their authentic selves. SFT hypothesizes communication and behavior are the same (Watzlawick et al., 1967). All members of a family are communicating at all times, and each family member is impacted by every member’s communication/behavior.
Play therapists have a foundational role in helping young children to explore their
true, authentic selves. This exploration is especially
sensitive for young children who are brought to therapy by concerned parents because they are displaying behaviors that generally may expectations refer to a social system that presumes a gender and sexual binary and enforces beliefs and practices that are considered Toomey et al., 2012).
Heteronormative Bias Natal boys are designated male, based on the presence of a penis at birth, and natal girls are designated female, based on the presence of a vulva at birth (Green & Maurer, 2015). Many children will explore other genders as part of their curious nature. However, when natal boys attempt to embrace female behaviors, roles, or interests, the heteronormative culture often dictates swift punishment for violating prescribed masculine roles and behaviors (Coolhart & Shipman, 2017; Johns et al., 2017; Kaitiala-Heino et al., 2018). Conversely, when natal girls embrace masculine roles and behaviors, the heteronormative culture often embraces and tolerates tomboys (Craig, & Lacroix, 2011). In exhibiting tomboy behavior, girls and women are allowed in spaces well beyond the heteronormative prescribed female gender role. The complexity of being a tomboy allows girls to embrace masculinity or to distance themselves from femininity (Carr, 2005; Claire & Alderson, 2013).
Therapy for
Gender-Nonconforming Children Play therapists have an important role in helping children that are struggling with gender dysphoria. In Toronto, Canada, Steensma et al. (2018) found that the mean age of referral for gender dysphoria was 7.38 years, with a sex ratio that was heavily skewed toward boys. For example, the male-female sex ratio for 3- to 4-year-old children was 6:1, meaning boys in this age group were six times more likely to receive therapy referrals than girls. This ratio gradually dropped to 1:1 by 9 years of age.
Very young children who present for therapy are highly likely to be natal boys, rather than natal girls. In a retrospective qualitative study of transgender adults, the reasons for presenting for gender presented due to external pressure to conform to societal norms on they would never have a penis, and expressing an ambivalence about reasons aligned with the current disproportionate number of young boys (under 8 years old) in a male-female sex ratio that present for therapy.
CLINICAL EDITOR’S COMMENTS:
Gender nonconforming children have needs that play therapists can address when personal biases are set aside.
Bracketing A critical part of working with gender-variant children requires play therapists to adopt a concept well known in phenomenology as bracketing. Therapists are immersed in the heteronormative milieu from birth and have had life-long experiences within that milieu. In understandings, past knowledge, and assumptions… must be set notions about how things ought to be, dogmatic religious or political understandings and assumptions, and a rigorous self-examination of the prejudices brought into the playroom. As a therapist, one has to be as open, accepting, and egalitarian as possible.
Authenticity in Therapy It is important that clients be completely comfortable before allowing therapy allowed the author to mitigate the enormous power difference that can exist between client and therapist. The author is a Caucasian male, older, and large. It took some time for the clients to fully trust him. It is of critical importance that play therapists gain clients’ trust, because clients are generally wary of disclosing their authentic selves. Through actions and words, the author conveyed the fact that we are
with children because they are some of the least present modes of communication experienced by young children. Whispering and strategic silence allow the child to fully explore the playroom and to choose how to play with the toys. Strategic silence is a term I use, and it involves paying close attention to non-verbal movements, sighs, or facial expressions. Listening with my eyes allows the opportunity to recognize the child is processing and not available for verbal communication. Adlerian play therapy provides a sound theoretical basis for engaging gender non-conforming young children.
The playroom is well equipped with typical toys, dresses, brushes, combs, and a long mirror. Once therapist-client trust was established, the clients began to explore the dresses, often just looking at them or touching them. In my experience, clients need to achieve a more I observed those behaviors, which are more in line with their more authentic selves. As trust began to build, each of the clients displayed
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