Book Review

Reviewed by Tracie O'Keefe

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Transgender Emergence:

Therapeutic Guidelines for Working with Gender Variant People and Their Families

by Arlene Istar lev
Published by Haworth Clinical Practice Press
I.S.B.N.139780789007087

This book is largely an academic review of the state of treatment of sex and gender diverse people.

Lev is a social worker, family therapist and academic with extensive experience in working with the gay, lesbian and trans community who has managed to develop a view of clinical services that is often cynical but nonetheless realistic.

Although Lev refuses to join the many professionals who view sex and gender diversity as mental illness, she stops short of revolution.

There is little doubt that many of the services offered to sex and gender diverse people over the past forty years have been extremely abusive and disempowering to the client; and continue to be so.

Surgeons and other health care professionals demanding extensive psychiatric examinations are only covering their own backsides in order to avoid being sued should a person change his or her mind after surgery. The stigmatisation of pushing sex and gender diversity into the mental disorder bracket is often responsible for the social plight that sex and gender diverse people throughout the world find themselves in, being seen as having a personality disorder.

Lev reviews many of her cases and tries to show that people and their families can often adapt to circumstance rather than prescription.

As a family therapist she has managed to understand that no one shoe fits all and regardless of very poorly researched, high and mighty opinions of many mental health professionals it is the people themselves in the sex and gender diverse communities who are the real experts on what can work for them.

Where Lev stops short is that she does not identify many of the doyens of the Harry Benjamin International Gender Dysphoria Association as being responsible for the profound suffering that often masquerades as health care.

Only when the H.B.I.G.D.A. changes its name to reflect sex and gender diversity and ceases to focus mainly on pathologisation will a humane ethos towards sex and gender diverse people have a real chance of emerging.

I recommend this book to those involved in caring for the sex and gender diverse communities because Lev in her comparative style shows many of the so-called expert opinions to be as ridiculous as they really are. It is clear from her work that the isolationists who are often very high on the medical and academic ladder do not much care for their patients but are simply prevaricating about their own expertise.

What Lev clearly shows from her experience is that treatment and help for sex and gender diverse people needs to begin primarily with the client's needs and not within flexible and often erroneous theory.

Polare is published in Australia by The Gender Centre Inc. which is funded by the Department of Community Services under the S.A.A.P. Program and supported by the N.S.W. Health Department through the AIDS and Infectious Diseases Branch. Polare provides a forum for discussion and debate on gender issues. Advertisers are advised that all advertising is their responsibility under the Trade Practices Act. Unsolicited contributions are welcome, though no guarantee is made by the Editor that they will be published, nor any discussion entered into. The editor reserves the right to edit such contributions without notification. Any submission which appears in Polare may be published on our internet site. Opinions expressed in this publication do not necessarily reflect those of the Editor, The Gender Centre Inc.I, the Department of Community Services or the N.S.W. Department of Health.