Gender identity exploration is good for everyone, not just trans people

When I asked you all to send in your questions about mental health a few weeks ago, I got an email so good I knew I had to write a newsletter on it.

Los Angeles resident Eli Lawliet wrote:

“I work as a gender doula — meaning I support folks through gender exploration and transition. When I first started to do this work, I assumed that I would be working with entirely trans people. And of course, that is the bulk of my clientele and my passion. But I have also noticed that gender exploration is a profoundly helpful and liberatory tool for folks of all genders and experiences.

I believe that there are profound implications for gender exploration as a component in mental healthcare, because in our modern culture, most people have a disrupted relationship to gender. We see this in the differences between lifespan for cisgender men and cisgender women, for example, with cisgender men more likely to die by suicide, accident or preventable illness. We also see this in the way that health, wellness and beauty standards impact both men and women, but women quite a lot more so.

I believe that this is one area where cisgender people could learn so much from trans people, and from how we engage with and disrupt gender in the overculture. “

With a bachelor’s in gender studies from UCLA and a PhD from UC Berkeley, Eli has a decade of experience researching transgender people and healthcare through the lenses of public health, policy, law, sociology and history.

I sat down with Eli — known as “the Gender Doula” on social media — over Zoom to talk about his approach to supporting nonbinary and trans people, what he’s seen people of all genders gain from thinking more deeply about how they inhabit their identities and bodies, the impact of anti-trans rhetoric and legislation, and why healing in community is so important.

Our conversation has been edited for length and clarity.

An interview with the Gender Doula

Group Therapy: I know about pregnancy doulas and death doulas, but “gender doula” is a new one for me! Tell me about your work and what kind of support you offer to people.

Eli: Trans people have supported other trans people through transition for time immemorial, so it’s not new work. But organizing it under this label is the part that is relatively new. The work that I do is famously hard to describe because it is deeply personal.

What I offer depends a lot on what’s needed by a specific individual at the moment they’re in with gender. Functionally, what that can look like is if someone comes to me and they’re like, “I just kind of feel weird about my gender. What do I do about this?” Then we can have some conversations about how we can explore this. I can give them exercises. We can talk through fears and hopes, and I can help them move through that process with less fear, and with more of a focus on joy and what feels good, and moves them towards an embodiment that’s more authentic. So it can range from that to helping people redo their whole wardrobe. That’s hard work. It can be helping people work through the medical part of transition if they’re curious about hormones or surgery, or if they’re on hormones and “things are weird and I need to talk about it.” Or, “I’m getting surgery and I don’t know how to tell a surgeon what I want my body to look like.”

I also work with people who are supporting trans people. Like “My partner just came out. I don’t know how to be a good partner to them. What do I do?” Or “My child is transitioning, like, help, you know, I’m really scared about the world right now, you know?” So how I support people depends a lot on where they’re coming from, but I like to think of it as full-spectrum support for anything that is related to questioning, exploring or transitioning gender.

Millennials and Zoomers explicitly talk about gender probably more than any other generations in the past, and are critically questioning what gender means to them on a large scale. How do you conceptualize gender?

It’s one of those funny things, because gender is everything and nothing at the same time. In my opinion, gender is everything because it infuses everything, at least in this culture. We’re taught from a very, very young age what is and is not available to us based on gender, often subconsciously or subliminally. Of course there’s a billion, million studies on that — you know, how cis girls are more likely to think they won’t be good at math, stuff like that. But I also think that gender is about how we conduct and present our bodies. It’s about how we relate to other human beings. It’s about what we see as the possibilities that are open to us. So there’s really a lot of different ways to approach gender or to bring gender into a conversation, even with clients. We might start talking about hormones, and then a few sessions in they wanna talk to me about their job, and they’re like, “I know this isn’t gender.” And I’m like, but it is! There’s no easy way to sum up what I think gender is, but I do think that we inhabit it or perform it in all areas of our life.

Can you give me an example of how “work can be gender,” as you just said?

Let’s say that a person is in a work situation and they’re unhappy or confused about why their position is being made small, or why they’re not being allowed to expand past it, especially if they’re noticing that other people around them are not being constrained in that same way. There may be many different aspects of that that are related to not only their gender identity, but also how other people relate to it. And being willing to inhabit and take up space or grow can be very hard if someone doesn’t feel secure in how their gender is coming through, and how they’re interacting and performing it.

In your email, you wrote that when you first started doing this work, you assumed you’d be working with trans people exclusively. But you’ve noticed that gender exploration is helpful for everyone. I would love to hear more about what you’ve seen people get out of exploring their gender identities.

