We sat down with a TGNC specialized psychiatrist and therapist to discuss internalized transphobia and its pernicious effects on the TGNC community.

It’s no secret that we live in a transphobic society. Just recently, the Trump Administration empowered the Department of Health and Human Services to protect medical providers who deny care to trans people because of “religious” or “moral” reasons. What’s more, again per President Trump, the Centers for Disease Control and Prevention are no longer allowed to use the word “transgender” in official documents, making it that much more difficult to protect and support the unique needs of the trans community.

This widespread discrimination contributes to a national culture of exclusion and even violence towards trans and gender nonconforming (TGNC) individuals, with anti-trans hate crimes conclusively on the rise. Immersed in this culture on a daily basis, it’s no wonder that some TGNC people struggle with internalized transphobia. Internalized transphobia takes hold when people unconsciously absorb messages that shame, criticize, and dehumanize trans people. Overt and subtle messages that degrade or serve to exclude trans people from full participation in life are especially harmful to TGNC people.

“Internalized transphobia influences every trans individual differently, but it affects so many people who may not even be aware of it,” explains psychiatrist, therapist, and Lighthouse provider Dr. Jack Pula. “They see so much transphobia around them that they might not realize how much they’re carrying around internally.”

We spoke with Dr. Pula to learn more about where internalized transphobia comes from, how it holds us back, and what we can do about it.

Where Does Internalized Transphobia Originate?

Internalized transphobia isn’t something that’s innate in TGNC individuals; it’s fueled by our society and the signals it sends to the trans community. These signals don’t just come from the current political climate. Heteronormative and cisnormative pop culture and systemic institutional practices establish ideals that rarely reflects TGNC experiences, but instead provide limited depictions of how people should identify, look, and behave.

From an early age, family units reinforce traditional gender roles and often act as regulatory authority over a child’s budding gender identity and expression. Consciously or not, parents might discourage boys from playing with dolls or wearing pink, while expecting girls to love both. Narrow and arbitrary ideas about acceptable gender norms are widely and automatically enforced from the moment a child is born. For children who struggle with gender expression and identity, parental and family rigidity serves not only to regulate the child’s development, it also can contribute profoundly to a child internalizing transphobic beliefs that may haunt them as they grow into adulthood and beyond. If such a child faces additional obstacles, such as abuse or other traumatic threats to their well-being, they may internalize many negative beliefs from their environment that congeal with transphobic internalizations in a way that amplifies the power of internalized transphobia in their psychic and worldview.

Schools, churches, and community organizations also play major roles in perpetuating gender norms and transmitting transphobic messages that can be internalized. The younger the child, the more susceptible they are to internalizing these messages. While bullying and rejection is unhealthy for children, adolescents, and adults of any age, it is often especially impactful on those who experience it earlier in development. Outside the home, our gender expression is highly regulated by rules such as what bathroom we can use and what sports teams we can join. When a child or adolescent breaks such rules, they are met with disdain, punishment, and violence. Forms of retribution, such as bullying and abuse, inject derogatory judgments into the person who has already endured victimization. Escaping or stopping such victimization is crucial but resulting psychic scars can be hard to overcome and may live on in a silent but often destructive internalized form.

It’s important to note that people who don’t identify as TGNC also experience internalized transphobia because of our culture’s rigid gender norms, and it may be holding them back in their personal development and their relationships. You don’t necessarily have to identify as trans or be questioning your gender to do the important work of uncovering gender beliefs and biases — it’s helpful for everyone.

How Do Therapists Identify Internalized Transphobia?

Psychotherapists know that a process of internalization is a normal mechanism involved in the development of the mind, mental operations, and relationship building. As defined by Psychoanalytic Terms and Concepts, internalization describes a process whereby the inner world takes in real or imagined aspects of the external world. This can include attitudes, beliefs, values, and functions learned from others, ways of relating, and aspects of important others. When this goes well people develop a healthy mental structure, including concepts of the self that encourage development, access to loving relationships, and ability to cope with frustrations, failures, and disappointments while building positive feelings about oneself. When internalization is weighted with negative ideas, which is too often the case for transgender and gender non-conforming people, it can lead to extreme negative feelings about the self, including self-hatred and shame. These ideas can organize around many aspects of a person’s identity, including but not limited to gender identity.

