Phantom sensation is the neurological phenomenon that causes a person to feel a body part that is not materially of their body. Our panel explores the common phenomenon of phantom penis in trans-masculine people from several perspectives. Many experience phantoms as an elated access to a real self, but they may also encounter dysphoria, despair, and even pain. How might we enhance the phantom experience with and without bottom surgery? What roles might medical and mental health providers need to play in facilitating such processes?

SJ Langer will discuss his theories related to interoception, body image/schema, phantoms, and gender associated with his clinical work with trans patients who have accepted, postponed, or declined metoidioplasty and/or phalloplasty. Chris Straayer will argue the phantom’s relevance to trans-future medicine, particularly to augmenting sensation in robotic prostheses, tissue-engineered penises, and penis transplants.

Although exploring the trans-masculine realm, we are not foregrounding identity, but rather exploring a phantom that non-trans and non-binary people may also experience. Further, much of our thinking is applicable to feminine phantoms such as those of breast and vagina. In order to acknowledge their trans advocacy and promote doctor-community dialogue, we have invited Dr. Loren Schechter to join us as discussants.

Panel Participants:

S.J. Langer, LCSW-R, is a writer and psychotherapist in New York City, where he maintains a private practice. He is on faculty at School of Visual Arts in both the MPS Art Therapy and Humanities & Sciences departments. His most recent academic article Trans Bodies and the Failure of Mirrors was the co-winner of the Symonds Prize from Studies in Gender and Sexuality in 2016. His forthcoming book on Theorizing Transgender Identity for Clinical Practice: A New Model for Understanding Gender will be release in January 2019 by Jessica Kingsley Publishers.
Pronouns: he, his, him

Chris Straayer, PhD is an associate professor at New York University, teaching interdisciplinary courses that combine trans studies with interests in science, social science, art, and cultural studies. He is the author of Deviant Eyes, Deviant Bodies (Columbia University Press). He serves on the editorial board of Transgender Studies Quarterly and is guest co-editor of the special issue on Trans Surgery. His current research projects are: structures of passing, gender and madness, and trans-physicalities.
Pronouns: he, his, him

Panel Discussant:
Dr. Loren Schechter attended the University of Chicago Pritzker School of Medicine completing his residency in general and plastic surgery and a fellowship in reconstructive microsurgery at the University of Chicago. He received entrance to Alpha Omega Alpha honor society and as The Outstanding Student in Surgery. He is on the WPATH Board and helped author SOC7. He serves on the editorial board of two transgender medical journals and authored the first surgical atlas, Surgical Management of Transgender Individuals. He won the 2013 Illinois State Bar Association Award for Community Service.
Pronouns: He, his

This presentation will describe psychoanalytically-informed clinical work with a patient who, borrowing a term from Griffin Hansbury (2017), occupies space in and around the “transgender edge.” In tracking the patient’s increasing ability to tolerate the trans aspects of their experience, it will be argued that play between the therapist and patient serves as the primary driver of therapeutic action in this treatment.

What is meant by “play” between therapist and adult patient? Donald Winnicott (1971), widely considered the most important theorist of play in psychoanalysis, has written that “psychotherapy takes place in the overlap of two areas of playing, that of the therapist and that of the patient. Psychotherapy has to do with two people playing together.” Using these and other ideas of Winnicott’s as a starting point, a conceptualization of play as a relational and developmental task in adult clinical work will be further explicated by vignettes and verbatim excerpts from the case.

This discussion will pay particular attention to the relational implications of Winnicott’s theory, focusing on the intersecting subjectivities of the therapist and patient and how, over time, the y played together. It will be argued that gender and transness, both imagined as “softly assembled” in the tradition of Adrienne Harris (2004), lend themselves particularly well to play in clinical encounters. The specifics of the case will be used to support the argument that therapist-patient play should be considered a valuable clinical tool for informing work along the (trans)gender spectrum.

Author Bio:
Sam Guzzardi, LCSW is a psychotherapist in private practice and psychoanalytic candidate at the Institute for the Psychoanalytic Study of Subjectivity (IPSS). Trained at the Silberman School of Social Work at Hunter College and at the Yale Child Study Center, Sam maintains a practice in New York City where he focuses on issues of gender, sexuality, identity, trauma and grief. Sam holds adjunct faculty appointments at the schools of social work at Fordham University and Hunter College. In 2018, Sam’s essay “’The only fag around’: Twinship needs in gay childhood” won the Candidate Award of the Psychology, Self, and Context journal. His first publication, “Digital collisions: Crashing into a patient online” is due out later this year.

This presentation will consist of a panel of LGBTQ researchers, clinicians, and trainees who will discuss the intersectionality of their identities and the impact it has on their work with trans* and non-binary communities across settings. The primary focus of our discussion will be contextualized in data and findings from the Transgender Identity Formation Study, a constructivist grounded theory study that examined the narratives of 31 adults between the ages of 18 and 55 living in New York City. Of the 31 participants, 27 identify as transgender, gender nonconforming, and non-binary. The remaining 4 are cisgender service providers that work with the TGNC community. Their narratives contain the following themes: navigating the coming out process in different social contexts, sexual fluidity and identity negotiation, partner preferences, relationship styles, sources of social support, housing contexts, vocational development, access to mental health services and other resources, identity development, cultural competency, LGBTQ+ training, and experiences working with TGNC clients. Our thematic and phenomenological analysis focused on understanding intersectionality, minority stress, and how gender diverse adults’ initial verbal and physical articulations of trans identity evolve throughout the life course. Our findings highlight how the evolution of trans discourses has shaped experiences of embodiment differently for individuals intergenerationally across a range of diverse cultures. As such, this presentation will discuss the experiences of trans* and non-binary people in many settings, including; school, employment, healthcare settings, inpatient hospitals, and correctional institutions.

