Loss and GriefPrinter-friendly version
When I was 39, my then-partner came out to me as trans, saying, ďIíve always felt like a man inside, and if I had the money, Iíd have an operation tomorrow.Ē I had not yet realized consciously that I had gender issues of my own, and this remark began a process of my coming to realize who I was. Along the way, I had to give up everything that had been important to me and learn how to grieve losing all my identities while not yet knowing who I was becoming, or whether it would all feel worth it in the end.
I came to realize, through my own process and conversations with other trans people, that there is a substantial element of loss and grief involved in transition, as well as excitement and relief at developing congruence between mind and body. However, I also came to realize that the therapy profession often does not adequately address the loss and grief component of transition.
In fact, I have heard several trans people say they were afraid to tell their therapists any feelings they were having of loss or grief, for fear they would not be allowed to transition. The fear was, ďIf I tell my therapist Iím having feelings of loss or grief, the therapist is going to think Iím having second thoughts, or that maybe transition isnít right for me, and will block my process. So Iíll pretend Iím 100% excited about this and not having any negative feelings at all.Ē (Fortunately, this was not my experience with therapy, but I was one of the lucky few who see therapists experienced with gender identity.)
Not only were these trans folks afraid to tell their therapists of their feelings, they did not often tell other trans people, either. Not knowing others were feeling similarly, each seemed to fear that their feelings were abnormal or wrong in some way, that they were not ďsupposedĒ to feel this way. Some wondered whether having such feelings did indeed mean they should not transition.
However, therapists have long understood that supposedly-happy events, such as the birth of a long-anticipated child, or a marriage between two people who love each other, always carry with them a component of loss. Any change involves letting go of what was, to make way for what will be. Making room for the new spouse or life-partner involves giving up the ability to be spontaneous and carefree, answerable only to oneself. Making room for a child entails taking on full responsibility, 24/7, for the development of another human being. Joyous, yes, but also a huge change from the life of the child-free individual.
What does the trans person give up in transitioning? The list is complex, and touches on every area of life. While trans people donít feel at home in their own bodies, nevertheless, there is a certain comfort in knowing what is expected of one in terms of gender role. The trans person may have chafed at that role, but giving it up is a venture into the unknown, and is scary! Loss of familiarity, the ability to live on autopilot, is one common feeling among trans people.
Another loss, the most major, involves relationships. Depending on circumstances, a trans person may lose all, a few, or no friends and family members because of transition. However, every relationship changes profoundly Ė every relationship transitions. Hence, the trans person must let go of every previous relationship and allow it to morph into what it will become in the future.
There may be elements of the trans personís old life that will not be present in their new gender role, which must be let go of entirely. For instance, I sang in a lesbian chorus that was the center of my life. I had to let go of the chorus in order to transition. This was very difficult, as I had no way of knowing beforehand whether I would have as good a bass or tenor voice as I had as an alto. And regardless of vocal quality or range, the lesbian chorus would no longer be the place for me as a singer. I lost the chorus, though not the individual friendships Iíd developed among its members.
As a therapist, part of my work with trans clients is helping them understand that feelings of loss and grief are not just common among trans people, but are part of the process of transition. Identifying the feelings, talking them through, bringing that process into the therapeutic setting, is a key element in transition. Repressing the grief process merely prolongs it, making it difficult for trans people to truly let go of the past in order to fully embrace the future.
Iíve known trans people who have committed suicide after a seemingly-successful transition, and I canít help but wonder after the fact if there were feelings of loss and grief, bound up with transition, that they had never felt free to verbalize to anyone. Iíve known other trans people who have changed their minds after transitioning, and gone back to living their previous gender role. While I canít know for sure, I suspect not giving voice to their feelings of impending loss or grief may have prevented them from fully accepting the magnitude of change they were undertaking.
I tell clients, ďExpect change. You canít always know in advance what the changes will be, what direction your life may take, but you can know in advance that nothing is fixed.Ē I also normalize for them the idea that change involves positive feelings as well as feelings of loss, hoping that clients will then feel free to bring all their feelings into session, not just the ones they feel will be acceptable to me.Back to top of page