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Gender Identity: The Importance of Personal Reflection

Gender identity isn’t just a subject for our gender variant clients. We all have a gender identity, including those of us who may never have had cause to question it. Therapist and transgender consultant Madison-Amy Webb, the author of a recent practitioners guide to the subject, explains why giving thought to our own gender identity is an essential reflective practice for therapists.


“Congratulations! It’s a boy/girl!” There it is: the moment our sex is assigned to us. In that instant, how we will be treated and the role we will be expected to perform within society have been set. Also, in that moment – and it usually occurs without question – we are implanted into a social group (our family), and all the expectations and dynamics that go with being part of that are laid firmly and unknowingly upon our shoulders.

Sometimes these are explicit, but for the most part they are not. Either way, we transgress them at our peril!

In recent years, we have seen increasing media awareness that there is more gender variation within the population of planet earth than simply the binary of male or female. But unhelpful debates persist, and society is still slow to accept that there are gender variant / trans people out there – myself included – living a multitude of gender identities and expressing these in extremely personal ways.

My work with gender variant clients has raised particular considerations that relate to us all.

Firstly, we all have a gender identity regardless of whether we have ever considered or questioned it – Cis people included. Secondly, our birth sex has no real bearing upon our extremely personally expressed gender identity. Again, this includes Cis people.

At this point it might be useful for me to clarify some basic but often confused terminology around sex and gender:

  • Sex: This is assigned at birth and is based on the physical genitals present at the time (penis or vagina). Sex can be male, female or intersex.
  • Gender identity (GI): This is regardless of our physical sex (penis, vagina, breast). Gender identity can be male, female or something else. It is how/who we sense or feel ourselves to be.
  • Cissexual (Cis): Where an individual’s self-perception of their gender matches the sex they were assigned at birth. It is likely that the individual will have never challenged or questioned their gender identity.

When working with gender variant clients, unwittingly reinforcing the outdated belief that gender binary is the only true gender construct can have a catastrophic impact on the development of the therapeutic alliance. As I mentioned earlier, gender identity is also something we may express in extremely personal ways. For instance, one client disclosed to me that they felt they could best describe their GI as purple. Even I, with my own gender variance, momentarily faltered in knowing how to reply.

So it is fundamental that all therapists reflect on our own gender identity, whether or not it is something we have questioned before. Some helpful questions to ask yourself can be:

  • How do you know what makes you… you?
  • How do you know you’re the gender you experience yourself to be (what informs your knowledge)?
  • If you do identify as binary Male or Female, reflect upon how you do that gender

Gender identity isn’t just relevant to those who are questioning their own. It affects how each of us experiences ourselves within the world – and is something all therapists should be paying attention to.


Madison-Amy Webb

Madison-Amy Webb is a woman with a trans history and has been a counsellor for 20 years. She has considerable experience exploring her own Gender Identity and supporting others questioning theirs.

Madison is the author of the 2019 book, A Reflective Guide to Gender Identity Counselling. She is a member for the Peterborough LGBT network Committee and has developed a Trans Social Activity Inclusion Group, which operates in the Peterborough area. She has experience of working in statutory and non-statutory organisation as diverse as MIND, the Probation Service, HMP Peterborough, the YMCA, and the NHS Substance Misuse Service.

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