Moreover, we aim to draw parallels across cultural difference to underscore the experiences of trans* and non-binary people of color. Our speakers will discuss their experiences working with Latinx, Afro-Latinx, African American, Asian, and Middle Eastern people across settings. We will be also be discussing international mental health service provision with the khawaja sira (transgender) community in Pakistan. Together these narratives expand the research literature by making space and giving voice to compelling stories of resilience, empowerment, visibility, and self-exploration across generations and cultures. Increasing awareness of these complex experiences the transgender and non-binary communities face will help inform the development of competent practices and community-based interventions.

Author Bios:

Taymy J. Caso, M.A. (Ph.D. ABD) is a fourth-year doctoral candidate in the Counseling Psychology Program in the Department of Applied Psychology at New York University. She identifies as a cisgender, queer/pansexual/bisexual, poly, Latinx person of color. She currently works as a Psychology Extern at Bellevue Hospital in the Adult Inpatient track and has experience working in outpatient mental health settings, community mental health clinics, and college counseling centers. She holds several leadership roles, including: Member for APAGS Committee on Sexual Orientation and Gender Diversity, Student Committee Member for the National Latina/o Psychological Association, Campus Representative for APA Division 45, and former Student Representative for the for APA Division 17’s Section for LGBT Issues. Taymy also serves as a mentor for APAGS LGBT Mentoring Program and USC’s RISE Grad Prep Academy. Her research centers around social justice, decolonization, minority health disparities, intersectionality, consensual non-monogamy and exploring identity development among transgender and gender expansive people of color (POC) over the life course from a multidimensional, dynamic systems theoretical perspective. Taymy leads a research team at NYU of graduate and undergraduate research assistants and is the Principal Investigator of the Transgender Identity Formation Study (TIFS).

Geti-Ara Syed, M.A., M.H.C., is a psychotherapist, teacher and researcher. She identifies as a cisgender, queer, South Asian, person of color. She is passionate about working for LGBT rights in her home country, Pakistan, where these identities are still criminalized. She is particularly interested in exploring the relationship between mental health and community mobilization. She received her Bachelor of Science in Applied Psychology in Pakistan, where she started a conversation about sexual diversity in Pakistani academia by studying homophobia for her undergraduate research project. In order to pursue her clinical interests, she underwent training in humanistic and psychodynamic psychotherapy at Therapy Works in Lahore, Pakistan and completed her Master’s in Counseling for Mental Health and Wellness at NYU Steinhardt. During her Master’s, she built upon her knowledge of psychoanalysis and enhanced her preexisting skills by interning at Training Institute for Mental Health in New York City. Moreover, she followed her drive for LGBT activism by joining the Transgender Identity Formation Study (TIFS) at New York University, where she studied the experiences of TGNC folks in New York City as a Research Assistant for doctoral candidate Taymy Caso. She is currently working in Lahore, Pakistan, as a therapist and teacher at Therapy Works, as well as volunteering at at a non-governmental organization as a community resource person for LGBTQI+ people.

Molly Wilder is currently a Senior at New York University majoring in Applied Psychology with a minor in American Sign Language. They identify as gender non-conforming and queer and do not prefer specific pronouns. Molly is particularly interested in the ways that gender identity and sexuality intersect with race and ability. They have been a research assistant on the Transgender Identity Formation Study (TIFS) for the past three years and has been co-project managing for the past few months. In addition to working on TIFS, Molly is an intern at Quest to Learn, a public charter school and writes book reviews for the International Journal of Psychotherapy.

Max Schneider, B.A., is a first-year masters student in the Counseling for Mental Health and Wellness Program, with an Advanced Certification in LGBTQIA+ Health and Wellness, in the Department of Applied Psychology at New York University. They identify as a non-binary, gender expansive, queer, poly, autistic person. Max has extensive experience working in therapeutic recreation and employment coaching settings, with children and young adults with various disabilities and mental health needs. They work with the ASD NEST program, at New York University, as an educator and a disabilities advocate. The NEST program supports grade schools around the greater New York area, in being more accessible and inclusive for students with autism. Max is a research assistant with the Transgender Identity Formation Study (TIFS), a grounded theory study aimed at understanding how LGBQ transgender people perceive fluidity in their sexual orientation and gender identity, particularly in intimate relationships, as well as their access to barriers to culturally competent community resources. In addition, Max provides consultations with roller derby leagues to develop inclusive gender policies, coach skating skills, and develop and promote positive team culture.

