An interview with our Annual Meeting Panel Members by Amelia Canally

Beyond the Binary: Exploring Gender and Gender Identity in Groups

In January at the AGPS Annual Meeting we will gather and learn from select Austin group leaders how they are exploring gender within their ongoing therapy groups. We’ll start here with a teaser question…

In 2017, gender took a front seat in our political discussions, with proposed bathroom bills, the #metoo movement, and an outpouring of sexual harassment charges within Washington and Hollywood. I asked our panel participants: How have you seen these gender issues and the heated political climate impact your groups?

Paula Buls: 

The last several years have been a pivotal time for issues related to gender and for those people for whom “traditional” gender roles and expressions may not fit. Prior to and throughout much of the 1990’s, the general philosophy among therapists working with the trans community was to emphasize the ideal of “passing”; the idea being that the better one could be perceived as cisgender i.e. not trans, the better. Often, the ability to pass as cisgender would determine whether someone would even be allowed access to hormones and surgeries. This bias was accompanied by a lack of positive trans roles models in mainstream media. In many respects, the depiction of Sophia Burset (Laverne Cox) in Orange is the New Black was a turning point. The character is portrayed as a sensitive human being with a compelling backstory which defied stereotypes. More importantly, she was portrayed by an actual trans woman who is herself a well-spoken activist within the community.

In the most recent round of special elections across the nation, no less than eight trans people were elected to public offices.

This increase in positive trans role models and depictions in the media has led to a time of greater trans visibility as well an increased political  push toward trans rights. One response to this progress has been an increase in attempted legislation to curtail those rights. In turn, this backlash has led to an even greater awareness of the needs and vulnerabilities of the trans community. In the most recent round of special elections across the nation, no less than eight trans people were elected to public offices.

In general, I have noticed many clients respond to these societal pressures by retreating to previous coping mechanisms. Coping strategies vary from person to person and it is important not to overgeneralize. People on the transmasculine end of the spectrum, who were socialized as female, often came out within lesbian communities. As such, they have perhaps a greater tendency to seek out community during the transition process and to take refuge in unfriendly political climates. People who tend toward the transfeminine end of the spectrum,who were socialized in their early years as male (especially as heterosexual males), often struggle more with issues of internalized transphobia and a resistance to engaging in LGBTQ communities for support. As such, they often experience far higher levels of social isolation. Group treatment helps to draw everyone into the conversation, and is a very valuable tool for work with these populations.

Paula Buls is a native Texan and has lived in Austin since her family moved here when she was in the eighth grade. Prior to her transition in the late ’90s, she worked as a Licensed Substance Abuse Counselor. She worked for the Texas Commission on Alcohol and Drug Abuse (TCADA) under the administration of then governor Ann Richards. She developed substance abuse treatment programs at various central Texas facilities including St. David’s Pavilion, Solutions Counseling and Austin Recovery. Following “coming out” as transgender, she left the substance abuse field to focus on her transition. She became involved in trans and queer activism, was a founding member of the Transgender Education Network of Texas, and has served on the board of directors for the Austin Gay and Lesbian International Film Festival. Paula was the first openly transgender woman in the University of Texas School of Social Work where she completed her Master of Science in Social Work. While there, she was a student co-chair for the Dean’s Advisory Committee on Social Justice. She has served as a Commissioner for the Human Rights Commission for the City of Austin and is currently Vice Chair of the LGBTQ Quality of Life Commission. Paula has also served on the board of AGPS. Paula and her wife Phaedra live with their rescue dog, Taylor, in the heart of Austin.

Pam Greenstone:

My response to the current political climate was to start a new women’s therapy group. I wanted to provide space for women to talk to one another, learn from each other, and learn effective ways to protect themselves out in the world. Some women, due to the pervasiveness of sexual harassment in their life experiences, can allow themselves to be more vulnerable in women-only spaces. I chose a women’s group as my first adventure into group therapy as a client (18 years ago!).

I found myself being much more direct than usual about how this group was going to be inclusive of all women.

