«Call me by my name»: Language issues in counsellors’ cultural competence with gender non-conforming people

  • Konstantinos Argyriou
Keywords: Counselling, Therapeutic alliance, Misgendering, Deadnaming, Cultural competence


Language, both through its verbal manifestations and its non-verbal and environmental ones, is a locus of particular interest in counselling with trans and gender non-conforming people. Discrimination and microaggressions can be evidenced in all three aforementioned domains of communication. Linguistic marginalisation occurs when counsellors or psychotherapists commit acts of misgendering and deadnaming, or seem incapable of addressing the specific needs of their clients. Cultural competence, person-centeredness and the informed consent model have a particular involvement in mental health providers’ training, but are frequently used as falsely universal values that address also universalised experiences and identities. In contrast with this view, the present paper wishes to highlight the situated value of these innovations in therapeutic alliances. Each sociocultural context supposes a different adaptation of terms, meanings and dynamics. During the last years, but particularly after the recent ICD revision in 2018, discussion on gender diversity has evidenced changes worldwide: in that respect, I briefly examine three different Mediterranean contexts, those of Italy, Spain and Greece.


Annoni, Marco (2018), «Lying, deception, equivocation and the ethics of prescribing placebos in clinical practice», in Rivista Italiana di Filosofia del Linguaggio, 12, 1, pp. 30-41. doi: 10.4396/20180601.

Atienza Macías, Elena and Armaza Armaza, Emilio (2014), «La transexualidad: Aspectos jurídico-sanitarios en el ordenamiento español», in Salud Colectiva, 10, 3, pp. 365-377.

Benson, Kristen (2013), «Seeking support: Transgender client experiences with mental health services», in Journal of Feminist Family Therapy, 25, 1, pp. 17-40. doi: 10.1080/08952833.2013.755081

Bettcher, Talia (2009), Trans Identities and First-Person Authority, in Laurie Shrage (ed.), You've Changed: Sex Reassignment and Personal Identity, Oxford University Press, Oxford, pp. 98-120.

Bettcher, Talia (2014), «When Selves Have Sex: What the Phenomenology of Trans Sexuality Can Teach Us About Sexual Orientation», in Journal of Homosexuality, 61, 5, pp. 605-620. doi: 10.1080/00918369.2014.865472

Cavanaugh, Timothy, Hopwood, Ruben and Lambert, Cei (2016), «Informed consent in the medical care of transgender and gender-nonconforming patients», in AMA Journal of Ethics, 18, 11, pp. 1147-1155. doi: 10.1001/jounralofethics.2016.18.11.sect1-1611

Clark, Tory and D’ Andrea, Livia (2018), An AFFIRMative approach to counseling transgender clients and their families, from http://transgenderalliesgroup.org/pdfs/2018TAGCounselingTransgenderFamilies.pdf

Coleman, Eli, Bockting, Walter, Botzer, Marsha, Cohen-Kettenis, Peggy, DeCuypere, Griet, et al. (2012), «Standards of Care for the health of transsexual, transgender, and gender non-conforming people (7th edition) of the World Professional Association for Transgender Health», in International Journal of Transgenderism, 13, 4, pp. 165-232. doi: 10.1080/15532739.2011.700873

Davy, Zowie, Sørlie, Anniken and Suess Schwend, Amets (2018), «Democratising diagnoses? The role of the depathologisation perspective in constructing corporeal trans citizenship», in Critical Social Policy, 38, 1, pp. 13-34. doi: 10.1177/0261018317731716

Favero, Marcus and Ross, Donald (2003), «Words and transitional phenomena in psychotherapy», in American Journal of Psychotherapy, 57, 3, pp. 287-299. doi: 10.1176/appi.psychotherapy.2003.57.3.287

Giannou, Dimitra, and Ioakimidis, Vasilios (2019), «“Neither invisible nor abnormal!”: Exploring the invisibility and pathologisation of LGBT people in the Greek National Health System», in Critical Social Policy, pp. 1-22, doi: 10.1177/0261018319840187

Hochdorn, Alexander, Faleiros, Vicente, Camargo, Brigido and Cottone, Paolo (2016), «Talking gender: How (con)text shapes gender – The discursive positioning of transgender people in prison, work and private settings», in International Journal of Transgenderism, 17, 3-4, pp. 212-229. doi: 10.1080/15532739.2016.1222923

Kapusta, Stephanie Julia (2016), «Misgendering and its moral contestability», in Hypatia, 31, 3, pp. 502-519. doi: 10.1111/hypa.12259

Keys, Os (2020), (Mis)gendering, in Bonde Thylstrup, Nanna, Agostinho, Daniela, et al. (eds.), Uncertain archives: Critical keywords for the age of Big Data, MIT Press, Cambridge MA, pp. 339-346.

Keo-Meier, Colton, and Ehrensaft, Diane (2018), Introduction to the gender affirmative model, in The gender affirmative model: An interdisciplinary approach to supporting transgender and gender expansive children. American Psychological Association, Washington DC, pp. 3-19.

Lev, Arlene Istar (2004), Transgender emergence: Therapeutic guidelines for working with gender-variant people and their families, Routledge, New York.