Rodney T. Lin is a current undergraduate student majoring in Applied Psychology and Global Public Health at New York University. Their research interests are counseling psychology with a focus on gender and sexuality within East Asian populations. They have worked with the Transgender Identity Formation Study (TIFS) for two years as both a research assistant and project coordinator. Rodney has also volunteered for the Satellite Baby Project where they assisted in art therapy sessions with the children of Chinese immigrants. In addition, they also work with the Culture and Relationships research team based in Shanghai, which explores how sociocultural contexts influence parent-child, romantic, and other key social relationships. They identify as Taiwanese, non-binary, and pansexual.

Much of the existing developmental work regarding transgender individuals focuses on stages the clients may go through concerning gender identity development. These provide a counseling student or an early career clinician valuable insight into some of the stages their clients may experience. Additionally, these resources often highlight the kind of clinical work relevant to each stage. However, these models may lack how to address changes across time regardless of where a client falls in a given model. As we continue to work with our clients they continue to age and experience age related changes that, although may be distinct from their gender identity development, nevertheless intersect with this process. This proposal will discuss an alternative or adjunctive approach to stage models. Whitbourne (1996) presents the Identity Process Perspective, a model that addresses an individual’s ability to remain stable and change across the aging process. The model discusses the use of assimilation, accommodation, and identity balance as mechanisms utilized by an individual to manage changes as one ages. Given that transgender clients will each be in different stage of gender identity development at different times, and may ebb and flow through these stages, it is crucial to attend to a simultaneous aging process. The Whitbourne (1996) model considers assimilation to be the process by which one considers experiences that are relevant to their identity in light of existing cognitive and affective schemas. Although this allows for the maintenance of identity when exposed to information or experiences that are not compatible with their existing identity, it can also limit individuals by leading them to over endorse information consistent with their identity. Accommodation on the other hand involves changing ones identity to better fit the new information or experiences. Accommodation, used as a primary means of maintaining identity, can lead to challenges with self-esteem and increased self-doubt. Identity balance is the term used by Whitbourne (1996) to explain an adaptive approach to maintaining identity as one ages. This requires a somewhat balanced use of assimilation and accommodation.

Haan (2013) suggested that an imbalance between assimilation and accommodation may lead to the need for defense mechanisms during times of stress. If we return to any of our existing stage models of gender identity development we can quickly see the many possible points of stress on route, potentially leading to an overuse of defense mechanisms, if there is an imbalanced use of assimilation and accommodation. A robust understanding of the Whitbourne (1996) model can provide therapists a framework to help clients develop a keen understanding of how they use assimilation and accommodation across their life and how this intersects with their transgender identity. As such, this model becomes an incredibly flexible model that can layer over the top of the existing stage models or function as a stand-alone model that remains grounded in the lived experiences of our clients. This discussion will present the model both didactically and in light of a case example. Participants will be invited to discuss their cases and assisted in applying the model.

Author Bios:

Marty A. Cooper, PhD joined State University of New York (SUNY) College at Old Westbury as an assistant professor in the graduate Mental Health Counseling program in the department of Psychology. He is both a counseling psychologist a licensed mental health counselor with regional and international experience. His research focuses on the intersections of multiple minority statuses with specific emphasis on sexual orientation. His recently competed study looks at the predictors of sexual orientation competence among US psychologists. Additionally, Dr. Cooper is collaborating with Dr. Jung at SUNY Old Westbury returning to a previous line of research involving ageism. Dr. Cooper is the clinical director at Cooper Mental Health Counseling, PLLC where, in addition to his practice, he provides training opportunities for mental health counseling students. He maintains affiliation with American Psychological Association Graduate Students (APAGS) association as a mentor to doctoral students. He also acts as a supervisor in the APA accredited doctoral internship at Kings County Hospital Center. Dr. Cooper is actively involved with the New York City Medical Reserve Corp, the Post-Emergency Canvassing Operations, and Physicians for Human Rights.

Seojung Jung, PhD., is assistant professor of psychology at State University of New York (SUNY) College at Old Westbury. Jung received her Ph.D. in Applied Developmental Psychology from Fordham University. Her primary research focuses on psychosocial resources and mechanisms associated with optimal aging with emphasis on individuals’ subjective experiences of aging across the life span. Her recent projects have investigated developmental trajectories of self-perceptions of aging in middle-aged and older adults, and lay perspectives of successful aging. Another line of her research focuses on the factors that influence health and well-being of older adults in long-term care settings. At SUNY Old Westbury, Jung has developed SUNY Old Westbury’s first gerontology laboratory. She is collaborating with Dr. Cooper on improving our understanding of age-bias and age-stereotyping by younger populations unto older adults. Through her laboratory she has connected gerontological research with undergraduate college students. She has trained and mentored several undergraduate students to use well controlled and designed developmental psychology research approaches within the area of gerontological research.

