Okay, let’s do this… I never know what to say about myself in these bios. I came so close to just boring you to death in this one, my first impulse to fill it up with my credentials (how creative). But not to impress you. If anything, to put your mind at ease I know what I’m doing. Luckily for you, I gave it more thought. You can always find my credentials in other places (i.e., my business card, letterhead, professional disclosure statement, email signature), besides, I think it goes without saying boring you to death from the get-go might be counterproductive in getting you to come see me. I think you’ll be more inclined if I can give you a sense of who I am and how I think as a human being so you can determine if we’ll make a good fit.
Not your typical therapist. If I could tell you just one thing about me, it would be to forget what you know about therapists and university psychology professors—I’m not like my colleagues. Sure, I like to do my nails, wear makeup, and high heels, but I also like to use cuss words, commute to my offices on my Harley Davidson, tame wild horses, operate excavators and dozers, and target practice with my firearms at the ranch. Believe it or not, we have 400 Arabian horses on our 1,000 acre ranch scientifically bred and naturally raised for show and 100-mile endurance races. We fly them on airplanes to compete throughout Europe and the Middle East. (The Saudi gov't actually flew us and our stallion first class to participate in their annual Al Khalediah festival in Ryadh--what an experience that was!) I used to compete in rodeo as a teen and then evolved to jumping, classical riding (dressage), and natural horsemanship the last few decades. Today, I ride purely for pleasure on my warmblood while managing our herd and creating its promotional material. I am even certified to ultrasound our mares for follicles, perform embryo transfers, and collect and freeze the semen of our stallions for storage and shipment.
Clinically, I feel very fortunate to have had the ongoing support of my grad school professors to jump into my private practice straight out of grad school. Doing this allowed me the freedom and courage to intuitively explore and sink my roots deeply into each of my three clinical focuses (sexual identity development, veteran support, and law enforcement/first responder training and support).
Sexuality, veterans, and first responders? Yes, I know what you’re thinking—you can see an obvious connection between the veteran and first responder groups, but how did sexual identity development get in there? Believe it or not, there is a logical explanation. We live just south of the California-Oregon border in a rural mountain community desperately lacking in mental health services. Just out of grad school, I had not developed a niche, yet, so I was pretty much willing to see anyone within my scope of competence to acquire the hours needed for licensing. Figuring I can always refer a client out if needed, I checked almost all of the diagnostic boxes on my new PsychologyToday.com profile, including those related to sexuality. Within days, I was shocked to begin receiving calls from individuals experiencing gender dysphoria. “You realize I’m still an intern, right?” I asked, replied by, “But you’re the only one between Portland and San Francisco who checked those boxes!”
Knowing a few of my favorite grad professors had private practices, I went straight to them to ask why they had not checked the boxes for this already marginalized population. “It’s not that we are discriminating against this group,” they said, “the problem is we are not professionally competent to treat them,” explaining a therapist must be trained in evidence-based models to treat gender identity development while staying abreast of standards of care and available medical interventions to provide accurate diagnostics, treatment, and medical referrals. Therapists must also develop working relationships with local medical providers (i.e., physicians, electrologists, endocrinologists, surgeons, urologists, and gynecologists) who provide these interventions.
Given the narrow breadth and deep complexity of this population’s needs (combined with the already limited census of our rural community), who would blame me for joining my professors in shying away from this group? But after talking with just a few of these individuals, I was amazed how refreshing it was to meet them, to hear their stories with such unusual clarity of purpose in seeing me. And even if they were previously uncomfortable even thinking about it, I really appreciated their willingness to trust me with their most intimate thoughts, feelings, fantasies, and fears concerning their bodies. Most of all, I was struck by their level of self-motivation to engage in therapy and do their work, making my job a breeze.
I could also see these were not sick people, they were tortured and conflicted, suffering from the incongruence of internalized environmental expectations (the shame and guilt that keeps all of us trapped when living for others rather than ourselves). Once we’ve teased out all of that, what remains is typically their actual identity, and I observe a synergistic change occur. Taking the ball and running quickly with it, they become exponentially happier day by day, and my role transforms to providing psychoeducation, coordinating any necessary medical interventions, and helping orchestrate a life (and relationships) to nurture that identity.
My revelation summer 2020—No transgender identity? I’d like to point out here I do not consider myself to be a “transgender therapist.” It was while seeing a precious preadolescent kiddo last summer that I had the revelation I was not comfortable saddling him the rest of his life with such an unstabilizing, incongruent, politically charged identity as transgender. Why would I not, instead, wish for this child to walk out my door on a mission to live the remainder of his life a normal member of society? That got me thinking…
I am not treating transgender people—I am treating people suffering the debilitating incongruence of gender dysphoria, by definition, a sadness caused by the birth defect of erroneous physically developed sex traits. I have also come to believe not everyone with gender dysphoria needs to medically transition their bodies—ideally, someday in the future, our society will just accept themselves and others the way God made them, even if it includes such physical abnormalities.
Summer of 2020, I came to the realization I can no longer accept the word transgender as an identity, and any clinician who encourages a client to adopt it is both ignorant and clinically reckless. I will not get into the history of the word transgender, but I will say it was poorly articulated and introduced by way of scholarly journals as an “umbrella term” to include non-binary, gender fluid, and other ambiguous expressions.
Medical model—Not LGBTQIQ+? Because it reflects the way I think, for the purpose of my bio, let me also say I approach gender dysphoria through the medical lens, as opposed to the political LGBTQIQ+ nonprofit political lens inadvertently used by almost every one of my colleagues in the mental health field. In fact, the sooner my clients get away from these political identities, with social strings attached, the sooner they can integrate their identities to a single sex and get on with their lives as a normal, self-actualizing member of society in all their endeavors.
