by Claire Greenwood, AMFT

(ENCOURAGING) GENDER WITHOUT IDENTITY

How should we relate to gender identity and sexuality in psychoanalysis? In Gender Without Identity (2023), Avgi Saketopoulou argues that gender is not something fixed and innate; instead, gender is a way of “self-theorizing and not some true ‘core’.” In a brilliant yet risky argument, she uses Laplanche’s theories of ego construction to suggest that all gender, including non-normative genders, are responses to parent’s “sexual unconscious.” Because gender construction is a way of self-theorizing, or translating these intrusions from the parents, the role of the analyst is to be unobtrusive and affirming. The reasoning goes that a queer- or trans-affirming analyst should let patients attend to their own “self-theorizing processes” without imposing labels or judgment. 

As a newer therapist who works primarily with trans and non-binary patients, I read Saketopoulou’s work with great interest. Quite frankly, I’m unsure if gender is innate or conditioned – I think gender is perhaps too mysterious to understand so definitively – but I appreciate how theorizing gender in this way gives rise to greater complexity in therapeutic work, granting us room to view our trans and gender-nonconforming clients as humans with intricate psychic processes rather than fixed cores. 

Only one issue in her argument gave me pause, and that is the suggestion to simply (or perhaps not so simply for some) “dignify queer individuals’ own self-theorizing processes,” and to affirm “the patient’s right to have their own, nonlinear process.” Here, the therapist becomes merely a sounding board, aspiring yet again to neutrality, neither adding to nor taking from the patient’s views. But how far can “self-theorizing” go in a heteronormative, cisnormative world? Is it really the generative, creative act we might wish? I worry that leaving clients (whether cis, trans, or somewhere in between) to their own self-theorizing without adding anything to counter cisnormative societal pressures will lead to a therapy with necessarily cisnormative outcomes. In other words, by attempting to be neutral in a world that is decidedly anti-trans, we may unwittingly create more and more gender-normative patients. 

Saketopoulou argues for “patient affirmation,” or “adopting the ethical stance of affirming… the patient’s right to have their own nonlinear process.” The word “affirm” implies that something already exists to be affirmed; it is different from “encourage” or “cultivate,” which are about creating new ways of being. I wonder what it would be like to not only affirm our patient’s self-theorizing but also encourage non-normative gender theorizings. In a cisnormative world, arguing that we should encourage non-normative genders seems dangerous, almost blasphemous. But why does it feel so dangerous? Heaven knows our world encourages and cultivates cisnormativity all the time.