This paper will attempt to address the experience of transitioning later in life and the impact of female socialization in everyday life on this male identified transgender psychoanalyst. Despite valid efforts to maintain a sense of gender fluidity, society’s unrelenting call for a binary expression of gender has never been so stark- Society’s lack of “gender mentalization” and its insistence on defensively and unconsciously concretizing it, as it threatens basic organizing principles, reintroduce a sense of shame, shame which I meant to escape in the first place-I am now hiding in fear of mis-recognition, in a new way- Yes, gender as an internal experience, is a soft assembly, but in everyday encounters it is mostly rigidified and concrete – Going through multiple gendered/ungendered self states, I experience this most vividly, since I now pass as male, in men’s locker rooms that I am now required to use. Using Harris, Orange, Bromberg and Fonagy and Target, I will discuss this forced return and unrequited adoption of the binary and its psychic implications in terms of gender, mentalization, shame and trauma- in seemingly benign exposures to everyday encounters such as in the bare exclusivity of male only spaces.

Author Bio:

Luc Olivier Charlap PhD is a psychoanalyst in private practice in New York City. As a faculty member of various psychoanalytic institute he has taught classes on Trauma and its Treatment; Gender and Sexuality; Object Relations; Klein; and Envy, Narcissism and Borderlines Conditions. He is also a faculty member at NYU Silver School of Social Work. At present, as a faculty member and training analyst at the Contemporary Institute of Psychotherapy, he teaches in the Four-Year psychoanalytic program and supervises psychoanalytic candidates as well as supervises and teaches in the PCGS program.

This interactive session will review research on transgender identity development, focusing on intersections with psychosocial identity development during age 12-20. Experiences with social stigma, family rejection, and minority stress during this critical developmental time contribute to negative mental health outcomes and difficulty reaching developmental milestones in trans teens and young adults. However, research on resilience has identified a strong sense of identity as a potential mediator for minority stress. In addition, interventions focused on minority identity foster connections to gender, cultural, racial, and ethnic identities vital to cohesive, intersectional identity development. As mental health professionals, we have the opportunity to improve mental health outcomes by employing developmentally appropriate therapeutic interventions that support transgender identity formation and increase personal resiliency.

Efforts based in education to create “safe spaces” for transgender and LGB individuals show the positive impact that supportive homes and schools can have on anxiety and depression. Despite this, teens are still maturing into a world where they will experience some level of minority stress. When working with transgender teens and young adults, we must go beyond creating a “safe space.” Through case studies and guided discussion, participants will collaborate on developmentally timely interventions, welcoming our own discomfort, and how we can create “brave spaces” that go beyond supporting and affirming clients to actively supporting identity development to build resilience for the challenges ahead.

Author Bio:

Reese Ramponi moved to the East Coast from Alaska in 2009. She studied Religion and Psychology at Dartmouth College and is a 2018 graduate of Yale’s Psychiatric Mental Health Nurse Practitioner program, where she began her work with transgender and queer youth and young adults. Her interests include identity and personality development, both in individuals experiencing minority stress and in those diagnosed with Autism Spectrum Disorder, ADHD or other neurodevelopmental conditions. In addition, she is passionate about the importance of group and individual psychotherapy in the Psychiatric-Mental Health Nurse Practitioner role and looks forward to continuing her studies in this area. in She been involved in queer advocacy for the past 10 years as a photographer, healthcare educator, and curriculum diversity representative. In addition to her academic pursuits, Reese performs as a jazz singer and plays for the CT Allstars Roller Derby team.

Am Norgren MA

Informed Consent steadfastly affirms that that body autonomy is a fundamental human right, but it is far more complex than “hormones/surgery on demand”. Few know its’ roots or how truly innovative a philosophy of care it actually is.

What are its’ deeper implications? To what are we attesting when we sign letters? What are its’ strengths, limits, and complexities? How does Informed Consent provide the opportunity for our clients to pursue lifestyles and identities of their own choosing, whether traditional or radical?

This workshop offers an trans-positive, client-centered framework within which we as providers can conceptualize what we are already doing to support our trans and gender nonconforming clients… a model that remains true to our principles of client centered care and minimizes gatekeeping. This workshop places Informed Consent within the historical context of LGBTQ+ activism and features an in-depth examination of its’ nuances and practical applications to aid you in providing thoughtful care as well as to help you be both more compliant and more confident in your treatment of this vulnerable population.

Author Bio:

Laura A. Jacobs, LCSW-R is a Trans and GenderQueer psychotherapist, activist, writer, and public speaker in the NYC area working with TGNC, LGBTQ+, and sexual/gender diversity issues. Laura currently serves as Chair of the Board for the Callen-Lorde Community Health Center and is the first trans and genderqueer person to occupy that position. Recipient of a 2018 Gay City News Impact award and the 2017 Dorothy Kartashovich Award by the Community Health Center Association of New York State “In recognition of your dedication and advocacy to ensure high-quality health care for all”, they have been featured on NPR, MSNBC, NBCNEwsOnline, SiriusXM, CBSNews, The New York Times, and has spoken at countless organizations, conferences, and universities. Their book, “You’re In The Wrong Bathroom!’, co-authored with Laura Erickson-Schroth, was published in May 2017. As Lawrence Jacobs, they worked as a musician, composer, photographer, and less glamorous corporate middle management. www.LauraAJacobs.com

When the immigration process itself involves significant trauma, there may be far reaching implications for mental and physical health as individuals are dislocated from their social contexts and support systems. Prevalence of immigration-related trauma appears to be significantly higher for transgender and gender non-conforming immigrants (Heller, 2009; Shidlo & Ahola, 2013; Morales, 2013). Boulanger (2004) described the contextual disruptions associated with migration and how these may be represented in the psyche and enacted in the psychotherapeutic relationship; without a clear understanding of the immigration process and its impact on our patients’ social, physical, and mental well-being, we are missing valuable information and opportunities to deepen the therapeutic alliance.
Racial and ethnic discrimination further challenge the development and navigation of cultural identity, particularly as related to past experiences with interpersonal trauma such as physical and sexual abuse (Tummala-Narra, 2014). This intersectional effect is compounded by trauma related to gender identity. Current anti-immigrant policies and sentiments in the United States further contribute to safety fears and limit access to mental health care (Alameda County Public Health Department, 2017), and transgender immigrants face additional stigma and barriers to trans-affirming care.

