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The Psychotherapist Association for
Gender & Sexual Diversity


  • October 24, 2018 3:27 PM | Ryan Horvath

    The Gaylesta board is troubled and vehemently opposed to the most recent memo leaked in which the Department of Health and Human Services (HHS) may attempt to impose strict gender identification guidelines that may have a devastating effect on the visibility, care, treatment and equality of transgender/gender non-binary individuals.

    Our transgender community has been under constant attack within this administration, of note, the ban on transgender people serving in our military. The divisive language, rhetoric and lies that are put out by this administration and from the President himself create a threatening environment leading to numerous mental health issues, fear, PTSD, transphobia and death. We have seen a record amount of violent transgender deaths in 2017 and this trend is not letting up this year.

    This has been a time where most marginalized minorities are under attack and keeping up with the news can be overwhelming and triggering. For those that are overwhelmed, scared and immobilized, we ask that you do whatever you can to best take care of yourselves.

    Gaylesta's board would like to support any members that want to push back against the attacks and advocate for the transgender community. We need the support and effort to fight for equality of our membership and the community at large. Whatever we can do to support our colleagues, friends and family is welcomed starting by voting on Tuesday, November 6, 2018. We join with many prominent organizations in denouncing this latest push by the administration. Several statements can be read through the links below.

    American Psychological Association

    National Center for Transgender Equality

    Human Rights Campaign

    Transgender Law Center

    World Professional Association for Transgender Health

  • June 23, 2017 6:20 AM | Gaylesta Blog Moderator (Administrator)

    by elizabeth fox butler, PsyD

    When teens come out as transgender (male to female, female to male, or any variation of non-binary), many parents are confused and rattled.

    While your teen feels relief after sharing their inner experience, parents are left dizzy with questions and yearning for clarification. Some teens believe this is a one-time conversation and they’re shocked when parents want to further explore their news. Rest assured: This is positive, no matter how perplexed you feel right now. Transgenderism is not pathological and nothing is wrong with your child. In fact, this disclosure indicates the opposite!

    If you belong to the majority and your biological sex matches your gender (also called cisgender), this can be a particularly challenging concept to grasp. Chances are you never gave your gender much thought; for the cisgender parent, it feels bizarre that your child ever questioned the gender assigned at birth.

    Most cisgender people spend life assuming natal sex and gender line up for everyone.

    The Williams Institute at UCLA estimates at least 0.58 percent of the U.S. population [1] openly identifies as transgender. The numbers are likely higher, but many more transgender people don’t feel safe to share this minority identification. They remain hidden and avoid rejection or internalized transphobia, but they suffer in silence. The current understanding of gender conceptualizes it as innate, not always aligned with natal biological sex, and gender identity is not always binary. Non-binary means some people identify as genderless and others may express variations of stereotypically male or female identities, such as masculine of center lesbians. Note, however, that the flexibility inherent in seeing gender as a non-binary spectrum is not equal to your child’s identity being “a phase” and most transgender people, even those who seem hesitant at first, become even more certain of their transgender identity over time.

    You have a huge window of opportunity to make this a positive experience.

    No matter what, your child telling you about their transgender identity is a very good sign! Your child obviously feels safe enough in your relationship to share this secret, which they probably kept from the world for a long time. But it is crucial to handle this sensitive period with care. Until you have further conversations with your teen, investigate your own feelings.

    As your first step, your best option is to talk with others instead of your child. There will be plenty of time to explore further with them later. It makes a huge difference to initially reflect on your concerns, ask yourself the important questions below, investigate any negative internal reactions, sort your thoughts into a coherent narrative, and process with another trusted gender-knowledgeable adult. Then you will be ready for productive discussion with your child.

    Begin your exploration by asking yourself these questions.

    Make note of your own additional queries as you reflect. Dedicate time to write out your responses and share them with other transgender knowledgeable adults.