I have come to believe very strongly much of the internalized torture and discrimination my clients complain about is the result of the political polarities created by the LGBTQIQ+ groups. In fact, when the topic of what I do for a living comes up with my conservative friends, I validate their frustration with the political polarities separating our society and then I explain how the baby develops, the consequence of incongruent brain/body sexual development, and the personal experience of people with gender dysphoria simply wanting to fit into society. At this point, they are curious and even a little compassionate. Asking me one question after another, what was meant to be a 5-minute explanation of what I do for a living turns out to be a two-hour enlightenment for which they express deep appreciation.
What is the medical model? Thanks to technological advances, research in this area is improving every day. For example, brain scans show us there is a visible difference in the size and shape of significant nerve bundles between male and female brains. We also know all embryos start out as female until genes are activated to drop the ovaries to become testes, sending the physical body on its journey to develop male traits. In the case of the majority of my clients, who are feminizing their bodies from male to female, we now know it is possible they were genetically meant to be female, their brains already hardwiring into female brains when something happened, such as the adrenals creating too much DHEA (an androgen) or their mother’s hormones fluctuating during a critical window of fetal development, erroneously triggering the drop of their ovaries, thereby dooming their bodies to part from their female brain to develop masculine traits.
Unfortunately, we do not scan babies’ brains at birth to identify the hardwired sex between their ears, we simply look at the more easily identifiable physiological sex between their legs. The mental health field learned the hard way that while it is possible to change the sex between the legs, it is not possible to change the hardwired sex between the ears. So, in conclusion, the main construct of my revelation is this: if a person is born with a female brain and will live and eventually die of old age with a female brain, where is the transition? If anything, in my opinion, there is a medical intervention to correct the incongruence created during fetal development. It is a medical procedure meant to be private and allow people to enjoy happy, productive lives as the sex hardwired between their ears.
Believe it or not, most of my clients identify as heterosexual females, and they get angry when people confuse them with being gender fluid, nonbinary, hedonistic, or politically-motivated to shove their personal medical problem down the throats of others. Contrary to common belief, they do not enjoy talking about their private parts nor did they ask to be a part of the LGBTQIQ+ rainbow campaign.
Needless to say, I’ve sunk my roots deeply into sexual development and gender dysphoria. Surprisingly, it was not long before I had a full case load, including clients contacting me from hundreds of miles away in all directions via telehealth.
Psych Armor for Veterans… Upon licensure, I was contacted by the VA with referrals for veterans through what was previously called the CHOICE Program, now Community Care Network (CCN). Although these referrals were not gender-related, I have family members who served in the military, and the idea of supporting them is dear to my heart. So, I chose to go ahead and accept the referrals and participated in Psych Armor clinical training to learn more about the military culture.
I was prepared to see VA referrals for anxiety, depression, PTSD, relationship troubles, and substance dependency, but I was not expecting to see 70% of my VA referrals present with symptoms of gender dysphoria! (Upon meeting my new VA clients, I learned joining the military happens to be a common strategy for people with gender dysphoria to placate their loved ones and temporarily suppress their symptoms.)
It has been a true honor supporting my veteran clients; it makes me feel good to know I can be there for them and help them improve the quality of their lives and relationships.
My Backup for Law Enforcement. A few years later, my nephew joined the police force, and I began to wonder who is supporting our law enforcement officers (LEOs)? In researching the matter, my heart sank to discover we did not have a single licensed mental health provider certified to work with first responders within a 300-miles! To me, it looked like a big black hole of abandonment, a true lack of appreciation for the people who sacrifice holidays with loved ones, games with the kids, and risk their lives and sanity to keep us safe. LEO careers have always been challenging, both on and off-duty, but the recent wave of anti-LEO political movements across the US exacerbated the situation with increased stress on the job, budget cuts, low pay rates, reduced recruitment, and higher turnover. Needless to say, I was compelled to take action.
The red pill or the blue pill? September 2021, I began taking steps to fill that 300-mile-wide black hole. As if choosing to take the red pill in the 1999 movie “The Matrix,” I knew going in I would be seeing things I could not unsee and my view of the world around me would forever change. I must admit, part of me wanted to take the blue pill to remain in my safe little cocoon, albeit naïve.
Within five months, I spent over 100 hours with the local police department and earned my credentials as a certified first responder counselor (CFRC), a certified clinical trauma professional (CCTP), and a certified peer support team leader/trainer (CPSTL/T). To my delight (and relief), I was very warmly accepted by the chief, dispatch team, and LEOs, who all appeared to appreciate my efforts. I have created a new officer wellness campaign I call “My Backup,” consisting of emotional agility training, EAP services, ongoing confidential counseling, and 24/7-365 crisis support for all responders (LEOs, fire, dispatch, EMS...).
Both the PD and our county sheriff’s office have asked me to help create new officer wellness programs with them, and I have offered my clinical support to our local California Highway Patrol (CHP) office’s existing peer support team.
Where am I going? To advocate for my LEOs and reduce the stigma of mental health support, I will be creating new POST courses with them. I am also very excited to start my new video blog to increase awareness of responder wellness to the general public and responder loved ones. I also intend to visit first responder academies and university psychology and criminology departments to inspire upcoming therapists and LEOs.
Ironically, I am seeing similarities among the three populations I see. Aside from the glaring lack of professionally competent therapists to support them, all three groups are at dangerously high risk of:
For this reason, I will continue to do whatever I can to support them. I was planning to start my doctoral work as a clinical psychologist with a minor in sexology, but I am now determined to press onward with my work as a first responder therapist. Perhaps I will get a doctoral minor in both first responder work and sexology, who knows?
In the meantime, I will see you on YouTube!