Mace, Chris (2007), «Mindfulness in psychotherapy: An introduction», in Advances in Psychiatry Treatment, 13, pp. 147-154. doi: 10.1192/apt.bp.106.002923

Mason-Schrock, Douglas (1996), «Transsexuals’ narrative construction of the “true self”», in Social Psychology Quarterly, 59, 3, pp. 176-192.

Mauriello, Marzia (2017), What the body tells us: Transgender strategies, beauty, and self-consciousness, in Rees, Emma (ed.), Talking bodies: Interdisciplinary perspectives on embodiment, gender and identity, Palgrave MacMillan, Cham, pp. 55-74.

McLemore, Kevin (2016), «A minority stress perspective on transgender individuals’ experiences with misgendering», in Stigma and Health, 2, 1, pp. 1-46. doi: 10.1037/sah0000070

Missé, Miquel and Coll-Planas, Gerard (2010), eds, El género desordenado: Críticas en torno a la patologización de la transexualidad , Barcelona, Egales.

Mpouna, Andromachi and Papanis, Eustratios (2021), eds, Tautotita fylou kai sexoualikotita: Sygxrona Themata, Hdyepeia, Athens. (Ταυτότητα φύλου και σεξουαλικότητα: Σύγχρονα θέματα)

Muñoz, Vic (2012), Gender/sovereignty, in Enke, Anne (ed.), Tranfeminist perspective in and beyond transgender and gender studies, Temple University Press, Philadelphia, pp. 23-33.

Nadal, Kevin (2018), Microaggressions and Traumatic Stress: Theory, Research, and Clinical Treatment, American Psychological Association, Washington DC.

Nadal, Kevin, Rivera, David, and Corpus, Melissa (2010), Sexual orientation and transgender microaggressions implications for mental health and counseling, in Sue, Derald Wing (ed.), Microaggressions and marginality: Manifestation, dynamics, and impact, Wiley & Sons, New Jersey, pp. 217-241.

Nordmarken, Sonny and Kelly, Reese (2014), Limiting transgender health: Administrative violence and microaggressions in health care systems, in Harvey, Vickie and Heinz, Teresa (2014), Health care disparities and the LGBT population, Lexignton Books, Plymouth, pp. 143-166.

Papathanasiou, Nancy and Christidi, Elena-Olga (2020), eds, Symperilipsi & anthektikotita, Gutenberg, Athens (Συμπερίληψη και ανθεκτικότητα).

Pilnick, Alison and Dingwall, Robert (2011), «On the remarkable persistence of asymmetry in doctor/patient interaction: A critical review», in Social Science and Medicine, 72, pp. 1374-1382. doi: 10.1016/j.socscimed.2011.02.033

Platero, Lucas R. (2020), «Redistribution and recognition in Spanish transgender laws», in Politics and Governance, 8, 3, pp. 253-265. doi: 10.17645/pag.v8i3.2856

Saha, Somnath, Beach, Mary Catherine and Cooper, Lisa (2008), «Patient centeredness, cultural competence and healthcare quality», in Journal of the National Medical Association, 100, 11, pp. 1275-1285. doi: 10.1016/s0027-9684(15)31505-4

Schulz, Sarah (2017), «The informed consent model of transgender care: An alternative to the diagnosis of gender dysphoria», in Journal of Humanistic Psychology, 58, 1, pp. 72-92. doi: 10.1177/0022167817745217

Speer, Susan and McPhillps, Rebecca (2013), «Patients’ perspectives on psychiatric consultations in the Gender Identity Clinic: Implications for patient-centered communication», in Patient Education and Counseling, 91, pp. 385-391. doi: 10.1016/j.pec.2012.12.009

Tosh, Jemma (2016), Psychology and gender dysphoria: Feminist and transgender perspectives, Routledge, Oxon and New York.

Wilkinson, Willy (2014), «Cultural competency», in TSQ: Transgender Studies Quarterly, 1, 1-2, pp. 68-73. doi: 10.1215/23289252-2399641

Wiseman, Mel and Davidson, Sarah (2011), «Problems with binary gender discourse: Using context to promote flexibility and connection in gender identity», in Clinical Child Psychology and Psychiatry, 17, 4, pp. 528-537. doi: 10.1177/1359104511424991

World Health Organization (2018), ICD‐11: Classifying disease to map the way we live and die, WHO, Geneva.

Wright, Talen; Candy, Bridget and King, Michael (2018), «Converion therapies and access to transition-related healthcare in trangender people: A narrative systematic review», in BMJ Open, 8, e022425, pp. 1-12. doi:10.1136/bmjopen-2018-022425

Zandbelt, Linda, Smets, Ellen, Oort, Frans and de Haes, Hanneke (2005), «Coding patient-centered behaviour in the medical encounter», in Social Science and Medicine, 61, pp. 661-671. doi: 10.1016/j.socscimed.2004.12.006

Zottola, Angela (2018), «Narrating transgender identities: A linguistic perspective», in PuntOorg, 3, 1-2, pp. 51-62.
How to Cite
Argyriou, K. (2021) “«Call me by my name»: Language issues in counsellors’ cultural competence with gender non-conforming people ”, Rivista Italiana di Filosofia del Linguaggio, 15(1). doi: 10.4396/20210606.