TPC-Journal-V1-Issue1

The Professional Counselor \ Volume 1, Issue 1 59 with age because of the need for changed manners of speech and gesticulations. Legal issues include additional unique challenges as a change in gender is often associated with changed governmental benefits. For example, a formerly heterosexual marriage might be seen as an illegal same-sex marriage after one spouse transitions, and then formerly anticipated benefits, such as Social Security, might be revoked. As professional counselors work with the older adult transgender population, there are several important aspects about this community to be considered in treatment planning (Cook-Daniels, 2006). First, although transphobia in the medical community and healthcare facilities has not been adequately researched, it is well-documented (Donovan, 2001). Therefore, making effective referrals necessitates that the new service provider be familiar and comfortable with the transgender population. Professional counselors also should understand the roadmap for individuals who are transitioning, and in particular how they need to be declared mentally fit as well as diagnosed with Gender Identity Disorder before any treatment for transitioning may commence. Professional counselors also should understand that persons in MTF or FTM are often perceived to be, “…mentally ill until proven otherwise, and they are fearful and angry that—to a degree that is rivaled perhaps only by prisoners and the severely domestically abused—their life choices are under someone else’s control” (Cook-Daniels, 2006, p. 25). To the extent that a transgender person holds this perspective, it might interfere with his or her level of comfort in seeking the services of a mental health professional at all. Transgendered individuals also cannot control the coming-out process of their gender identity because visual or auditory cues may expose their status, and therefore they are left open to the opinions and reactions of others they encounter. Thus, it is important for professional counselors to assess their own comfort levels, and meeting transgender individuals or volunteering in an organization that serves this population is a great way to increase familiarity with and knowledge about this group. It also is important to recognize that transgendered individuals face financial constraints that are usually greater than those typically encountered by other gay, lesbian, or bisexual elders due to hormone medication or surgical procedures that are usually not covered by insurance. Therefore, as with other clients experiencing financial constraints, professional counselors might employ a sliding-fee scale depending on their client’s stage of transition and/or individual circumstances. Bisexual individuals also experience a sense of invisibility within the LGBT community. As another underrepresented group in professional research literature, the needs and experiences of bisexual older adults also are often misunderstood. Professional counselors likely will work with bisexual clients during their careers, and should approach treatment without the erroneous assumption that sexuality is necessarily dichotomous (Dworkin, 2006). Ageism typically precludes recognizing the sexuality of older adults (Hooyman & Kiyak, 2008). However, it is an important element. Consider a professional counselor who meets an older adult client who is happily married to a member of the opposite sex. That counselor likely will not consider that the client may in fact be bisexual—but it may be the case. Indeed, coming out as bisexual during a heretofore heterosexual marriage is the point at which a professional counselor might most be needed as issues of intimacy and restructuring of familial dynamics are addressed. There also is the myth of the impossibility of monogamous relationships for bisexual individuals that should be considered by professional counselors (Dworkin, 2006). Simply because a person has the capacity for attraction and/or commitment to both males and females does not mean that the individual is unfulfilled with a monogamous relationship or that polyamorous relationships are necessarily seen as negative. Aging Research and Identity Differences among individuals within the “LGBT” acronym highlight the necessity for a professional counselor to understand the complex nature of identity. Through a shared history, current activism, and support networks, individuals within the LGBT community have much in common with one another. However, they also have differences. In building rapport with an older adult client, a professional counselor should recognize these differences (beyond commonly understood stereotypes). For an older adult LGBT client, having a well-informed professional counselor is essential to relationship-building and establishing trust, i.e., a comfortable environment in which LGBT history can be addressed and acknowledged.