Becoming Women: Transgendered Identities, Psychosexual Therapy and the Challenge of Metamorphosis

As a practising psychosexual therapist, working in the UK's National Health Service (NHS), I seek to position myself in this article as a reflexive practitioner working with clients moving between transgendered identities. The conceptual and linguistic tensions arising from such processes of metamorphosis seem considerable and may be exacerbated by the rigidity with which the heterobinarism of gender and sexuality is maintained within medical discourses. Recent directions taken in the work of some (primarily) feminist and queer theorists offer a different perspective, which calls for the recognition of a plurality of genders. Gender therefore becomes, superficially at least, an unstable category, whilst perhaps retaining underneath a bedrock of polarities which struggle to fit the shifting images and identities presented. I consider here the impact of these challenges upon work with transpeople and notions of gender identity - those upheld by the professional context in which I am operating; those of transsexual clients themselves and my own.