Customer Reviews

Transgender Emergence: Therapeutic Guidelines for Working With Gender-Variant People and Their Families

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Are you - or a family member - considering or beginning male-to-female or female-to-male transition? You should study this book.
Transgender Emergence was written to fill the huge hole in the theory and practice of care for all gender-variant people and their families. It is a superb resource. Originally intended for professionals in psychiatry, psychology, family therapy, and social work, Transgender Emergence is also an excellent guide for clients to use in evaluating and choosing members of their support network.
Arlene Lev is a family therapist with over 20 years of experience addressing the unique therapeutic needs of LGBT people. She is a member of the Harry Benjamin International Gender Dysphoria Association - and is at odds with those who would use the Standards of Care to act as gatekeepers rather than guidelines to serve the needs of transsexuals. She postulates that much of the pathology experienced by gender-variant people is due to their experience with our cultural and sociological demands, rather than their gender variance.
Ms. Lev stresses that the transgender's/transsexual's personal identity is real, and cannot be changed. All clinical efforts should be geared toward helping the client and their family accept and adjust to their gender variance. The goal of the therapeutic relationship must be empowerment of the client and their family to rewrite their lives in a meaningful way. She believes that transgender is nothing more (or less) than a normal, healthy variation of human expression.
There are three parts to the book. Part I discusses transgender/transsexual throughout history, outlining various attempts at understanding sex, gender, and their relationship to each other. The historical premise is that anything other than the polar opposites of male and female is deviant - and must be punished or fixed. As most transgendered people know, "fixing" often meant behavior modification by punishment.
Part II discusses diagnosis, evaluation, and treatment philosophy developed during the past century. Lev finds that "The diagnosis of Gender Identity Dysphoria is part of a long historical process of labeling and pathologizing sexual and gender differences." She criticizes this diagnosis as a mixture of unscientific clinical assumptions that are inappropriate as the basis of treatment.
Part III examines potential treatment philosophies and recommends those treatments that honor diversity. The "disorder" or psychopathology found in transgender/transsexual clients is most often the result of gender suppression by family members and society rather than being the cause of their gender variance.
Unique to Lev's recommendations is the idea of providing therapy to the entire family throughout - and even after - transition. No family can absorb the announcement that a member is not what they seem without disturbing the established family dynamics. One chapter is devoted to discussion of the stresses imposed on other family members and several solutions to alleviate those stresses.
In the past - and often still today - many clinicians have treated transgender/transsexual children and youth by assuming a dysfunctional family. These clinicians then attempt to "protect" the child to accomplish a cure. Lev outlines treatment or therapy that recognizes and respects the child's reality.
Chapter 10 deals with care and treatment of intersex people. Lev examines the current medical practice of early surgery, and then advises accepting the recommendations of the Intersex Society of North America (ISNA): delay any and all irreversible procedures until the patient (child) matures sufficiently to make their own informed choices.
The basic premise of this book is that all gender variance represents natural and healthy expressions of human diversity. Lev's therapeutic goals are all geared toward honoring that diversity and helping the client and their family to accept that diversity and build a healthy and happy life.

"A MARVELOUS RESOURCE. . . . Well-written and well-researched. . . . . Provides enough information to give even the most inexperienced psychologist or counselor an understanding of the issues involved in working with the target population-but even counselors who have treated many gender-variant individuals should read this book."

Reviewd By: Dallas Denny, MA, Editor, Transgender Tapestry Journal

"FINALLY, a book that does justice to the life-changing power of psychotherapy in the transgender coming-out process. I recommend this book to any psychotherapist called to work with transgender clients. I also recommend it to transgender individuals who might benefit from understanding how psychotherapy can play an invaluable role. COMPREHENSIVE AND PASSIONATE. . . . TERRIFIC. . . . LONG OVERDUE."

