Today is the first day in the state of Washington that non-binary people can choose to have a third gender option on their State ID or driver’s license. This morning I went with 2 friends and stood outside the Washington state Department of licensing for a half an hour before they opened. As more and more folks lined up behind us, where we stood we could see the staff gathering for a staff meeting. Everyone received the same sheet of paper. While we couldn’t hear what they were saying, we could see it was the same sheet of paper that both of my friends were holding. It’s the “Change of Gender Designation” form by the Washington State Department of Licensing. As of today, November 13, 2019, you can apply to have gender X on your Washington State ID or driver’s license.
My friends and I had arrived early enough that as soon as the door opened, we were assigned a person to see immediately. The staff were friendly, kind, and maybe even a little excited at seeing the form for the first time. The whole exercise lasted about 15 minutes, photos were taken, addresses confirmed, etc. Both of my read friends received printouts of their temporary driver’s license showing gender designation X. Before these were printed, their information was displayed on a screen and in the gender field it read “non-binary.” There licenses will be mailed to them in the next 7-10 days. This whole process cost them nothing (no cost if you already have an ID). No note from a medical professional was required. We thanked the staff and walked out. In and out of the Department of Licensing in less than 15 min!
Several states have recognized a third gender option to be listed on driver’s licenses and IDs. Oregon was the first state to make a court decision in favor for this in 2016 and since then other states have followed suit. In Washington, it is possible to get an enhanced driver’s license with the third gender, which would allow you to travel by plane or cross borders into Mexico or Canada by land. There is not currently a third gender option for Federal IDs or passports, though this may be something we see in the future.
The Washington State Change of Gender Designation form can be found online at: https://www.dol.wa.gov/forms/520043.pdf.
An information sheet can be found online at: www.dol.wa.gov/about/driversrules.html.
Blog Posts, trans affirming hair removal, trans affirming mental health, trans affirming physical health
We have 3 (three!) free groups right now this fall at Rainbow Health Center. Each one is run by a practicum graduate student with supervision by a RHC licensed therapist
YOUTH SOCIAL GROUP Mondays 4 pm-5:30 pm 10/7-12/2
This is an 8 week group for LGBTQ+ youth 14-17 to get together for peer to peer support, connect with like minds, enjoy games and of course snacks every Monday 4:00-5:30. There will be sharing of resources and craft nights as well as youth-motivated activities as the group evolves. Support, create, relate.
Location: Community Room at Rainbow Health Center 1701 4th Ave East, Olympia. Mobility Accessible, Telecoil available upon request.
To sign up call or text (503) 673-6228
Facilitated by Kae Starr, practicum student at Saint Martin’s masters in counseling program. Supervised by Teresa Guajardo LMHC.
TRANS SELF CARE & SOCIAL TIME Fridays 7 pm-8:30 pm 10/4-11/22
Trans Self-Care and Social Time group is for transgender, non-binary, genderqueer, gender fluid, gender neutral, gender non-conforming, and questioning people ages 18 and up. Discussions, snacks, games, other activities- Feel free to bring any ideas you have. Participate at your own level of comfort (wallflowers welcome.)
Location: Community Room at Rainbow Health Center 1701 4th Ave East
Email to join firstname.lastname@example.org
Led by practicum counseling student Madison Johnson
LOVED ONES Saturdays 230pm-4pm Dates: 10/19, 11/9, 11/16, 11/23, 12/7, 12/14
Loved Ones is a free support and learning group for adult family, friends, and partners of transgender, non-binary, gender non-conforming, and gender-neutral people. If you are impacted by your loved ones gender identity or transition, this is the group for you. Loved ones is a space that welcomes questions, attendees are invited to share information and personal experiences. We honor love, complexity, and learning.
Drop In on 6 meetings on the following Saturdays 230pm-4pm: 10/19, 11/9, 11/16, 11/23, 12/7, 12/14
Location: Rainbow Health Center
Email for optional registration email@example.com
Run by practicum student Kat Harmon, supervised by Sarah Peace MA LMHC
In about two weeks, on Sunday October 6th, Rainbow Health Center is going to be hosting the first annual Trans Health Fair. The providers at Rainbow Health Center are doing this in partnership with some other local/fantastic programs: Partners in Prevention Education (PiPE) and Pierce County Aids Foundation – Olympia (PCAF). This event is free to attend, and is open to our community and also local trans care providers.
At 1pm, we’re going to have professional networking and information/Q&A panel just for local trans care providers.
At 2:30pm, all are welcome to come for….
