The truth that’s denied: Psychotherapy with LGBTIQ+ clients who identify as intersex

Abstract

There is an absence of literature about people with variations in sex characteristics in the UK. This leaves therapists ignorant of this client group. Since 2013, normalising genital surgery performed on babies born with developmental differences has been described as a human rights violation, and the psychosocial justifications for this surgery is now contested. This paper expands awareness so that psychotherapists will be better informed about the damage, both psychological and physical, which results from the pathologisation of those with what is also referred to as ‘intersex’ variations. Further it identifies how therapists can support this group. The paper presents the findings of a qualitative analysis of four interviews with clients identifying as LGBTIQ+ and intersex, focusing on their experiences of therapy. The findings demonstrate a significant mistrust of therapists and clinicians in general. They raise the possibilities that therapists may develop vicarious trauma, and that therapists’ lack of knowledge prevents exploration at depth of these clients’ gender, biology and sexuality. As a result of the imposition of normative sex and gender categories through institutional treatment practices, the bodily integrity and autonomy of this client group has been severely and repeatedly compromised. It is therefore vital that adequate therapy – and therapeutic training – is provided.