When I decided to become a gender doula, I was also in my PhD program at Berkeley. And so I started telling people around me who I’d always known to be cisgender, often heterosexual people, that I wanted to become a gender doula. And they would light up and be like, “I need a gender doula!” And I was like, “do you?” and would sort of laugh it off. But after it kept happening, I was like, wait a second. I’m missing something here because there’s multiple people who are saying this to me, and I’m making this assumption that they’re wrong, but maybe I’m wrong. And I was, because I think that as I started to really consider this work and the full scope of it, I thought about the fact that we all have a damaged relationship to gender because our culture has a damaged relationship to gender.

And so it is much more honestly accurate to conceive of that relationship applying to everyone, and that everyone has parts of their gender that need to be addressed or that need to be healed, or that need to be looked at. And then you combine that with the fact that no one fits cleanly into any sort of gender label, or what society expects of that label. Nobody fits all of it ever. So that means that most likely, we are all holding some sort of shame about how we don’t fit the norms of our assigned gender, or how we’ve had to cut parts of ourselves off or edit ourselves to try to fit into something that actually doesn’t fit us.

With that being very much a fact, everybody benefits from taking the time to be like, OK, wait, what if I had agency in my relationship to gender? What if I could choose how to inhabit gender in a way that felt fully good, and where I wasn’t having to edit down parts of myself and make myself fit into some constrained version of what it means to be in this world? And I also think that by each person being more liberated to be in the fullness of their actual authentic self, regardless of what that is, would have a huge ripple effect to help with healing that social relationship to gender that we’re all struggling with.

How do you think it would help heal our society’s relationship to gender? Can you elaborate on that?

Let’s say you’re part of a cisgender heterosexual couple, you’ve taken the time to really examine your relationship to gender and what it means to you to inhabit gender authentically, and then one of your children comes out as trans. You may be much less likely to feel threatened by that, because gender is not this box that you have to force your child into, and you understand your own gender because you healed your relationship to it. So when your child says, this is my gender, you can be like, “OK, that’s super interesting. Let’s explore that together.”

I also truly see this as a way of ultimately making the world a better place for trans people, which is my community. Make no mistake, that’s my goal here. But I do think that cis people, especially cis men, are unable to access so many parts of themselves. How much better off would we all be if we were all really able to not do that? I feel like we would have deeper relationships, and it would be much safer to be intimate and vulnerable with other people. And then that would ripple out. Because when we are able to access that compassionate and vulnerable self and offer it to people and have that held in a way that’s safe, how much better would mental health be? I see this as a huge seed from which many things grow.

We published a newsletter a few weeks ago about how men, on average, have fewer friends and tend to be lonelier than people of other genders, in large part because of how men are socialized to hide their feelings. This got me thinking a lot about the intersection of gender and mental health. I’m curious to hear your thoughts on how gender identity can affect our well-being.

I look at this and it’s sort of this like weird catch-22, where a lot of men feel very, very lonely, very dissatisfied. They feel a lot of pressure sometimes, pressure that they can’t even name. They’re just like, “Everyone expects everything of me.” And I think all of that leads to some of the things you described, like the loneliness and the suicide rate among men being so much higher, the rate of illness and accidents being so much higher. There’s gotta be a way for us to have this conversation, to reach for each other here that allows men to see there is actually a different way, that they can let go of some of this.

I’ve seen this on a small scale. I love to go to the Korean spa, and it’s sex-segregated, which … I don’t love. But in the nude area, most of the people there are men and most of them are just tending to their bodies. Being in that space has been a really beautiful experience for me, but also instructive when I go upstairs and see those same men with clothes on and women are around, and they’re a completely different person. And I’m like, we were just vibing in the hot tub together, but now that we’re up here you’re putting on a show.

Even in my own family, I have seen the ways that masculinity has played out on me and my siblings differently. Part of the reason I feel like being trans is such a blessing is that I can enact masculinity in a way that’s unharmed by being raised as a boy. And that has given me a window into masculinity that is very specific and different from someone who has socialized as a male growing up. I see how much different my masculinity is and how much freer it is, and I see what got me there. I can’t help but look at men who were socialized as boys and be like, OK, there’s a breakdown in there that should be addressed.

You’ve written about healing alone versus healing in community, and how there is “danger in going too internal, too focused on the self, where your own experiences become your only point of reference.” Why do you feel it’s important to heal in community? And why might doing so be particularly vital for people who are LGBTQ+ or have other marginalized identities?