- Clothing exchange with PiPE
- Rapid HIV testing and PREP information with PCAF
- Electrolysis hair removal process and timeline with Kaylin Clarke
- Ask a RHC Provider Q&A Panel
- Mental health letters for medical transition, prior sign up is required, please email firstname.lastname@example.org
- Details about our 3 upcoming free groups
- Crafting and Snacks
- Fundraising for the Trans Health Fund
- Information about services by Gender Justice League and Olympia Free Clinic
We hope you can join us!
Naturopathic Medicine and Gender Affirming Healthcare.
By Jill Corey ND
Naturopathic medicine has five principals listed here:
- First do no harm: using treatments that have low side effects.
- Prevention: working with the patient to prevent future health conditions.
- Supporting the body’s own ability to heal: help remove blocks to healing.
- Treat the whole person: understanding the patient and providing an individualized plan that includes physical, emotional, environmental and spiritual aspects.
- Docere (teaching): providing knowledge to the patient in order to help them feel empowered to take responsibility for their health.
One of the principals of naturopathic medicine is to treat the whole person. This principle ties in perfectly with gender affirming healthcare. Many of my patients are seeking to express outwardly what they identify as on the inside. We just want to feel more like themselves. Naturopathic Medicine provides many avenues to facilitate this process. For example, many people feel that they need hormone therapy (HRT) to feel more comfortable. HRT is a wonderful tool for gender affirming healthcare. However, hormone therapy can have undesirable side effects. That is why when I provide HRT for my patients I also make sure to keep in mind the whole person. For example, HRT can cause be taxing on the liver. The liver is the organ that process hormones and toxins in our body. That is why certain herbs and supplements can be taken to help the liver function optimally. I will sometimes recommend Milk Thistle, Artichoke or Glutathione for support. Also, if our liver is not functioning optimally the toxins processed by the liver can also cause skin issues such as acne or eczema. Furthermore, HRT can also cause mood fluctuations. Remember going through puberty as a teenager and how moody you were? Well, fortunately there are lots of herbs like St. John’s Wort or Lemon Balm. That can ease the emotional roller coaster that HRT can cause. There are also many lifestyle changes such as exercise and meditation that can have profound effects on mood. As a naturopathic doctor I typically provide recommendations for diet, lifestyle modifications, exercise and herbal medications to ease the transition for all of my patients seeking gender-affirming care.
We are social animals with nervous systems that have developed over time to keep us alive. One of the reasons that I love Polyvagal Theory is that it provides a useful way to understand our nervous system responses. Deb Dana, one of the main scholars and writers about Polyvagal Theory calls it, “the science of connection.” The job of our nervous system is to collect information about and process cues of safety and danger. It rules our impulses toward survival and even our longing to connect with others.
What are nervous system responses? I’m sure you’ve heard of fight and flight. Perhaps you’ve heard of freeze, appease, or collapse? People keep adding to the list because our nervous systems do so many things. Polyvagal Theory organizes these different responses into three categories: ventral vagal, sympathetic, and dorsal vagal. These three nervous system states, or pathways, developed over a long long time throughout our evolution into the humans we are today.
As you read the following responses, notice if there is one you feel more familiar with:
The first nervous system state to develop in our evolutionary journey is the “dorsal vagal” response. We are in a dorsal vagal response when we are scared to death. Sensations associated with this state are feeling shut down, frozen or collapsed. We might feel foggy and disconnected, dissociated, despairing, and hope feels unreachable. Our heart rate slows and our breathing becomes shallow.
The next oldest pathways is the “sympathetic” response. The sympathetic response is about mobilizing us to action, like fight and flight. It can feel like a rush of adrenaline, or anxiety. Our hearts pound faster, our focus narrows as we listen and look for danger in our environment. We may misread cues from other people. For example, a neutral face or body posture of someone nearby may register as dangerous.
We needed a prefrontal cortex in order to develop the most recent of the evolutionary nervous system states: ventral vagal. In this state we have a regulated heart rate and are able to take full deep breaths. We feel that we have access to choices for ourselves. We can experience curiosity and connection with others. We can reach out for support and also offer support. We have access to feelings of altruism. When we are squarely located in ventral vagal we feel safe and connected to ourselves and to others.
Were you able to recognize any of these states from your own experience? We are actually going in and out of these states all the time, every day, even moment by moment. Our nervous systems are incredibly flexible. We move into disregulation (sympathetic or dorsal vagal), and then back into regulation (ventral vagal) all the time. We are constantly sending and receiving cues of safety and danger from and with those around us. Basically our nervous systems are talking to other nervous systems all the time. As we move about our days our bodies are collecting and responding to this information totally outside of our conscious awareness. This is called “neuroception.”