In response to the attempt to pass an anti-trans bathroom bill, I spent this past Texas Legislative Session as a volunteer with the Human Rights Campaign (HRC) and Equality Texas. During the same time period, as I was talking with my clients and colleagues about starting the new group, I found myself being much more direct than usual about how this group was going to be inclusive of all women, talking openly about including gender non-conforming, gender fluid, bisexual, trans, and lesbian women in the group. Some client reactions were surprising to me and led to deeper discussions about gender identity. I realized that some women seek out a women’s group because of some idea that they will always feel “safe” in an all women’s group. This led me to point out that, at some point in group therapy, the experience will feel scary, vulnerable, and uncomfortable. The conversations gave me room to address more directly my conception of the group as more of a “brave” space than a “safe” space, and gave me the chance to find out what members might need from me when they feel scared or vulnerable. Over time, I hope my explicit support for a non-binary conceptualization of gender will lead to an even deeper and more complex exploration of identity for the members. 

Pam Greenstone, M.A., L.P.C. has been a group therapist since 2002. She loves group and especially enjoys her work with the LGBTQ community and with eating disorder recovery. She runs a Women’s Psychotherapy Group on Monday evenings in her North Austin private practice. Pam is a past president of AGPS. Most recently, Pam presented at a conference on how group therapy can be helpful for adult adoptees in reunion with their birth families. 

Anne Marie Jennings:

Yes, I have definitely seen a shift. Gender roles in my group have become more strained as issues relating to sexuality and violence against women have been addressed on a national level. It seems hard for men in my groups to know how to relate to women in a way that acknowledges injustices but still honors the men’s truth. For women, including myself, I find that anger is closer to the surface, as the need for a woman to protect herself and other women feels critical.

As a female group leader preparing to write this response, I found myself doubting whether my perspective was valid enough to share without some external validation. I even considered asking my male co-facilitator for his thoughts as a way to avoid the exposure of my point of view. I find that this hesitation to trust my own voice in certain situations mirrors the experience of my clients as they face the many challenges specific to women in these conversations, such as becoming silent, resigned or even self destructive.

For women, including myself, I find that anger is closer to the surface, as the need for a woman to protect herself and other women feels critical.

These uneasy times have differing impacts on group members. I notice an underlying fear of being misunderstood or causing misunderstanding. Thankfully, members care about each other and want to stay in connection, so they are willing to slow down and hear differing perspectives about the personal experiences that reflect broader social issues. Sometimes feelings are hurt or members become angry with one other around issues of gender. All in all, with some time, work and curiosity, the differences expressed in group seem to increase members’ understanding of one another.

Anne Marie Jennings has been leading groups in private practice since 2012 and has co-facilitated a mixed gender group since 2015. Anne Marie specializes in the treatment of adults with bipolar disorder and is trained in EMDR, which she uses to work with a wide range of issues. She is in her third year of a modern analytic training group with Jan Morris and is excited to continue to train with the Center for Group Studies in NYC.

Derek Leighton:

My therapy groups are formed under the umbrella of sexual and relationship health.  Sex and gender and power dynamics are frequently on the table. I expect because these issues are already in the mix, I haven’t noticed a marked shift in how group members are talking about the recent climate around sexual harassment and assault.

My therapy groups are formed under the umbrella of sexual and relationship health.  Sex and gender and power dynamics are frequently on the table.

Right after I received your question for this article, one of my group members expressed how relieved they felt about a ‘bit of sanity’ from the election results in Alabama. The ensuing discussion included whether it was possible to separate judgment about the candidate’s expressed beliefs from the allegations about his sexual behavior. This is of course a microcosm of some of the discussions we’re having as a  society. I am aware that many group members are reviewing past experiences, often silently, and I continue to remain excited to see what emerges in my groups that is not yet being talked about.

Derek Leighton, LMFT-S, LPC-S, CGP, CST is in private practice as a psychotherapist in Austin, with a focus on sex therapy, relationships, LGBT issues, and trauma resolution. He works with individuals, couples, and those in polyamorous relationships, and provides supervision and private practice consultation to other therapists. As an AASECT Certified Sex Therapist, he specializes in helping people have great relationships and healthy sexuality, in self-defined ways. Derek is a past president of AGPS. Quite often, when he stops to consider the work he gets to do being in the business of hope and change, he believes he’s one of the luckiest people around!


Amelia Canally, LCSW, CGP has been working in private practice and agency settings as an individual, couple and group therapist since 2000. Amelia is trained in EMDR, Somatic Experiencing and Psychobiological Approach to Couple Therapy.  She enjoys the ongoing learning and evolution within a private practice and the vitality and flexibility that come with the work.

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