Reviewed By:Walter Bockting, PhD, Co-editor, Transgender and HIV: Risks, Prevention, and Care; Assistant Professor and Coordinator, Transgender Health Services, Program in Human Sexuality, University of Minnesota Medical School

"The information contained in this book is SO IMPORTANT THAT NO CLINICIAN CAN AFFORD TO MISS IT. The book offers a clear, comprehensive, and cogent review of the history of the mental health field's thinking about sexuality and gender, and an extraordinarily thoughtful and extensive exploration of assessment and intervention issues with gender-variant people and their families. Lev's knowledge of the subject is phenomenal, and the breadth and clarity of her writing are brilliant. This book lays out an enormous amount of complex material in a highly readable and useful text. . . . BELONGS IN THE LIBRARY OF EVERY PSYCHOTHERAPIST, COUNSELOR, AND HEALTH CARE PROFESSIONAL."

Reviewed By: Monica McGoldrick, MSW, Director, Multicultural Family Institute, Highland Park, New Jersey

Lev compiles a terrific anthology on working with transgender clients. Whether you are a health professional or mental health professional, Transgender Emergence offers the information and skills to be successful with transgender clients. This is a must-have if you work directly with this population.
-Brad Baranowski
Counseling Intern

I don't know what's more depressing - finally reading this book or reading all the full-starred reviews where everyone conflates sexual orientation with sexual identity.

This book is a basic introduction to the concept of trans identities. It has some clinical models, some heartfelt anecdotes and a lot of misinformation that perpetuates stereotypes and therefore violence. Like the ridiculous concept that all transmen were once butch lesbians. The author has taken one person's experience and extrapolated that to be all-encompassing. It limits horrifically what it means to have a trans identity and I can only hope that others will publish different experiences so that we are closer to seeing a more complex picture.

That said, it's better than what else is out there for care providers. If this excites people to know that transfolk exist and we don't as a general rule go about raping women and murdering babies, then that's a step in the right direction. Why we teach people to think different means dangerous and create a need for books that are way too basic is a bigger question and not one this book addresses.

It's ENDA again. And what happened prior to 1973 when homosexuality was still in the DSM as a pathology. It's a long slow road to make it into the common vernacular and to get through the checkout line without a snicker or an unwelcome comment or worse from an unaffected party. If you need hand-holding, this is your book. If you're ready for more comprehensive thought, read Whipping Girl by Julia Serano. It's got more meat without the pretty diagrams.

Much of the time reading books from professional book publishers are like running through mud--lots of hard work and very tiring. Transgender Emergence is packed with excellent information that is written in an accessible style. I've learned a great deal and feel comfortable recommending the book to clients who are struggling with gender issues, including transgender and intersex.

This book is outstanding in every respect. The cover, however, I feel may unfortunately narrow its readership - "Therapeutic Guidelines for Working with Gender-Variant People and Their Families." I am a lay person who is fairly well read on the subject matter and I find that this book would valuable for anyone to read. It has the potential to help emancipate the transgendered population that is still stigmatized and oppressed by the medical profession and society including religion and politics. It certainly should be required reading for policy makers in the government, the legal profession, the justice system, human resource personnel, etc. The book is not only well researched and well written, it is easily understandable by anyone, meaning that no background in the field of psychiatry is required to be able to appreciate the material. The book is very up-to-date (2004). The Publisher would do well to advertise this book to a wider audience.

Lev's "Transgender Emergence" provides the most comprehensive outline and review of empirical literature pertaining to the assessment, treatment, and understanding of transgendered individuals to date. Any mental health professional working with the GLBT population MUST add this to their collection, as well as, provide Lev's work as psychoeducational therapy to patients and their significant others. Additionally, psychologists working in forensic populations or with issues of sexuality should review this book for an overview of the etiology, epidemiology,theoretical understandings, assessment, diagnosis, and treatment of patients presenting with gender identity disorders or dysphoria.

Lev's work is a masterpiece and should be required by MA, PsyD, and PhD programs in diversity training. It provides a non-judgemental, well-written, and well-researched voice to a population which has been largely ignored by current literature and funding. I found "Transgender Emergence" phenomenally useful in researching and developing a model of best care practices for male to female transsexual inmates. Bravo Arlene!