    1.             How can I validate my teen? And how will affirming my child’s identity connect us?

    2.             Does this worry me in some way? If so, what are my concerns?

    3.             How will expressing my worries impact my child? Might my child misinterpret my worry for disapproval?

    4.             How can I talk to my child without contradicting his/her/hir/vis/their [2] needs?

    5.             Do I doubt my child? What makes it hard to trust them? What would it mean to me if they changed their mind later?

    6.             What prevents me from embracing my child’s gender identity? Will my child’s expressions (e.g. clothing, haircuts, chosen name) actually harm anyone?

    7.             In what ways have I internalized societal norms? How could it hurt my teen to impose these expectations on them?

    8.             Am I resisting this change for personal reasons? Am I confusing my individual worries and reactions with the idea that “something is wrong?”

    9.             How do I reframe this so it’s not a problem, but just a fact?

    10.          Have I ever felt unaccepted by the majority? Can I use this shared experience to better understand my child’s process?

    It’s important to talk to at least one well-informed person - and preferably multiple people -  who are active in lesbian, gay, bi-sexual, transgender, queer, questioning, intersex, asexual or agender, and 2-spirited (LGBTQQIA2S a.k.a. LGBTQ+) communities.

    If no one lives nearby, seek virtual or email contacts through organizations on the frontlines of transgender advocacy. See [3] and [4] below.

    It takes a village to raise a child (and many villages need a mental health professional).

    Even if you don’t live in the Bay Area, many regions now have LGBTQ+ specific directories similar to When you search for a mental health professional, actively avoid anyone who uses “reparative therapy” or “conversion therapy,” as these practices are unethical, illegal for minors in California, and harmful to your child.

    For more immediate tips on responding to and talking with your teen, visit’s parenting and family page [3]. You can also find a helpful glossary of sexual orientation- and gender identity-related terms via PFLAG [4].

    Dr. Elizabeth Butler has a private practice in Pleasanton, where she helps teens and adults in the LGBTQ+ communities overcome anxiety, improve their self-esteem and overall wellbeing, and heal long-term relationship conflict. If you’d like to learn more, call 925-421-6860 to schedule a free 15-minute initial phone consultation or visit [5].






  • June 08, 2017 8:29 AM | Gaylesta Blog Moderator (Administrator)

    Everyone likes to be pleased. And we all of us put out vibes to others letting them know how it is they can please us. Some of us are very susceptible to the vibes put out by others and we fall into a pattern of succumbing: we give others whatever they seem to us to want from us to make their lives easier.

    This people-pleasing pattern harms us. Without fully realizing what we are doing we will unquestioningly give others the results they wish. In doing so we may suppress or not even bother to ascertain our own feelings and inclinations, from which we become detached. We do this with our parents, our spouses, our children, our friends and also in business negotiations. When we are selling a house or car we accept an offer that is lower than the price we might have obtained. When we are buying we pitch our offer higher than we might have done to avoid upsetting or offending the seller.

    But the monetary cost to us of people pleasing pales into insignificance beside the psychological cost. The suppression of our own feelings and inclinations, our own needs and welfare, builds inner tension and affects wellbeing. The accumulated stress is evidenced in various ways. We may be chronically anxious or depressed and we may exhibit defensive behaviors including irritability, process addiction (for example, compulsive shopping) and self-medication with alcohol or other substance.

    Underlying our pattern of people pleasing are early family experiences from which we concluded that it is of vital importance to us to keep other people happy. The idea of making someone upset or angry fills us with dread – although we may not be fully conscious that we have these cognitions and that they govern our behavior.

    The work in psychotherapy of bringing to consciousness and exploring these cognitions, those memories and that dread releases us from the people-pleasing pattern.

    Emerging from people pleasing feels like emerging from a dark cave into the light. It feels like growing wings. New possibilities – never before available – present themselves. We offer the price we are prepared to pay for the commodity we wish to buy. We tell our friend that we wish to have dinner at 7 o'clock and not at 8. Curiously, when we do these things, we do not provoke the anger of the seller or lose the love of our friend. It feels as if we have entered another world. We had, as usual, forearmed ourself with that slight, almost imperceptible inner tension we experience when we think we may be asking someone for something the person does not wish to give us. We find, initially to our surprise, that we didn't need the anticipatory tensing.