In this presentation, we will explore the impact of trauma during the immigration process through case examples of two trans-identified individuals in long-term psychotherapy during their years-long processes of becoming documented residents of the U.S. Both patients identify as transgender and report adverse childhood experiences and immigration-related trauma. This interdisciplinary presentation will explore case examples using psychodynamic, public health, and human rights frameworks.

Author Bios:

Karalyn Violeta earned her B.S. in psychology from the City University of New York’s C.U.N.Y. Baccalaureate Program, and her M.S.W. from New York University. She is an adjunct faculty member at Fordham University’s Graduate School of Social Service and serves on the Executive Committee of ICP’s Psychotherapy Center for Gender & Sexuality. She works predominantly with trans, non-binary, and queer clients in private practice. She has published in the Journal of Gay & Lesbian Mental Health and is co-editing a volume of conference papers from ICP’s 2016 Transgender Mental Health Symposium.

Valentina Ramirez is an Infectious Disease Epidemiologist working at the Bureau of HIV/AIDS Prevention and Control at the New York City Department of Health and Mental Hygiene. She obtained her Bachelor of Science in Neuroscience and Behavior from Columbia University and her Master of Public Health degree from Mailman School of Public Health, Columbia University. She is currently a doctoral candidate at the City University of New York in the Health Policy and Management Track in the Graduate School of Public Health and Health Policy. As a Hispanic immigrant, she is interested in gaining deeper understanding of the lived experiences of immigrant and undocumented persons in order to improve equity and access to health care services through policy.

Gender is not a settled matter. For none of us. As the trans community becomes more genderqueer and variegated, trans individuals are bringing to the fore aspects of the ongoing unsettled nature of gender development that affects all of us, even though not all of us experience this ongoing negotiation with the same intensity. What makes trans individuals so “challenging” to many therapists and society at large is not that we are so different, but that we are quite similar after all. As I will explore, interactions with transgender individuals often (and especially in therapy) become occasions that heighten the intense experience for therapist and client of the ongoing unconscious relational processes of being bodily addressed and responding in elaborating all vectors of embodiment. Only as long as we and those around us follow along the socially relatively settled scripts sheltered by normative cisness and whiteness, do we hardly notice these negotiations.

One of the paradoxes of gender is that we can experience it as immediate self-knowledge, while we can at the same time accept that gender development is thoroughly relational and mediated. We develop our gender embodiment in relation to our body morphology as it changes over time, in relation to familial constellations, and in relation to social and cultural norms of our communities. But once assigned and taken up, gender tends to be presumed as relatively stable and our everyday mostly unconscious negotiations tend to revolve around “What kind of woman, man, person do I want to be in relation to the models of similarity and difference around me?” However, transgender individuals, especially ones embarking on transitioning, ask “Am I a woman, am I a man, am I a person of another gender altogether?” Because of the thorough ongoing relational negotiation of gendered embodiment, trans individuals also inevitably challenge cis individuals to ask themselves, “How do I actually know my own gender in the first place?”

It may seem that this question is primarily one of gender, but as I will elaborate, the trans experience often reveals how racialization is a medium of negotiating gender, and vice versa. Being perceived as a black male body imposes different shapes of precarity and danger than transitioning to having to navigate the world as a black female body. Conversely, for white female-bodied individual the minoritarian gender experience may throw their whiteness into relief, while a gender transition also forces a new confrontation with white maleness. Transitions raise the issue of raced embodiment and address to the therapist the question of their own negotiation of the intersection of gender and race.

Overall, in order to improve mental health care for the trans community, I would like to propose that rather than understanding gender as primarily a self-reflexive, even if socially mediated, self-identification, we can make sense of and grapple with the intensity of the hostilities (as well as the fetishizations) that trans individuals experience better if we understand gender and race as an ongoing elaboration of embodied addresses and responses.

Author Bio:

Yannik Thiem is Associate Professor of Philosophy at Villanova University and a Research Fellow in the School of Humanities of the University of South Africa (UNISA), Pretoria. Thiem specializes in feminist theory, queer theory, psychoanalysis, critical theory, and social and political philosophy. He is the author of Unbecoming Subjects: Judith Butler, Moral Philosophy, and Critical Responsibility (Fordham UP, 2008). He is currently working on a book project entitled Politics of Affect: Race, Religion, Sex, and Other Monsters. Additionally, Thiem has published articles in feminist and queer theory, politics and religion, as well as critical theory. Most of his work was published under his previous name, Annika Thiem, which remains Yannik’s official double as far as the government of his country of origin, Germany, is concerned.