People experiencing internalized transphobia may be totally unaware of its presence. As Dr. Pula explains, very few patients seek out therapists explicitly to deal with the phenomenon. Instead, it’s something that therapists and patients may detect through exploration of beliefs and behavioral patterns. This may be discovered in someone who does not yet identify as transgender or gender questioning but has presented for treatment for other reasons. It can be detected in those who are outright transphobic and those who are unaware of their transphobic beliefs. It is especially noteworthy when it crops up in trans people because it can make for intense internal and external turmoil that may contribute to mental health problems and overall unhappiness.

“By listening to patients, you can understand how they experience themselves as trans. If they have a negative self-perception and are constantly worried about what others think of them — a valid and frequent fear in the trans community — that’s a sign that they’re struggling with internalized transphobia,” says Dr. Pula. “Likewise, if they are frequently critical of other trans people, prone to shaming them for various aspects of their transgender identity expression, that may be a sign they are struggling with internalized transphobia that they project onto others.”

Internalized transphobia turns the shame and vulnerability that TGNC individuals absorb from society into a personal shame that gets in the way of daily life. Statistics back this up. A survey conducted by the National Center for Transgender Equality found that 71 percent of the more than 28,0000 respondents felt the need to hide sexual orientation or gender expression for fear of discrimination, with 57 percent delaying transitioning entirely. The threat of violence no doubt plays a role in these responses, but fear of negative public perception can similarly affect how TGNC individuals live their lives.

Read More: Is Internalized Homophobia Impacting Your Relationships?

How Does Internalized Transphobia Affect Personal and Romantic Relationships?

Internalized transphobia can have extremely destructive effects on the friendships and romantic relationships that TGNC people form inside and outside the community.

“Internalized transphobia contextualizes trans relationships in shame and can fuel projective processes that are deeply critical of other TGNC individuals,” Dr. Pula says. “It can lead to sabotaging your own progress in relationships, avoiding relationships in general, or engaging in a sort of competitiveness with those around you.”

TGNC people who are conditioned to feel ashamed of their own gender identities and expressions may defend against such difficult feelings by projecting that shame onto others within the community. For example, someone struggling with internalized transphobia might police other trans people who are too “overtly” trans rather than in alignment with the gender binary.

Perfectionism is another unhealthy way that we try to overcome self-perceived shortcomings, especially in LGBT communities. We’re accustomed to scorn or rejection related to our identities, so we overcompensate in other areas of our lives. And while a sense of ambition can naturally be a positive force in your life, it can also become harmful if left unchecked. We fear that a partner will see too much of who we are, so we put up a front and drive them away. We desperately want society’s approval, so we become workaholics. We’re made to feel insecure about our appearance, so we generate an immaculate, unhealthy social media presence. We can also develop rage, resentment and expressed anger that tear others down.

It is important to try to develop understanding of one’s mind and emotions and circumstances in order to successfully grapple with the realization that one is living with internalized transphobia. Becoming aware of these ideas and feelings and how they get expressed psychically or in our behavior and relationships can be tremendously freeing. Coming to understand the ways in which such unconscious ideas restrict and harm us and those we love can take time, patience, and often require work with an empathetic and supportive, trans-friendly therapist, like those part of the Lighthouse network.

What Can Therapists and Patients Do to Mitigate Internalized Transphobia?

Internalized transphobia is the result of a complex process and how any one person suffers from it will depend on their individual circumstances. Working on this problem takes time, patience, and compassion. “Sometimes, if you try to address internalized transphobia early on, people become defensive,” explains Dr. Pula. “People want to present themselves as proud, not as someone who is playing a role in their own suffering. But after a relationship is established, there can be an alliance between therapist and patient where you can begin to talk more fully about this.”

Once such an alliance is established, therapists and patients can develop the level of honesty and trust needed to tackle deep internalized transphobia in small increments. As one reaches a fuller understanding of their mind, including these insidious and painful ideas, a process of mourning can occur, modified ideas can take hold, and reframing and constructing new ways of thinking and feeling can take place. This occurs in the context of a trusting therapeutic relationship in which the therapist and new relating in each session is internalized as a healthier version than took hold earlier in development. Greater flexibility and self-compassion can mitigate and lead to improved patterns of thinking and relating to yourself and others. This can lead to improved self-esteem and self-acceptance, enhanced pride in one’s transgender identity, more openness towards others, and more fortified ways to cope with ongoing transphobia in our society.

Interested in exploring the impact internalized transphobia might be having on your life? Head over to Lighthouse to find a vetted, LGBTQ-affirming therapist today.

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