On Being an “Expert-Enough Expert”: Working Psychoanalytically with Transgender Patients

Abstract

It’s easy to assume that a transgender expert would automatically be the best psychoanalytic choice for someone transitioning their gender identity. But is this true? And what exactly do we mean by trans expert? A relational-constructivist framework places tremendous value on uncertainty and ambiguity, suggesting that too much insistence on sameness and knowing can shut down psychoanalytic exploration. Even trying to be a supportive ally can become paradoxically problematic. Working with my trans patients as a non-expert made generative use of our differences, encouraging the development of mutual recognition and teaching me the value of being “expert enough.”

Keywords:

• expert enough
• expertise
• gender identity
• relational-constructivist framework

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

¹ When I first met Sam, she identified as female and used preferred pronouns of “she” and “her.”

² Because I am trained as a medical doctor, I prefer to use the term “patient” in keeping with that convention.

³ I switch back and forth between the pronouns “he, him, and his” and “she, her, and hers” based on how Patrick/Patrice self-identified at the time.

Additional information

Notes on contributors

Hilary Offman

Hilary Offman, MD, FRCPC is a psychiatrist and psychoanalyst with a private practice in Toronto, Canada. She is a lecturer and supervisor in the Department of Psychiatry at the University of Toronto. She is also a supervising analyst and Board member for the Toronto Institute for Contemporary Psychoanalysis (TICP). She is the former co-chair of the Candidates Committee for the International Association of Relational Psychotherapy and Psychoanalysis (IARPP) and a current member of the IARRP Board of Directors, where she chairs the International Membership Outreach Committee. Her writing interests include themes of otherness, queerness, and fatness.