Our plenary will be an intergenerational, gender diverse panel that spans 60 years. We will explore how one feels and understands their gender internally and within different social contexts. It will also be a discussion of how context and lifespan effects our conceptions of gender.

Panel speakers include:

Kim Watson
Pauline Park
Jamison Green
Youth from local NYC LGBT organizations

What kind of experience is one seeking, consciously and unconsciously, when getting a tattoo? What does it mean to create a wound and then, watch it heal? Can a surgery scar become a birthmark? How do these varied experiences of the skin’s surface respond to and interact with one’s experiences of their gender?

The intrapsychic and relational meanings of tattoos and scars (both the practice of scarification, as well as scars from gender-affirmative surgeries) have been frequently overlooked and under-theorized in psychoanalytic writing and practice. The pathological stance of the majority of writing and thinking that does exist on this subject delimits the possibility for more nuanced, creative and potentially adaptive interpretations.

Using Didier Anzieu’s theory of the skin-ego as a jumping off point (as well as the work of other psychoanalysts and gender theorists), I will attempt to explore some of these intrapsychic and relational meanings using vignettes from my clinical work with trans, gender non-conforming and non-binary patients.

Author Bio:

Kathleen DelMar Miller, MFA, LCSW is a writer and psychoanalyst-in-training at the Institute for Contemporary Psychotherapy. She has served on the Executive Committee of ICP’s Psychotherapy Center for Gender & Sexuality (PCGS), as well as taught modules and workshops for both PCGS and ICP’s Family & Couples Treatment Services (FACTS). She is currently writing about Didier Anzieu’s skin-ego, transgender embodiment and creativity. She maintains a private practice for adolescents and adults in New York City.

My clinical work with trans people in psychotherapy has led me to theorize that core gender is an aspect of consciousness. There are no cases in the medical literature of a person’s gender identity changing as the result of a brain injury or lesion. This directed me towards a theory of gender as qualia as opposed to an aspect of personality. The feeling of gender incongruence is not only based on visual incongruence but interoceptive sensations and one’s predictions regarding those sensations. The free energy principle will be used to explain why and how transgender people feel and experience their gender differently than cisgendered people through predictive coding.

Using the scaffolding of Damasio’s formulation of consciousness, I will demonstrate how gender is a foundational element of consciousness primarily integrated through the insula. Core gender develops along with the proto-self in lower level consciousness. One’s ability to identify, in articulated language, gender identity emerges out of core consciousness which forms the core self in the present tense. Then the autobiographical self, with its ability to have a past and future, consolidates one’s identity and gender expression as it relates to culture.

Working from a frame of the psychophysical nature of gender through interdisciplinary theorists such as Damasio, Craig, Edelman, Friston and Tsakiris. This presentation will plumb these theories to develop a model of gender in consciousness, establishing how gender is an essential aspect of humanness which springs from the mind’s understanding of the body.

Author Bio:

S.J. Langer is a writer and psychotherapist in New York City, where he maintains a private practice. He is on faculty at School of Visual Arts in both the MPS Art Therapy and Humanities & Sciences departments. He is a member of the Executive Committee for the Psychotherapy Center for Gender and Sexuality at the Institute for Contemporary Psychotherapy. His most recent academic article Trans Bodies and the Failure of Mirrors was the co-winner of the Symonds Prize from Studies in Gender and Sexuality. His first book Theorizing Transgender Identity for Clinical Practice: A New Model for Understanding Gender will release in January 2019 by Jessica Kingsley Publishers.

The emerging adult in today’s culture is someone between the ages of 18 and 25. This stage of development is currently characterized by insufficient income to be become fully independent and therefore, continuing to live one’s parents. According to Arnett (2000) this developmental period of “Emerging Adult” status is the age of: 1) identity exploration, 2) instability, 3) self-focus, 4) feeling in-between adolescence and adulthood and 5) a sense of broad possibilities. In terms of relational achievements, there is a redefinition of the parent-child relationship, significant changes in family dynamics and often the development of a “significant other” relationship. Some have suggested that Emerging Adults have a “roleless” role: no clear vocational or financial pathway towards adulthood’s demands. What happens when these issues intersect with the opportunity and freedom for transgender and gender expansive youth to make their own decisions, and to feel empowered, in their transition process?

During the past year, we have worked with many transgender and gender expansive Emerging Adults seeking psychotherapy for themselves, and in some cases with their families, in our unique clinical setting, a training clinic of a doctoral program with special services for gender and sexual minority clients. Clinical examples will illustrate the challenges unique to individuals who did not feel in synchrony with their assigned gender during their child and adolescent development but moving into their next developmental stage (over the age of 18) allowed them, for the first time, to consolidate their sense of self. Theory posits that the tasks of the psychosocial developmental stage of Identity vs. Role Confusion (Erikson, 1963) are usually achieved between the ages of 12 and 18 and teens then transition into the next psychosocial stage of Intimacy vs. Isolation in the search of meaningful connectedness. Although Erikson did not propose an Emerging Adult Status, it seems that the Identity and Role Confusion stage is more protracted in our current Western culture. We hypothesize that the developmental tasks of this stage take even longer to achieve for transgender and gender expansive youth, due to the heteronormative and cisgender world they grow up in that often leads to identity confusion during childhood and adolescence. Typical childhood and adolescent development may also be impacted or delayed by trauma experiences and significant family dysfunction, which is more frequent among gender and sexual minority youth.

