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Currently Reading: Thinking Outside the Binary Gender Box

Currently Reading: Thinking Outside the Binary Gender Box

By Marcia Quackenbush, MS, MFT, MCHES | May 16, 2016
Senior Editor, ETR

My car rolled to a stop at a crosswalk. A young man strode across my path. Even with my tired, end-of-a-long-workday brain, I noticed his confident bearing. He stared ahead, eyes slightly narrowed. His cap was pulled low on his forehead.

And then I did a double take. The young man was actually a client in my psychotherapy practice—a young lesbian I had just seen in a session. She glanced my way, smiled and nodded, and we both moved on.

A post by Emmie Matsuno on the Psychology Benefits Society blog (American Psychological Association) brought this memory, and that client, to mind. It’s titled, “Are You a Boy or Girl? No: Living Outside the Gender Binary.” I think about my client’s questions, struggles and issues, and I wonder if she might have fit in that gender non-binary world.

We didn’t actually talk about this in our work together. It’s been a number of years since I did clinical practice. The concepts and language many of us are learning about gender today were not in circulation at the time. But I wish this client and I had had a chance to discuss this. I think it would have been an interesting and illuminating conversation for both of us.

More Options Today

How fortunate, then, that those of us working in health care delivery, health education and mental health have so many more options now to be attentive and responsive to people of varying gender identities. Matsuno points out some of the significant psychosocial risks facing people with non-conventional genders, as well as the distressing lack of preparation most psychologists have to work with gender non-conforming individuals. She also offers a sound set of recommendations, including Practice using “they”/“them” as a singular pronoun, one I am definitely still working on.

I recommend Matsuno’s post for anyone interested in advancing their awareness and skills in this arena (wow, did I just use “their” as a singular pronoun?). The Teaching Transgender Toolkit by Eli R. Green and Luca Maurer is another exemplary resource. Author Luca Maurer also wrote this excellent post on our blog.


Marcia Quackenbush, MS, MFT, MCHES, is Senior Editor at ETR. She can be reached at


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