Neuroception is our body’s unconscious assessment of either danger or safety. This information is gathered from inside our bodies, our external environment, and in our relationships with others. When we have a neuroception of danger, our nervous system responds by affecting physiological changes inside our bodies to mobilize us into sympathetic, or take us into the collapse response of dorsal vagal. Because our brain is always in conversation with our nervous system, the brain makes up a story in order to make sense of the state our body is in. The story follows the state change. When we can bring conscious perception to our neuroception, then we can start to become a student of our own system.
Our nervous systems are shaped and toned over time through relationships. This means that if we grew up in a family where we rarely, if ever, felt safe, we may develop a habitual response of disconnection. We may feel that being seen is dangerous so we try to disappear. Some people find themselves habitually in a state of sympathetic arousal, or in dorsal vagal. I want to stress here that our nervous systems shape our responses so that we can survive. Every nervous system response we have is in service to our survival. Understanding the science behind our survival responses can sometimes help reduce shame we feel about those responses. When we can begin to reduce the shame, we can begin to get curious. When we can get curious then we can begin take a more active role in getting to know our particular nervous system. We can begin to notice what our thoughts, behaviors and beliefs are when we are in each state. It’s an empowerment process that we can participate in with ourselves, with a therapist, or with a safe and compassionate other.
Just like neuroplasticity shows us that we can change our brains, Polyvagal Theory shows us that we can re-shape our nervous systems over time through becoming active and conscious in our own response patterns and experiencing repeated interactions with safe others. We can become active in re-shaping our nervous system to bring greater flexibility, and build our capacity for regulation and connection.
Training: Integrating Polyvagal Theory into Clinical Practice with Deb Dana
Therapy can be gross. What I really mean is, therapy can make you feel less ok about things then you felt before you sat down and started talking. A colleague of mine describes this feeling as “stirring up the gunk.”
We all have coping mechanisms that help us move through our day to day. We all deal with our emotions and struggles in *some* way. And often what happens in therapy is that we are asked to think about finding different ways to cope. Maybe we have enough self-awareness to say to our therapist in an early session, “This way I’ve been coping isn’t working, I need a new one.” Many people – including myself when I first started going to therapy as a client – don’t start there. We start with something like, “I don’t know, I guess I’ve been really anxious.” We’ve heard talking to a therapist can help, so we try it. And then at some point in therapy we reach this meme-able moment:
We realize – or our therapist gently tells us – that our coping mechanisms could use some work. And that is why therapy can be gross.
Learning new ways of doing things is hard. It takes work and practice. It brings up all the feelings of not being good at something because you haven’t tried it before. Gross, gross, gross. It can ask us to examine where we learned how to cope like this, maybe from family dynamics or traumatic events. It can require us to be really vulnerable with naming the emotions we’re coping with. And vulnerability often feels super gross. Vulnerability feels hard and uncomfortable because we hide things really well from ourselves that we can’t hide as well with another person. Dr. Brene Brown defines vulnerability as “uncertainty, risk, and emotional exposure.” Just what we all want to do with a stranger on a Thursday morning!
But here’s the thing about vulnerability in therapy. When we open ourselves up and let whatever “gunk” we maybe didn’t want stirred up come to the surface, our therapist knows what to do next. As a therapist, the moments when a client can be vulnerable with me feel like sinking three-pointers. Except I don’t feel like the Steph Curry in that scenario. I feel like the Steve Kerr. Because my client has ability and skill and wisdom and experience that have nothing to do with me. And those things – they’re part of the gunk. What we’ve been taught, as therapists, is to be able to say “look at that gunk, isn’t it neat!” We’re here to help you consider that maybe that gunk, those gross feelings, are actually important and valuable. We’re trained to encourage your understanding that this coping mechanism you had, while it was helping you get through your day to day, also involved feeling feelings and saying “gross” to yourself, instead of saying, “I feel really disappointed right now, because this thing I wanted isn’t going to work out.”
That is a hard thing to do. Harder for some feelings than others. Harder at some points in our life than others. The difficulty doesn’t always go away, but therapy helps us get better at. Weights don’t get lighter, muscles get stronger. The basket doesn’t move closer, we get more skilled. Practice doesn’t make perfect, especially in therapy. Practice just makes it easier to do the hard thing. We still feel the way we feel. The things that have happened to us don’t magically evaporate. But stirring up the gunk becomes a thing we know how to do, even if we find it gross.