Kathleen Farrell, PhD.

WestCare, Florida: COPE Program’s transgender support group meets every Wednesday from 7 to 8:30 PM, no fee, contact Ricki Liff at 727-502-0188 or rliff@westcare.com; www.copeoutreach

WestCare's transmen therapy group meets on the first and third Saturdays of every month, significant others are welcome, no fee, contact Dr. Farrell at 727.551.9851 or Dr.Farrell@tgtherapist.com

Tri-Ess, a national support group for heterosexual crossdressers and their partners - local chapter Tri-Beta meets monthly, FMI: www.tri-beta.com/

StarBurst, a gender support group for individuals throughout the Tampa Bay area, meets monthly. FYI: www.starburstgroup.org

Dr. Farrell was on the CBS show, 48 Hours, which aired on 02/25/04: www.cbsnews.com/stories/2004/02/23/48hours/main601801.shtml

Writing (From Transgender Tapestry)

The Power of One Little Pronoun (Spring 2004)

Maggie Becoming Mark (Summer 2003)

The Power of One Little Pronoun (Spring 2004) by Kathleen L. Farrell, Ph.D. ( Dr. Farrell's experience as a therapist with pronoun use)

It has been over two months since I experienced one of my most embarrassing moments as a therapist, and the memory still stings. In group therapy, I made the mistake of using the wrong pronoun. Strangely, I didn’t hear myself do it. But I noticed her retreat. Since it was her first time in the group, after trying unsuccessfully to pull her into the discussion, I decided it was related to a low comfort level and let it go.

After the meeting she asked to speak to me. She seemed angry. I was tired after a long day, but I tried to listen. Despite years of experience in dealing with every kind of emotion aimed at me, including anger and disappointment, I felt myself become defensive. At first I could not believe I had used ‘him’ instead of ‘her.’ I was in denial and said, "Are you sure that was what you heard? I am extremely sensitive to this issue. I don’t think of you as male. I think of you as female."

Later I would analyze this and recall what I noticed when Margaret came in. The seating was such that I saw her primarily in profile. For the first time, I noted she was right about her nose. Many times in individual therapy, she expressed the desire to have a nose job and she thought her jaw line could be improved surgically. That evening, as the group gathered, I studied her, silently agreeing with her about her nose and disagreeing about her jaw line. I don’t remember exactly how I phrased my thought, but it was something like, "She’s right, her nose is detracting from a more feminine appearance." In retrospect I am 99% certain my thoughts matched her presentation. I thought of her as she.

From time to time, when seeing a male-to-female who is pre-op and dressed in fem, I have been struck by the thought, "She still has male body parts!" I stay very focused on the gender presentation of the person. As a genetic, right-brained female, it is easy for me to relate to other female brains. This is not to say that I do not notice when someone misses the mark. When Grizzly Adams is sitting in front of me and tells me he is planning to transition, I find myself pondering the improbability and thinking, "Perhaps I could refer this person to a colleague."

Sitting across from Margaret and feeling bad about being confronted, I found myself zeroing in on my feelings rather than concentrating on hers. Lost in denying my culpability, I could neither comfort her nor relate to how upset she was by what she believed she heard. Then something in her certainty gave me pause. I struggled out of my denial, and, flushed with embarrassment, I began a feeble apology. I was so flattened by my own error, I did not process her emotional distress. She left, and I was in shock. Then I noticed she left the book behind that she had intended to borrow. I grabbed it and ran to the parking lot. She was at her car some distance away. I called her name and indicated the book. She shook her head in refusal and quickly drove off. I was left holding the tangible thing that could have brought her back.

A greater sense of disappointment in myself and a lesser concern for Margaret followed me as I went through the motions of closing the office and driving home. I answered the telephone calls that were waiting on my voice mail, all the while thinking about how I had reacted to Margaret. It was not until the next morning, after a sleepless night, that I began separating my feelings and assessing the clinical damage. My thinking became focused on the emotional toll it had cost Margaret, really looking at what I might have taken away from her and how this would affect her self-esteem in her battle to become herself. I hoped this would become an opportunity, since ideally the therapeutic process provides a safe environment in which to open up all emotions and examine them. While I hoped she would make her next appointment, I had a sinking feeling that she would not—that when her therapist slapped her by calling her him that was the end.

