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Are Sex People the Best People to Work With Gender People? (1997)

Are Sex People the Best People to Work With Gender People? (1997)

©1997, 2013 by Dallas Denny

Source: Denny, Dallas. (1997). Are sex people the best people to work with gender people? Is there a need for gender specialists? Paper presented at 1997 Joint Meeting, the Society for the Scientific Study of Sexuality and the American Association of Sex Educators, Counselors, & Therapists. Arlington, VA, 12-16 November, 1997.


This paper was read by Dr. Sandra Cole at the joint meeting of the Society for the Scientific Study of Sexuality and the American Association of Sex Educators, Counselors, and Sex Therapists, Arlington VA, November, 1997.

Are Sex People the Best People to Work With Gender People?

Is There a Need for Gender Specialists?

By Dallas Denny


Individuals with gender identity issues often lead tumultuous lives. Although current opinion holds that expressing one’s gender in an individualistic manner is not in most cases an indication of psychopathology and is likely, in fact, to be an indication of mental health, society’s reaction to unconventional gender expression can be swift, sure, and deadly. Transsexual and transgendered people are at grave risk for hate crimes, sexual and physical abuse (Wilchins, et al., 1997, Witten, 1997), discrimination in the workplace and at schools (Hoffman, 1997), and outright rejection by their families (Denny, 1995). Additionally, current health practice requires those who desire access to body-modifying medical technologies to obtain authorization letters from therapists (Walker, et al., 1990). Consequently, there is an alliance of sorts between mental health professionals and transsexual and transgendered people. One survey found that transgendered people were a very compliant population, with more than 93% of the 184 transgendered respondents who self-identified as transsexual reporting they had sought counseling for their gender issue (Denny & Roberts, 1997).

Although some graduate training programs address transgender issues, there are no programs which provide specialty degrees in this emerging field. There are, of course, a few universities with graduate degrees in sexology or sex therapy, but most such programs provide only minimal training in gender identity issues. Acknowledging this, and recognizing that a wide range of skills are required for effective counseling of gender-variant people, the Harry Benjamin International Gender Dysphoria Association (HBIGDA), the primary professional organization for gender identity issues, notes in its Standards of Care (Walker et al., 1990):

Certification in sex therapy or counseling does not necessarily attest to competence in the diagnosis and treatment of gender identity conditions or disorders. Persons recommending sex reassignment surgery or hormone therapy should have proven competence in general psychotherapy, sex therapy, and gender counseling/therapy.

The Standards of Care do acknowledge the importance of training in sexology:

 Persons recommending sex reassignment surgery or hormone therapy should have proven competence in general psychotherapy, sex therapy, and gender counseling/therapy.

The requirement for expertise in sex therapy is a curious one, due as much, perhaps, to the historical lack of distinction between sex and gender issues as to the actual nature and needs of transgendered and transsexual persons. Transsexual people will say, in no uncertain terms, their issue is one of gender, and not sexuality—and yet transsexuals, like everyone else, must make sense of their sexuality, a process which is confusing for all of us and is bound to be even more perplexing for those who transition from one gender role to another (Denny & Green, 1996). It’s clear also gender issues play an important role in many paraphilias and that much crossdressing is primarily sexual in nature.

All of this leads to the following questions: Is training in sexology important for counseling professionals who work with transsexual and transgendered people. Is it necessary? Is it sufficient?

I will not address in this paper whether sexological training is important or necessary for those who work with transsexual and transgendered people (although I would say privately it is important, but unless the individual has an issue with sexuality as well as gender, it is not necessary). I will argue, however (as does HBIGDA), that sexological training, however important it may be, is not sufficient in and of itself, but must be augmented by special training and acquisition of special skills in gender issues.

Current Training of Sexologists

There is little doubt that in their training, sexologists learn much which will come in useful in working with transsexual and transgendered clients. However, issues of gender-variant identity and behavior may be only touched on or glossed over, and information presented may be outdated or overly pathologizing to the target population. The nineties have seen the world turned upside down in regard to gender expression, and textbooks which acknowledge this rapid and dramatic change are only now going to press. Existing material is not likely to paint an accurate picture of the contemporary out, proud, transgendered man or woman—but moreover, much of the existing literature recommends life paths and strategies for counseling that are obsolete and which are in fact harmful. For example, dated materials—and unfortunately, even some books and papers published only this year—may state baldly that crossdressing in heterosexual males is always sexually motivated (it isn’t), and that those who identify as transsexual should attempt to emulate as closely as possible nontranssexual people of the new gender and assimilate into society as presumed nontranssexuals (a strategy many transgendered people find disempowering). Existing materials may also insist there are no female-to-male crossdressers, or that all female-to-male transsexuals are exclusively attracted to women—assertions which are most assuredly not true (cf Denny, 1997).

Of course, much can be ameliorated by updating textbooks and resource material and by hiring staff who specialize in gender identity issues, but I would submit that building a thorough and up-to-date gender library and hiring instructors who do not share their colleagues’ enthusiasm about homosexuality, impotence, vaginismus, rubber fetishism or the study of pedophiles is unlikely to be a priority for sexological programs. Those who think their programs are up to snuff should check their libraries to see whether they contain Pat Califia’s Sex changes, Zachary Natif’s Lesbians talk transgender, Riki Anne Wilchins’ Read my lips, and the journals Chrysalis, Transsexual News Telegraph, and Transgender Tapestry, and look around to see whether there is a bona fide gender specialist on staff.

