proud.” But Western society is maturing in its ability to accept and understand transgender and gender non-conforming people–aided by the coming-out stories of celebrities like actor Laverne Cox, film director Lana Wachowski (The Matrix) and others. My philosophy of transgender care includes helping clients see their presentation accurately, and “toughen their emotional skins” adequately while experimenting with taking their privately-lived gender expression out into safe venues. The Transgender Center of the Rockies and the GLBT Community Center of Colorado both are great resources. The Standard of Care of WPATH advises this gradual adjustment to living publicly in one’s true gender, before genital sex surgery is recommended.
My role is to assess, offer counseling, and recommend my clients for hormone therapy and/or surgery, helping them know the risks and benefits and without unrealistic ideas about how their lives will and will not change after transitioning. I help clients to thrive in the world, with good self-esteem and coping skills when ‘read’. Transgender people must be realistic about the real risks. And they must find community to become strong enough and wise enough to live in society proudly and successfully. They have ultimate decision-making power about living ‘out’. I have worked with 1000s of transgender clients, for as little as a few months, to as long as several years in many cases, until we reach your goal.
Meanwhile, I advocate for society’s acceptance of people who do not look like the “gender-normative” cisgender person. My dissertation work in developing interfaith pastoral responses to transgender people of faith aims to update religious clergy’s pastoral theology to accommodate biological facts about gender diversity and dysphoria. Religious leadership shapes public perspective and politics of even secular society’s treatment of human beings, also made in God’s image: for the Bible says, “male and female God made them,” not “or.” Clergy and theologians must become responsible to understand the science and the proven treatments for gender dysphoria. Religious authorities should feel morally bound to update doctrine about human beings with accurate knowledge from the human sciences. Pastoral teachings must catch up with spiritual wisdom about the sanctity of the person, including those who may require alterations of the body in order to live in peace.
I work with transgender people and their families and spouses as needed. I understand the need for expert assessment and support when medical and social transition is the best route to psychological (and when clients ask, spiritual wholeness as well: I am also a trained pastoral/spiritual therapist). I provide consultation to therapists, psychologists and psychiatrists with transgender clients, according to the Standards of Care of WPATH, of which I am an active member. Please visit About Dr. Thor for more information.