Our clinical examples will illustrate the sense that we have often had that our clients are developmentally much younger than their chronological age and that our expectations and clinical interventions map more directly onto our usual approaches with adolescents. We will describe a number of dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT) interventions used to assist our transgender and gender expansive clients with their developmental challenges and move forward to the possibilities that can be a part of their future. Discussion will include the appropriateness of the Emerging Adult phase for our clinical population.

Author Bios:

Eva L. Feindler, Ph.D. is professor of psychology and Program Director of the Long Island University Doctoral program in Clinical Psychology. As a faculty member of the Track in Family Violence and as former Director of the Psychological Services Clinic, she is directly involved in programs to help families manage their anger and resolve conflict. Since the Launch of the new PHC (Pride Healing Center) in 2017, Dr. Feindler has served as clinical supervisor for individual and family cases with transgender and gender expansive clients. She received her undergraduate degree from Mount Holyoke College and her graduate degrees from West Virginia University. Her clinical internship was completed at the Children’s Psychiatric Center in Eatontown, New Jersey. Prior to her position at LIU, Dr. Feindler was Professor of Psychology at Adelphi University and Director of the program in Applied Behavioral Technology. She has authored several books (Adolescent Anger Control: Cognitive-Behavioral Strategies; Handbook of Adolescent Behavior Therapy, Assessment of Family Violence, Comparative Treatments of Anger Disorders), numerous articles on family anger, its assessment and treatment and has conducted professional workshops across the United States and internationally. She is featured on a training video (published by Research Press) on Aggression Replacement Training.

Finally, she has served an appointed term on the New York State Board for Psychology and a term on the Board of the Nassau County Psychological Association. She also served on the APA Commission on Violence and Youth and on the APA Task Force on Violence and the Family.

Rae Egbert J.D., M.S. grew up and attended college in the South, where she witnessed firsthand the hardships faced by gender and sexual minorities for being their authentic selves. While attending Capital University Law School, Rachel received a concentration in Child and Family Law and advocated for the rights of women, children, and refugees who had experienced traumatic life experiences. Recently, as a doctoral candidate at Long Island University-Post, Rachel founded PRIDE Healing Center, a trauma-focused specialty clinic for the LGBTQ+ community. As director of Pride Healing Center, Rachel has created community and research partnerships, developed trainings for clinicians and community members, and provided psychological services for LGBTQ+ individuals, groups, and families. In May 2018, Rachel received a graduate certificate from George Washington University in LGBT Health Policy and Practice. Rachel’s clinical and research interests include gender and sexual minorities, psychological trauma, substance abuse, and grief work.

Pronouns: she/her/hers and they/them/theirs

Institutional and social constructions frame access to healthcare. This is especially noticeable in the case of persons with marginalized identities. Through an evaluation of identity formation, intentional prioritization of white cis-heterosexual bodies and behaviors, and rigid gender and sexual orientation taxonomies, the presenter will identify difficulties these persons face with respect to care, safety, and social validation. Cultural safety frameworks will be used to facilitate discussion regarding relevant clinical care.

Author’s Bio:

Ronica Mukerjee is a Doctor of Nursing Practice, acupuncturist, and clinical faculty at Yale University. She is the Clinical Director at CHASI, a community-based syringe exchange in Staten Island, and serves as Clinical Director for an integrative practice in New Haven, Connecticut, “Tree of Life Primary Care and Recovery.” Ronica finished her doctorate in nursing at Yale, focusing on the ethical care of trans patients, and she is clinically certified in HIV care as well as buprenorphine/suboxone treatment for opiate use disorder. She also provides medical care for two telemedicine clinics in New Delhi and Calcutta, India for trans women seeking hormone care.

The world of transgender mental health care has been rapidly expanding over the past decade. With access to care increasing and insurance companies now paying for gender-affirming treatments, people who have waited for years now have access to care they were previously denied.
Transitioning at an older age has its own set of challenges. From a biological level people might not be physically able to handle surgical procedures, and hormone treatments might affect them differently. In additional to physical barriers, older transgender people may face psychological challenges. They might have spouses and children and are worried about how these changes might affect them. With the lack of civil rights in place, some people risk losing their jobs. There are also feelings of envy for a younger generation of transgender youth who have access to treatment options at an early age. Many also have limited social supports creating feelings of isolation. Lack of support from other trans-identified individuals can lead to poor outcomes following gender-affirming care.

This presentation will look at the dynamics of transitioning at an older age and encourage discussion so that therapists can be prepared to consider all potential stress factors facing patients transitioning later in life. We will present case examples, cover key topics, and have a clinical discussion gathering perspectives from attendees.

Author Bios:

Angeliki Pesiridou, MD is the Director of Psychiatry at Callen-Lorde Community Health Center, certified in dialectical behavioral therapy (DBT), and clinical leader of Callen-Lorde’s Trauma Track. Dr Pesiridou completed medical school in Padua, Italy and completed her residency in psychiatry at Saint Luke’s Mount Sinai Program in Manhattan. She provides treatment in five languages.

