“Gender dysphoria”: Therapist negotiations of oppressive practices

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Julia Ellis


Julia Ellis (She/Her), MCP, BA(Hons), is a Psychotherapy and Counselling Federation of Australia (PACFA)-accredited counsellor and psychotherapist based on Dharug, Guringai, and Cammeraygal country (Sydney, Australia). She has worked across non-profit, education, and private mental health settings. Her areas of interest include gender theory, trauma-sensitive care, and violence prevention. As a cisgender woman, Julia aims to be acutely aware of the power and privilege she holds. She seeks to disrupt and problematise this as she moves throughout her personal and professional worlds, showing a commitment to cultural humility and critical reflection. She approaches therapeutic work as social justice work.



It has long been demonstrated that psychological and psychiatric fields pathologise and discipline certain bodies. However, few have explored practitioners’ resistance to, and critiques of, gender oppressive practices. Drawing from theoretical frameworks of transgender studies and queer theory, this paper reports on qualitative data gathered from semi-structured interviews with six therapists in Sydney, Australia. Case studies highlight the ruptures, dissonances, and possibilities of transgender and gender diverse (TGD) mental health care in practice. Thematic analysis of therapist case studies demonstrates how notions of “allyship” are inadequate in problematising power dynamics, binary gender, and cisgenderism, as therapists engaged in problematic discourses and practices in relation to their TGD clients. Exploring the limitations of traditional gatekeeping models, the paper situates counselling and psychotherapy practices within an Australian context as holding unique opportunities to engage in anti-oppressive practice with TGD clients. The research makes clear that active frameworks for challenging oppression in the lives of clients are essential to ethical, client-centred work.


Keywords: anti-oppressive practice, anti-oppressive counselling, gender dysphoria, transgender mental health, LGBTIQ+ psychotherapy


Address for correspondence:
Julia Ellis
Email: juliaellis@mac.com