    As we experiment further with new, more adaptive behaviors in explaining our position or asking for what we need, we grow more accustomed to others' positive response. We experience the anticipatory tensing less and less: the other person is not angry or upset and is responding to us in a way that suggests our relationship is as strong and cordial as it was before we made the request or offer or explained our position.

    As we emerge from people pleasing we discover that our environment is very well able – much more so than we ever before dreamed – to tolerate our expression of our feelings and needs. What we want has equal validity to what others want and is experienced by others as perfectly reasonable. If what we want and what others want are not quite the same thing, we are able to negotiate calmly and fairly. We are free from the crushing burden of having to subordinate our self to others' preferences. We have finally come into our own.

    People-pleasers are disempowered individuals. The foregoing description accurately delineates the path to and experience of empowerment.

    Peter Geiger

  • June 08, 2017 8:16 AM | Gaylesta Blog Moderator (Administrator)

    How do I know if my loved one is addicted?

    People often tell me about a loved one's drinking or drug use, and then they want me to decide if their loved one is an addict or alcoholic. I respectfully suggest that they can answer that question themselves by asking several other questions:

    ·       How is drinking or drug use impacting the loved one's life?  How is it impacting others?

    ·       How is their health? Their job? Their schoolwork? Their family relationships?

    ·       Have they developed new friendships and left old friendships behind? How's that working?

    ·       Do they have legal problems associated with drug or alcohol use?

    ·       What is their attitude about their lives?  Angry? Sad? Argumentative?

    When you consider these questions, write down your thoughts - positive and negative - on paper. That can give you perspective and provide support as you objectively assess just how well life is working for your loved one.

    And here's the question I get most often: Why don't they just stop drugging (or drinking)? It's because addiction/alcoholism is a primary, chronic disease of the brain’s reward system, which profoundly affects their motivation, memory and related circuitry. It is considered a brain disease, rather than a disease of character or will power.

    Addiction/alcoholism is characterized by the inability to stop drinking or using drugs in spite of negative consequences like poor grades, expulsion, DUIs, and family issues. It is a physical disease, NOT a disease of character or willpower. And it's a disease that cannot simply be “loved away”.

    Without treatment or involvement in recovery activities, addiction is progressive and can lead to disability, premature death or involvement in illegal activities and incarceration.

    Through treatment, people can learn to live healthy lives free of alcohol and other drugs. They can reclaim their lives, their families, their work and their health. And that's the best answer of all.

    Scott Henrywestwood

  • June 08, 2017 8:09 AM | Gaylesta Blog Moderator (Administrator)

    Prospective therapy clients in the San Francisco Bay Area are among the best-informed people anywhere in the world. Counseling and therapy have been embedded in the cultural landscape for decades. But too much information can be bewildering. Especially since there are many different kinds or theories of counseling and therapy and people seem to feel quite strongly about them.

    The dominant paradigm for helping people with problems used to be psychoanalysis. After WWII things began to change. There were many more people looking for psychological services and most of them did not fit the profile of the ideal candidate for analysis: for one thing analysis is expensive in time and money; for another there were too few analysts. At this time people began experimenting with new ways of doing talk therapy. The great theoretical pioneers of the second part of the 20th century were mostly trained in psychoanalysis and operated in a context in which psychoanalytical constructs were part of the background. Fast-forward forty or so years. The dominant paradigm for helping people with problems is now cognitive-behavioral therapy or CBT. A dominant paradigm always provokes reactions and thinkers and researchers are now reacting to CBT in the same way as, four or five decades ago, they reacted to psychoanalysis. New ways of doing therapy are springing up.

    So what do you do if you are looking for a therapist? Some clients decide on the kind of treatment they want: "I'm looking for Gottman couples therapy." Some decide on the kind of clinician they want to work with: "I want a woman, older, but not too old, and really smart." Some prospective clients come with experiences they feel they want to see reflected in their therapist: "I'm gay/straight and I want a gay/straight therapist." "I'm a divorcing heterosexual woman of color and I want to see a nonwhite female therapist with experience working with divorce and eating disorders." All these ideas are sensible. The person looking for therapy is anxious and these ideas give some reassurance, feelings of certainty and of being in control.