I wonder how often pronoun mishaps happen in gender therapy. I have had transwomen tell me about former therapists, who did not specialize in gender issues, refuse to address them by their female names and even insist on using Mr. I help the battered move beyond these negative experiences. It is my job to help the emerging woman cope and move on when strangers and unsupportive relatives and friends are unkind. I assist them with perspective when goofs are made by supportive relatives and friends—gently helping them understand the period of adjustment everybody is going through and the difficulty of reversing a lifetime of referring to a father, son or brother as he and him. In gender therapy, more often than not, a transwoman initially presents in guy mode, and after the gender shift, I always use her name. In individual sessions when the person is sitting right in front of me, there is rarely a reason to use a personal pronoun. When family members or important others join us for a session, their struggle to use the correct gender name and pronoun is often so obvious it makes it easy for me to avoid misspeaking a pronoun.

Actually, this was my second pronoun faux pas—the first was over a year ago at a Halloween party for StarBurst, the Tampa Bay support group I founded in 1988. As an advisor, I attend meetings from time to time, and last year I volunteered to host a game of Halloween Charades.

It was the first time at StarBurst for Gina, an attractive woman who I was seeing in individual therapy. Gina had a defensive posture that I perceived as a vestige of the years she practiced hiding Gina behind Gene.

With both teams close in points, we were in the final round and the game was opened up so that both teams had the opportunity to guess. The room was charged with energy and merriment. One of Gina’s teammates was acting out Night of The Living Dead. Guesses were coming at me from both sides of the room. Gina, in a voice barely above a whisper, gave the correct answer. I pointed at her and said, "He got it." If this were a Hollywood movie, everyone would go dead quiet and stop in mid-motion. In fact, what happened is that no one except Gina heard "He got it." Finally I yelled above the crowd, "Gina got it!" Gina experienced a truly bittersweet moment—crushed by my words and congratulated by her teammates for winning the game for them. Gina confronted me about it, I listened and we worked through it.

After the unresolved incident with Margaret, I did what I hope every therapist does when something like this happens—I made an appointment to see my therapist. "Is there something about me and my feelings toward Gina, and now Margaret?" I try to examine all the possibilities. Gina was raised in the same midwestern city where I grew up, and she is the same age as my younger brother. I spent many years in the same northeastern city where Margaret grew up, and I finished my education there. Gina and Margaret also share some personality traits—they are very bright, generally mistrusting, and have difficulty in relationships.

I tell my therapist that I have abused their trust and feel responsible for their fragility. I am especially concerned that Margaret will use this as the sign she has been looking for to discontinue her pursuit of her true self, her happy self.

I complain that she cannot understand the real significance of this blunder. "And you can?" she asks. I make a weak comparison about how the young people I see talk about their old parents and then look at me and go, "whoops."

My therapist and I talk about everything, and we spar—actually, mostly I spar and she watches. Sometimes she intervenes, sometimes she is patient until I figure out what I need to figure out. She asks if I were hoping for a therapeutic relationship with Margaret like she and I have, like I have developed with Gina.

I probe what I believe is the common link—the masculinity I observed in both these women who were in the early stages of transitioning. I say, "I am not shifting the responsibility away from me, but I am certain this was a factor." Finally she gently tells me that I need to let this go. I know she is right, but I am saddened that I have no way to reach out to Margaret, to bring her back into therapy and work this through with her. And I anguish over Margaret and others who are damaged by what may seem a small thing.

This lesson is not just for me—it is for all therapists who work with transgendered individuals and for all society. When will we learn how destructive words can be? In the case of Margaret, the course of her life may hang in the balance—that is the power of one little pronoun.

Note: Margaret, not her real name, has not returned to therapy with Dr. Farrell; Gina, not her real name, continues to see Dr. Farrell and is successfully transitioning.