Serena M. Chang, MD is the Associate Director of Psychiatry at Callen-Lorde Community Health Center and an Assistant Clinical Professor in Psychiatry and Child and Adolescent Psychiatry at NYU School of Medicine, where she lectures on human sexuality. She completed her Child and Adolescent Psychiatry fellowship with a focus on working with trans youth at NYU Child Study Center/Bellevue Hospital and her psychiatry residency at Jackson Memorial Hospital in Miami, Florida. Serena is a graduate of the University of Vermont College of Medicine, where she co-founded the school’s Gay-Straight Alliance and worked to expand LGBT topics in the school’s curriculum. She decided to pursue a career in medicine because she wanted to advocate for sexual and mental health among underserved communities.

How do partners of those in transition cope with the possibility that their relationship history may become erased, while racing to embrace their future as an intact couple? Through navigating the five stages of grief, based Kübler-Ross and Kessler’s book, On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss, partners learn to mend the loss of the past and accept their unknown future. As partners of those transitioning and trans-identified individuals work together as their relationship moves forward, each person’s own needs must be honored and voices heard, as they evolve stronger as a team. While many partners experience some or all of the stages: denial, anger, bargaining, depression, and acceptance, clinicians are strongly encouraged to be aware that the transition can be extremely confusing, disorienting and even traumatic for their clients. This interactive workshop will focus on creating a space to explore realistic solutions, easy exercises, and simple strategies that professionals can apply when helping their patients deal with the various challenges facing the partners of those in transition as they embark on the success of being in a relationship with a person who identifies on the transgender spectrum. This presentation will afford an opportunity for therapists, academic scholars, and graduate students to understand the transition through the lens of the partner. Acknowledging that grieving may play a critical role throughout the transition, as a part of the healing process for partners, can only empower the couple’s journey together and the future they yearn to unite as one.

Author’s Bio

D. M. Maynard is a veteran teacher with over 30+ years in the field of education and the director of Maynard’s W.I.S.D.O.M., Inc., an Education Service. Her article, Introducing Gender Equality in the Early Childhood Classroom, published in 2013, was presented in 2011 at the 1st Global Conference on Femininity and Masculinity in Poland and at WPATH in Bangkok, Thailand in 2014. In 2012, her article, The Magic of a Creative and Engaging Classroom, published in 2014, was presented at Oxford University. In 2014, she was on the plenary panel at the Trans*Literate Conference in NYC for PCGS. In 2016, D. M. gave a workshop at the Trans+Sexuality Conference for PCGS as well. Ms. Maynard presented at Baltimore’s Gender Conference East in 2015 and at the Trans-Wellness Conference in Philadelphia, Pennsylvania from 2012-2018. In March of 2018, she presented a workshop for the Moving Trans History Forward conference in Victoria, British Columbia and in November of 2018, she presented at WPATH in Buenos Aires, Argentina based on the chapter she wrote for PCGS’s upcoming book. Jessica Kingsley Publishers will release her forthcoming book, The Reflective Workbook for Partners of Transgender People: Your Transition as Your Transitions, in 2019.

We will be screening Part 1 of a short film: An intimate look into the story of Armenia’s beloved, record holding weightlifter, who is the pride of the nation until his gender nonconformity became known. Mel faces incredible opposition and public outcry and his gender costs him his fame, his fortune, his family, and even his homeland.

The only person whom he hasn’t lost is his girlfriend, Lilit.

There will be an opportunity for Q&A with Audrey Kalajian of Bars Media after the screening. There will be a casual voluntary request for financial support that will be sent to the filmmakers to help finish Part 2, currently in preproduction.

Audrey Kalajian is one of the ‘silent’ founders of Bars Media (2003), now Armenia’s largest independent documentary production company. The studio works with the region’s most talented film professionals, producing in-depth, narrative-driven and human-focused stories that have been broadcast internationally on ARTE, PBS, YLE, NHK and Al Jazeera. Prior to her work with the studio, Audrey led fact-finding missions to war and earthquake-stricken regions, delivering humanitarian supplies, and implemented a sustainable, nutritional mother-child initiative. She also produced photos and film footage documenting extreme conditions and human rights violations during the war in Nagorno Karabagh, specifically refugees and prisoners, which were later used in international human rights publications and congressional records. During this period, Audrey was instrumental in the release of imprisoned Armenian journalist, Vardan Hovhannisyan, the ‘not so silent’ founder of Bars Media. Though she is based and works in the US, Audrey still continues to mentor and consult on various development projects related to Armenia and Bars Media.

*The Institute for Contemporary Psychotherapy is recognized by the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed psychoanalysts.

*The Institute for Contemporary Psychotherapy is recognized by the NYS Education Department State Board for Social Work as an approved provider of continuing education credit for licensed social workers.

*The Institute for Contemporary Psychotherapy is recognized by the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors.

*The Institute for Contemporary Psychotherapy is recognized by the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed marriage and family therapists.

For more information about the CEU credits please call 212-333-3444.