    But they do not predict how therapy will in fact turn out. It's probably true to say that if we can predict how our therapy will turn out, we can figure things out for ourself and don't need to be in therapy.  Your CBT therapist will inevitably deviate from the CBT model at some point and work psychodynamically with you. Your Gottman clinician will also use other methods. Your therapist experienced in your issue might at some point feel to you like she doesn't get it. If this happens, it's important you and your therapist talk about it.

    When choosing an eye surgeon we can research techniques and procedures and come to an informed decision. It is much harder to do this if we are about to enter therapy and when we are worried and perhaps under intense pressure. Here are some guidelines. Researchers such as Bruce Wampold and Zac Imel believe that, when it comes to therapy modality, it doesn't much matter which therapist you choose. We are all trained to work with all kinds of clients having all kinds of problems. We all make clinical choices to switch between goals-based ways of working (such as CBT strategies and sequences) and process-based ways of working (such as uncovering and working through feelings). Good therapy is good therapy irrespective of its label. But some therapists are more skilled than others, Wampold and Imel believe, and remain so over time. So the most important therapist attribute is that she or he be a good therapist. Choose someone whose office is easy for you to get to and use your gut instincts to guide your choice. Good luck in your search for a clinician and please email me if you have any questions.

    Peter Geiger

  • June 08, 2017 8:02 AM | Gaylesta Blog Moderator (Administrator)

    Sometimes it is hard to feel the passion needed to "get things moving" in one's life. It can be hard to understand the signs of mild, or on-again, off-again depression. The symptoms are often subtle, but definable.  Do you know of someone who has had any of the following symptoms: Lower energy or lack of motivation? Sleeping too much - or too little? Feeling down on oneself - or having self-esteem issues? Poor concentration? An empty feeling? Everyone feels a bit blue now or then, but this is different.

    Dysthymia is a mild, chronic form of depression that one might not even know one has, because it has come to be the norm. Also, one might feel motivated for a few days here and there - but not predominantly. Please feel free to contact me if you think you or someone you know might be experiencing a mild depression. There is so much that can be done.

    Cheryl Deaner

  • June 08, 2017 7:54 AM | Gaylesta Blog Moderator (Administrator)

    In this article I will explore two strands of the “straight safety net”—heteronormative assumptions and heterosexual privilege—and how these create often unacknowledged stress for queer couples. Following are three different scenarios from my sessions with queer couples that exemplify some of these common stressors.

    1) Yvonne & Angela: How homophobia ruined our romantic vacation

    After I asked a lesbian couple why they hadn’t taken a vacation together in five years, this is what they told me:


    I took her on what was advertised as a “gay-friendly destination” but as it turned out, we were the only queer couple in sight! Consequently she was really paranoid in public and wouldn’t hold my hand on the beach or became really uncomfortable if I suggested a restaurant that looked slightly romantic. She’s a butch woman, so people were staring at her anyway because they couldn’t quite place her on the gender spectrum. It pretty much killed the romance factor out in public, and unfortunately it translated into the bedroom as well. She just couldn’t make that transition when we were alone. It was as if she didn’t take a breath until we got home. Needless to say, we haven’t been on an overseas vacation since!


    I think on some level I just didn’t feel safe. I didn’t speak the language or know the people. They stared at me all the time. I think they couldn’t figure out if I was a guy or a girl. It might sound ridiculous, but I was expecting to be attacked at any moment. Consequently, my guard was up at all times.

    This couple had to deal with a whole set of stressors that a heterosexual couple would probably never need to consider when planning their holiday (like having to find a “heterosexually-friendly destination”). So much of the travel industry is geared towards the romantic getaway, but those getaways are mostly aimed at heterosexual couples. This omission of queer couples is part of what is termed “heteronormative assumptions.”