Maggie Becoming Mark by Kathleen L. Farrell, Ph.D. (a fictionalized account of Dr. Farrell's real life experience)

I was going through this, my tomboy phase, when I found out that I wasn’t going to be allowed to play Little League. My eight-year-old spirit was crushed. My older brother played. Well, actually he warmed the bench, but he got to wear the uniform. I loved the uniform. I told my grandma who stayed with us during the summers that I thought I wanted to be a boy. ‘Why on earth would you want to be a boy," she asked, as she pulled a second cookie sheet from the oven.

"Cause they can play hardball."

"Pooh," was her answer, she always seemed half in the present and half somewhere far off. Earlier I heard my mother fussing at her about heating up the kitchen on such a hot day and that the kids ate too many sweets anyway. Still there she was, her gray hair held in place by a net and her housedress dotted with orange poppies protected by a full body faded pink phlox print apron smelling like somethin’ ‘lovin’ from the oven turning out chocolate chippers by the dozen. Then she added, "If you really want to be a boy, all you need to do is kiss your elbow." I stared at her hard. "It’s a fact, kiss your elbow and change your sex."

I grabbed a handful of cooling cookies and made a beeline out of the kitchen. Ten minutes later my best friend Maggie and I were chewing away in our crudely dug out fort that overlooked a cavernous depression ladled out during the ice age which now served as the town dump. I told Maggie grandma’s advice. "Let’s try it," she said.

"I don’t know." All of a sudden reality gave my imagination a sharp shove.

"Why not?" she demanded.

"I don’t want one of those hanging wee wees."

"You probably won’t get one, but we’ll be able to play for Nelson Buick’s Little Bulldogs, me at shortstop and you in left field." Now Maggie wanted to play on the team very badly, probably more than I did because she was better than I was.

So we spent the next few minutes bending and pushing and pulling our arms to capture the elusive elbow with a kiss. "Does it matter which elbow?"

I gave up, Maggie would not. After planting a sweaty one on the inside crook of her elbow, she asked, "Does that count?"

‘No, it has to be on the tippy end."

"Okay, I know what’s wrong," she sighed, exasperated by the effort. "Before we can do this, we need to try being boys." So, sitting cross-legged in our fort on a blistering, airless afternoon, we put our heads together and came up with ideas. Caveman-style, Maggie used a stick on the earthen wall to Roman numeral our brainstorm in words and pictures. When we were done, we chose I, IV and V.

Because we got sick smoking when we lit up after school last spring, we rejected the line with a curl at the end—number II. Maggie objected to III on the grounds of sin, VI because we would get caught, and VII was beyond our financial means.

The first test was an over-nighter in our fort. After carefully choreographing permissions to sleep over at each other’s houses and before night descended upon us Maggie told me she would be Mark and gave me the boy name of Karl. She said our names had to be the same as our first initials and were never to be used when anyone else was around. We secured this with our new on-penalty-of-death sign Maggie devised—we simultaneously kissed each other’s elbows. My mother was always asking me, "If Maggie jumps off a cliff, are you going to jump too?" I always answered no but in my heart I knew I was doomed.

We shivered through the long, warm night. Time took on a mythical spaciousness like kids who travel through wardrobes or fall asleep next to tree trunks and live lifetimes before returning or waking up. We were spooked at every sound—the wind sent the scent of terror through the trees, the howl of a dog was a werewolf on the prowl, a scavenging raccoon was a mass murderer about to butcher us, and the silence was a pride of lions crouched and ready to pounce. At long last we praised first light and shook hands at our extreme courage.

A week later the second test was easy. On our belt loops we tied our handmade, Brownie-project knapsacks that we packed with peanut butter and jelly sandwiches and Cokes, and slipped down the bank behind the church into the creek. We walked a quarter mile to where the Little Miami River spread out before us. Fording the river that had dried to a trickle from a summer drought was not a challenge, so we spent the day turning over rocks and exposing crawdads, finding more fossils than we could lug home, and generally rearranging the river bed. That left the last test to determine our worthiness for boyhood.