We talk a lot about about going to therapy, about working on yourself. It’s all about the self — “I’m looking at myself, I’m healing myself. I have to heal myself before I can be in communal space.” And I think that there’s a lot to be said for balancing healing of the self and healing in community.

When you heal yourself for the purpose of, “I just want to be healed,” it’s really easy to sort of veer off into places that are not actually helpful. You get into this mode of constantly having to improve. “Am I eating all the right foods? Am I exercising all the right ways? Am I always showing up to therapy? What about this new modality? What about that new modality?” And it becomes this capitalistic consumptive form of “healing” that is not actually healing. I think that one of the ways of working with this is to re-frame the desire of bettering yourself to wanting to be able to exist in community better — wanting to be in relationship with the earth, with the people around you in ways that are deeply fulfilling and good for everyone. That requires this balance between addressing your stuff when you notice you’re acting in ways that are hurting people or hurting yourself, but also having relationships so that you can work on these different skills as you’re learning them, instead of getting into this consumptive black hole of trying to fill myself up by buying the next course or whatever.

This is especially important for LGBTQ folks. We’re already a deeply traumatized community that is actively being targeted every day in all these really violent ways. And that’s gonna make it really hard to cohere as a community and to come together, because it is very easy to lash out against each other when it feels like it’s impossible to lash out against the system that’s oppressing us. Part of how we live through these backlashes that happen in a very cyclical way (the AIDS crisis, and before that, in the midcentury, there was a huge backlash against trans people) is by coming together. If I lose all of my friends because they don’t want to know me now that I’m trans, I have people I can come to and I can be held by. By engaging in that reciprocity, we are able to access a much deeper well of wellness and healing, rather than going and trying to buy the next crystal or whatever.

As you noted, gender-expansive folks are being actively harmed by anti-trans rhetoric and policies. What would you like to say to folks who are struggling with the effects of this discrimination?

First of all, I just want to validate that it’s really hard right now. But I also don’t think fear-mongering is helpful; for example, a lot of big-name trans influencers spend a huge portion of their content responding to hate comments. And I think that that’s super harmful. I don’t think we should be doing that. Why are we platforming hate? When people love each other, why are we not platforming that instead? There’s a balance to be struck in saying like, yes, this is very hard right now. And also we get through this by coming together. We don’t get through this by constantly wasting our time yelling at people who aren’t gonna listen to us.

Pulling myself off the soapbox, I would say that there are a lot of really important skills that are gonna help us get from this moment, through the election and however long it takes for this backlash to die down. And I think that there’s a set of those skills that involves how you care for yourself. I did a workshop called “Love Your Trans Self,” where I went deep into how we can take care of these bodies in a really practical way, and also how we engage in community and how we find care there. There’s also value in creating separation between what’s happening on the large scale and what’s actually happening to you in the moment, so that you’re not constantly taking on the whole Earth’s worth of trauma into your body as something that’s being done to you. We see all the headlines, we see all this hate content. We’re like, oh my God, everyone’s specifically trying to come after me. That’s how our bodies feel, even if our brain knows that’s not true. So modulate the content you’re taking in, and take breaks from it. And if you need to, focus on like, “Hey, I am in my bedroom. I am with my cat. I am safe right now.”

Until next week,

Laura

If what you learned today from these experts spoke to you or you’d like to tell us about your own experiences, please email us and let us know if it is OK to share your thoughts with the larger Group Therapy community. The email [email protected] gets right to our team.

See previous editions here. To view this newsletter in your browser, click here.

More perspectives on today’s topic & other resources

In their book “Beyond the Gender Binary,” poet and activist Alok Vaid-Menon deconstructs and reimagines the gender binary. Taking from their own experiences as a gender-nonconforming artist, they show us that gender is a malleable and creative form of expression.

We need better narratives about gender, according to queer writers Masha Gessen and Lydia Polgreen. In this great podcast episode of the Ezra Klein show, these two reflect on the legislative and cultural backlash against LGBTQ+ rights and what it means to understand queer life more expansively.

Other interesting stuff

At a public hospital in L.A. serving some of the poorest and most vulnerable people in the nation’s most populous county, the psychiatric inpatient unit has restrained patients at a higher rate than in any other in California, according to a Times investigation by my colleagues Ben Poston and Emily Alpert Reyes. This is despite the fact that hospitals are forbidden under federal law from restraining psychiatric patients except to prevent them from harming themselves or others. Restraints are seen as a last resort and can traumatize patients.