    [Heteronormative assumptions] refer to automatic unconscious beliefs and expectations that reinforce heterosexuality and heterosexual relationship as the ideal norm. Thus, heteronormative assumptions create a society where only heterosexual relationships are visible (McGeorge and Carlson, 2011).*

    Although the travel industry has become savvy to a whole previously untapped market and there are now ads for gay-friendly destinations on every queer travel site, the truth is that this can also be a marketing ploy. As Yvonne and her girlfriend found when they got to their “gay-friendly” destination, the locals hadn’t been informed!

    2) Gloria & Maria: A pregnant lesbian couple’s first birthing class together


    I was so uncomfortable that we were the only queer couple in the room! On top of that the trainer had us do an experiential where she asked the fathers to go on one side and the mothers on the other. She at least corrected herself when she saw me standing there awkward and alone. I felt so humiliated!

    The rest of this session was spent processing Maria’s feelings about the class and her ambivalence toward attending more classes. Although Gloria was sympathetic to Maria’s dilemma, she was also clear that she wanted Maria’s support at the birth and needed to know that Maria had the knowledge to provide it. In the end, despite the stress the first class had caused, they did go back for another class and found to their delight that there was a new trainer who was much more GLBTQ savvy and aware. What a relief!

    Again, these are not stressors a heterosexual couple would ever have to deal with. Being part of mainstream culture, it is easy for heterosexuals to take for granted the safety net that is automatically available. This is part of what is coined as “heterosexual privilege.” Furthermore the lack of affirmative mirroring that queer couples receive has both subtle and gross implications. “One of the less visible, but potentially most influential privileges that heterosexual individuals receive is an increased self worth that comes with being part of the dominant socially sanctioned group” (Hoffman, 2004; Worthington, Savoy, Dillon & Vernaglia 2002). When who you are and how you love is not reflected in your world, whether on TV, in films, books or other forms of mainstream media, the effect on self-esteem is persistent and corrosive, once again creating more stressors for queer couples

    3) Disturbing comments from well-meaning family members

    Even family members who are normally respectful toward a gay couple can fall prey to heteronormative assumptions. The following occurred during a session with a gay couple, one of whom was unemployed and looking for work. He had been offered a position overseas but had decided to turn it down because it meant being too far away from his partner.


    Can you believe my Dad encouraged me to take that job in Singapore with no regard for how it would affect my partner who has a full practice here? It was as if he saw me as a single man, living with “a good friend,” but certainly no one to consider if I was being offered employment overseas. He would never say that to my heterosexual brother and his wife!


    Your dad is always friendly to me when he sees me but hearing that makes me feel invisible.

    Mike’s father was unintentionally hurtful by omission. The undermining quality that this lack of mirroring creates has a corrosive effect on self-esteem. Mike is left with the message that his relationship is less visible, less valid, and less valuable than his heterosexual brother’s.

    In summary…

    When I hold space for a queer couple in session, I am also considering factors outside the couple dyad, such as the effects of heteronormative assumptions and privilege that can exacerbate existing stressors in the couple. For instance, Gloria and her wife have all the stressors of being pregnant but not the knowledge that they are seen and held in a supportive community. Yvonne and her girlfriend finally find the time and money to take a vacation together only to discover they have to keep their guard up and don’t feel safe enough to express their affection and love for one another. Then, there is Mike having to deal with the crushing effects of unemployment on his self-esteem, only to have his father exacerbate this problem by unintentionally disregarding his long-standing partnership.

    Queer couples simply don’t have the safety net that heterosexual couples can take for granted. The society at large does not provide the validation and affirmation that a queer couple could rely on for support during difficult times. The need for this validation and affirmation first has to be acknowledged by the individual or couple and then self-generated. While many queer couples have been very resourceful in generating their own safety nets by building their own communities and support systems, the freefall, in terms of the stigma of being an outsider and the resulting isolation, is ever present for those who do not.

    *McGeorge, C. and Carlson, T. S. (2011) Deconstructing Heterosexism: Becoming an LGB Affirmative Heterosexual Couple and Family Therapist. Journal of Marital and Family Therapy, 37(1), 14-26.

    Ondina Nandine Hatvany, MFT