It was a hot hazy day when we boarded an empty Southern Pacific boxcar that was moving toward downtown Cincinnati. For years we watched the long trains slow to a crawl as they approached the city. We cheered from the bridge as some of the town boys jumped on and off making sport of dares. Maggie who was tall and well coordinated made it on board without any effort. I managed to get my upper torso inside and Maggie grabbed the seat of my pants and pulled the rest of me in. We felt a surge of boypower as we settled back to ride the rails in a car that smelled like musty straw with a floor pitted from the hooves of jostled, fear-ridden animals on their way to market.

Careful to avoid detection, we scrambled off after the train stopped and went to the next track and climbed on board a stationery train. For a long time the train didn’t move and we were nearly ready to disembark when suddenly it lurched forward and we knew we were on our way home. The shortsightedness of our planning became immediately apparent—the trains heading out of the city did not go slow. In fact, by the time we arrived at our town we were whizzing by houses no longer defined by their design or color—our suburb became a blur. We knew we would be killed if we jumped off. We screamed for help and our little voices were lost on the rushing wind and then drowned by the train’s whistle. We huddled together and cried, but we were too scared to offer any comfort to each other. The train rumbled on, tossing us about like groceries in a bicycle basket as it bounced over uneven track and road crossings. It was miles before our stomachs told the rest of us the train was slowing down. When we peered out, it was onto another planet— cornfields and pastureland punctuated by an occasional barn and farmhouse. The train came to a stop in Wilmington, a town unfazed by city ways. A few years later I would watch a Twilight Zone about a man who got on a commuter train and got off a century earlier in a town called Willoughby. In REM sleep with the sound alike names of the towns, his experience and ours, became fused and confused in my often-repeated dream.

As soon as we staggered out of the car in the Wilmington train yard we were grabbed by a security guard who, gripping our arms, dragged us into his office. We were terrified, but before he was able to begin what was certain to be an abusive interrogation a railroad worker came flying in. "Bob, you gotta come, there’s a body in B & O six thirty seven." Telling the worker to watch us, Bob rushed off. A minute or two later, we heard a yell from Bob to come and help him. The worker shrugged and took us along. Several other workers arrived at the scene, and they lifted a man out of the car right behind the one we had ridden in. Neither Maggie nor I had ever seen anyone dead. They laid him face up on the side of the tracks. He was a black man in greasy overalls with ashen gray skin and crusted blood under his nose. We seemed to be waiting for something when suddenly all eyes turned to the policemen who were striding toward us. Maggie looked scared; I peed my pants.

Right away one of the police asked, "What’s these kids doing here?"

Bob said, "The one is mine," he tossed his head in our direction and then ordered one of the workers to get us back to the security shack.

When Bob got back to us, he still seemed a little less tough and listened to our need to get back home real soon before we got into a whole lot of trouble. For Maggie it would mean staying in her room for a while, but for me, with my more corporal-minded mother, it would be lots of licks with the wooden spoon. Later I figured Bob must have done some bad stuff as a kid, because he put us right in his station wagon to drive us home. Maggie sat up front—it was obvious it was her he wanted to be his kid. He gave me a newspaper to sit on in the back seat. Most of the way home, he admonished us to stay away from trains. Just before we reached the Terrace Park incorporation line sign, he let us out.

I don’t believe the dead guy ever found his way into my dreams, but I remember his face clear as if he was a family member or as if it happened ten minutes ago. And I think about him a lot, and I try to give him life before he wound up in the railroad yard. He became my central focus of that summer, even though Maggie and I never spoke about him. And we talked very little about our prowess tests and I never tried to kiss my elbow again, but I knew Maggie kept trying—all through junior high and high school she wore her hair short and was the best player on all of the girl’s teams. When I saw her during college vacations, she seemed more interested in looking like a guy than dating any, and I suspicioned she was a lesbian. Then five years ago, when I was visiting my parents, we got a call that Maggie’s mother died. I went to the wake and was surprised that Maggie wasn’t there.

I was about to leave the funeral home when a guy who looked like one of Maggie's relatives sidled up to me and thanked me for coming. It took a minute before I realized it was Mark. Later we met for coffee, and he told me it was a big struggle but he had finally kissed his elbow.