If a transgendered or transsexual person sees a sexologist for counseling, there is a danger the gender issue may be turned into a sexuality issue. There’s a saying that if you want to be operated on, you should see a surgeon. The way we view the world is colored by our training and other life experiences. Sexologists, quite simply, are fascinated by sex. They see it everywhere. They’re enthusiastic about it. At a recent regional conference of the Society for the Scientific Study of Sexuality, hardly anyone attended the seminar on gender issues; however, it was necessary to charter a second bus for the late-night tour of the stripper bars and fetish clubs. I, a transsexual, have never been to either a stripper bar or a fetish club and in fact have a plain vanilla sex life and like it like that—yet it’s easy to see how the impassioned, sex-positive attendees of the late-night barhopping tour might project their issues with sexuality onto me, should I choose to see them for therapy for an issue entirely unrelated to my sexuality.


A Need for Gender-Specializing Counselors

Transgendered people, and especially transsexuals in transition, have needs which have nothing to do with sexuality. Coming out issues, stresses on relationships or the emotional fallout from rejection by family and friends, employment difficulties, anger caused by public harassment, and other adjustment problems require a specific set of counseling skills—in other words, a gender specialist—and yet there are no formally recognized gender specialists.

There are, of course, therapists who specialize in gender issues; many, of course, are sexologists. They have practical experience and are widely read on gender issues, and are quite knowledgeable about the issues faced by gender-variant folks. Transgendered and transsexual people learn who these gender specialists are via the TG grapevine and seek them out, but the fact remains that aside from membership in the Harry Benjamin International Gender Dysphoria Association, there is no formal recognition of their special competencies. So far as I know, only one person in the world—Dr. Louis Gooren in the Netherlands, has any formal status as a gender professional. Gooren has the title Professor of Transsexuality. Others may have titles reflecting their positions as directors of gender programs or as researchers, but they have no official certification which signals to others their proficiencies as gender experts in the manner that, say, AASECT certification credentializes sex therapists.

In their forthcoming book Transgender Care: Recommended Guidelines, Practical Information, and Personal Accounts, Gianna Israel and Donald Tarver designate those who work with transsexual and transgender people as gender specialists. I believe the creation of this category has been long overdue, and can only say it needs to be formalized by the creation of formal guidelines and an accreditation process for gender specialists. And I sincerely hope those with training in sexology don’t assume that because of their training in human sexuality, they qualify automatically or should be automatically grandfathered or grandmothered as gender specialists.

So are sex people the best people to work with gender people? My assertion is “not necessarily.” The best people to work with gender people are gender people. If they are also sex people, so much the better.




Califia, P. (1997). Sex changes: The politics of transgenderism. San Francisco: Cleis Press.

Cameron, L. (1996). Body alchemy: Transsexual portraits. Pittsburgh, PA: Cleis Press.

Chrysalis. Published by American Educational Gender Information Service, Inc., P.O. Box 33724, Decatur, GA 30033-0724.

Denny, D. (1995). Prodigal son: A tale of noncommunication and rejection. (1995, February). Chrysalis: The Journal of Transgressive Gender Identities, 2(1), 23-27.

Denny, D. (1997). Needed a new literature for a new century. Paper presented at the XV Harry Benjamin International Gender Dysphoria Association Symposium: The State of Our Art and the State of Our Science, Vancouver, British Columbia, Canada, 10-13 September, 1997.

Denny, D., & Green, J. (1996). Gender identity and bisexuality. In Firestein, B. (Ed.), Bisexuality: The psychology and politics of an invisible minority, pp. 84-102. New York: Sage.

Denny, D., & Roberts, J. (1997). Results of a survey of consumer attitudes about the HBIGDA Standards of Care. In B. Bullough V. Bullough, & J. Elias (Eds.). Gender blending, 320-336. Amherst, NY: Prometheus Books.

Hoffman, Petra. (1997). The Pizza Bitch of Midtown. Chrysalis, 2(3), 15-20.

Israel, G., & Tarver, D. (1997). Transgender care: Recommended guidelines, practical information, and personal accounts. Philadelphia, PA: Temple University Press.

Natif, Z.I. (1996). Lesbians talk transgender. London: Scarlet Press (Available in US from Inco, Inc., Chicago).

Transgender Tapestry. Published by International Foundation for Gender Education, P.O. Box 229, Waltham, MA 02154.

Transsexual News Telegraph. Published by Gail Sondegaard, 1355 Pine, #6, SF, CA94109.

Rogers, K. (1997). Transitioning on the job (with a little help from your friends.) Chrysalis, 2(3), 31-34.

Walker, P.A., Berger, J.C., Green, R., Laub, D., Reynolds, C., & Wollman, L. (1990). Standards of care: The hormonal and surgical sex reassignment of gender dysphoric persons. Distributed by American Educational Gender Information Service, Inc., Atlanta, GA.

Wilchins, R.A. (1997). Read my lips: Sexual subversion and the end of gender. Ithaca, NY: Firebrand Books.

Wilchins, R.A., Lombardi, L., Priesing, D., & Malouf, D. (1997, 13 April). Genderpac first national survey of transgender violence. New York: Genderpac.

Witten, T.M. (1997). Violence within and against the transgender community. Paper presented at the Second International Congress on Sex and Gender Issues, King of Prussia, PA, 19-22 June, 1997.