01.11.2013 "Counselling trans people is only a small, but nonetheless vital piece of the puzzle."
Forum Hannes Rudolph. A special unit for trans people (Fachstelle für Transmenschen) has been in service at Checkpoint Zurich since March 2012. It was set up in cooperation with the Transgender Network Switzerland (TGNS) to advise people, whose gender identity does not match that assigned to them by birth. It is the only paid unit in German-speaking Switzerland that offers trans people independent counselling by other trans people, though there is a second such unit at Checkpoint Vaud to serve French-speaking Switzerland. Besides counselling trans people themselves, the unit also provides advice for their relatives and people who, for other reasons (e. g. professional), have questions about trans* issues (the asterisk refers to all of the identities within the gender identity spectrum).
The response has been overwhelming.
In the first ten months alone, the unit counselled about 100 persons, the large majority of them trans people. Approximately 70 counselling sessions were conducted by e-mail, 26 face-to-face and a number by telephone. This means that the capacity limit of the unit, which is financed to the amount of 0.2 full-time equivalents, has already been reached. In addition, once a month on average, the unit has provided external institutions with information (between 90 and 120 minutes) on various aspects of trans* issues and on how to handle the specific needs of trans people."How do I get hormone treatment?" Even though by no means all trans people opt for medical gender-reassignment procedures, the most frequently asked question concerns hormone treatment. If the mandatory health insurance is to reimburse hormone treatment, a doctor's prescription is required. Most doctors require a note from a psychiatrist or psychotherapist that the treatment is indicated and confirming that the person is trans* and that there are no compelling reasons for not prescribing hormone treatment. It is particularly important to ensure that trans people have realistic expectations about the treatment and are able to deal with its consequences. Supportive therapy is still considered mandatory, even though experts long since agree that this mandatory nature significantly impairs the therapeutic relationship. Trans people often feel under pressure to prove their gender identity, but it is simply not possible to diagnose somebody as trans* – it is a diagnosis that can be based exclusively on the statements of the person concerned. An additional problem of mandatory treatment is the fact that specialists with trans* experience are few and far between and therefore often have long waiting times to get a counselling session.
Apart from this, the counselling sessions have covered a wide range of issues:
– "I think I feel more like a woman, but I'm not sure how to find out."
– "Where and how can I ask for my papers to be changed and what conditions would I have to satisfy?"
– "I want to live as a man. So what lies ahead for me? What can medicine do and what can it not do?"
– "Where can I find specialists?" (In endocrinology, gynaecology and urology, psychiatry and psychotherapy, dermatology for epilation,
speech therapy, etc.)
– "I'm right in the middle of my training. Should I come out now or should I wait until afterwards?"
– "My parents will throw me out if I insist on living as a man. Where can I go?"
– "I've found out that I had surgery for intersexuality, when I was a child, but I don't have any precise details. My identity doesn't match the gender I was brought up as. What can I do?"
– "Can I change my papers without my marriage being dissolved? I'm from Argentina and my wife is Swiss."
As these questions show, trans people often need help, particularly because the ways in which they can live in Switzerland according to their own sense of gender identity are still very opaque and riddled with bureaucratic obstacles. A further problem is the poor acceptance of trans people, both privately and in the jobs market. Information and visibility campaigns implemented at various key places offer very great potential for improving the situation of each individual trans person. Counselling trans people is only a small, but nonetheless vital piece of the puzzle, because we have to improve lastingly the life circumstances, the psychological and physical health of trans people. The units would like to do a lot more, but because counselling takes up all their capacity, they would need more funding.
Hannes Rudolph, born in Leipzig in 1977, psychologist and stage director, trans man, head of the special unit for trans people at Checkpoint Zurich since March 2012.