The cost of being transgender: where socio-economic status, global health care systems, and gender identity intersect

Around the globe, trans and gender diverse people have a wide range of access to health care, psychological as well as physical, that is unique to their home country’s context. Some of the contributing factors are nations’ health care systems, laws and policies surrounding discrimination, adequate resources, and under-trained health care professionals. Unfortunately, inability or difficulty in accessing transition related health care and support leads to negative impacts on mental health. In this article, the authors describe the unique contexts related to transgender health care in Canada, Japan, South Africa, and the United States. We focus specifically on the financial cost of transition for trans and gender diverse people, including gender affirming surgeries as well as mental and health care more broadly. We discuss the role of mental health professionals as advocates for gender affirming care and the fundamental human right to health care. We include discussions of therapy, assessment, medical care such as hormone replacement therapy (HRT) and surgeries, and additional invisible costs. We highlight the importance for all mental health professionals to be aware of the impacts to trans and gender diverse people’s mental health when their fundamental health care needs are not met. Furthermore, we provide recommendations for how mental health professionals can advocate for their clients’ access to transition related care.


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The Psychological Society of South Africa’s guidelines for psychology professionals working with sexually and gender-diverse people: towards inclusive and affirmative practice

In this article, we outline the practice guidelines for psychology professionals working with sexually and gender-diverse people, ratified by the Psychological Society of South Africa’s Council in 2017. The guidelines are an augmentation of the Psychological Society of South Africa’s position statement of 2013 providing a framework for understanding the challenges that sexually and gender-diverse people face in patriarchal and hetero- and cis-normative societies. An affirmative stance towards sexual and gender diversity enables psychology practitioners to work ethically, effectively, and sensitively in this field. The guidelines – a first for Africa – are aspirational in nature and call on psychology professionals to become aware of their own biases, conscientise themselves of the best practices in the field by continued professional development, and to utilise the guidelines as a resource in their related work. Brief mention is made of the development process, before the rationale and possible applications of the 12 guidelines are explored.

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PSYSSA 2019 Practice Guidelines

Does marriage counselling really work?

Therapists have described Marriage counselling as being similar to piloting a helicopter do a hurricane. This leaves us to ask the question: does marriage counselling still work? 


The traditional approach where a therapist will sitting in a room talking with both spouses is only making the problems worse. This is prone to cause distrust with at least one of the Spouses. It can make them believe that you as a marriage counsellor are sided with the other.


Another approach has been seen by many experts as much more effective.  is where the Counselor would use a combination of individual therapy and couples therapy. This lets the counsellor get a much better perspective on both spouses points-of-view. It changes their role from hostage negotiator to Messenger. There are many factors that can influence each spouse’s thought processes and perspective, especially in our country. These factors can include class, race, gender and culture. This makes it especially important and difficult for the therapist to have an incredibly good perspective. 


One of the most difficult couples to deal with is the mixed agenda couple. This is where one of the spouses wants to break up but the other one doesn’t necessarily want to. In this case, it’s left up to the counsellor to try and figure out if the couple has come to try to stay together or to break up.


 There are many different reasons why a couple would have to go for marriage counselling. All of these reasons, in turn, would require different approaches. It is very important that you do your research and get a competent marriage counsellor.


While it has been proven to work for many people, If the couple doesn’t want to stay together, their marriage is doomed to fail. The reverse is also true of course. If a couple is devoted to each other and determined to stay together, it becomes much more likely for their marriage to succeed and get through difficult times in one piece.


How do you know if you need to see a mental health professional

It is no secret that over the last couple of years, both the frequency and severity of all types of mental health problems have increased dramatically. This is especially true in the case of adolescents and young adults.


With mental health problems on the rise, it becomes more and more important to diagnose yourself correctly in the early stages. It is also important to, if needed, get help from a mental health professional before the problem becomes too severe tadalafil and alcohol .


Some symptoms to take note of include:


  • Constantly feeling unhappy, sad or irritable
  • Constant feeling of worry, anxiety or stress
  • Having thoughts of harming yourself or other people
  • Emotional struggles that interfere with your everyday functions such as eating, sleeping or work
  • Struggling with addictions or substance abuse
  • Having an eating disorder or struggling with body image
  • Struggling to communicate effectively with people in your life


If you are experiencing several of the above-mentioned issues, don’t be alarmed. It’s not a definite indication of if you need the help of a mental health professional or not. It might, however, give you a better idea of if you at least need to talk to one. This could help to identify any serious mental health problems early on.


There are also many different types of mental health professionals that you can talk to, a psychologist can give you counselling, as can a psychiatrist. The difference between a psychiatrist and a psychologist is that a psychiatrist can prescribe medication while psychologists can’t. There are many other types of mental health professionals as well. You might by accident end up with the wrong one, who was just lucky to gain popularity thanks to the promotion from The Marketing Heaven or any other marketing agency, but no worry. Any trustworthy mental health professional will be able to refer you to the correct type.


The only thing you need to do is take the first step and not be afraid to contact someone to help you with your problems.

What is cognitive behavioural therapy

Cognitive behavioural therapy is a form of talk therapy. It is short term and goal orientated. It helps you manage your problems by changing the way you think and behave.

Unlike more traditional psychological treatments, cognitive behavioural therapy focuses less on things that have happened in your past. Instead, it focuses more on the problems you are currently facing. It helps you deal with overwhelming problems by breaking them down into smaller pieces and dealing with them individually.

It can help treat anything from sleeping disorders to anxiety and depression. It works by identifying negative thought patterns and vicious cycles in your everyday life. Then it helps you to deal with them in a more practical way.

An important advantage of Cognitive Behavioural Therapy is that it can be completed in a relatively short timeframe compared to other types of talk therapy. Research has also shown that it can be just as, if not even more effective than only taking medicine in most cases. The skills that you learn in cognitive behavioural therapy are also practical and useful and can be incorporated into everyday life.

If CBT is recommended, you’ll have between 5 and 20 sessions about every 2 weeks. During these sessions, you’ll work with your therapist to break your problems down into separate parts such as thoughts and feelings. You and your therapist will then work together if these parts are unhelpful or even harmful. Your therapist will then help you figure out how to change your unhelpful thoughts and feelings.

CBT does have it’s sceptics, however. Reputable psychologists state that it is focused on the symptoms and not the cause of those symptoms. It does, however, deal with those symptoms effectively and as a result, helps to tackle the cause.

In the end, it is up to the patient to decide what would suit him best, but any licensed professional will be able to help him/her do so.

Reflections on my journey going into remission

“One reflects when looking into water. What you see is not just the lines of experience in your face, the depth in your eyes wrought by the thing we want to call life. You also see yourself as you are now, reflecting that which you are experiencing now. You see a future you, the dreams, wishes, desires and fears. You stand against a background of more than yourself, a changing context that blurs – sometimes with your reflection and sometimes seemingly all on its own. And then the water itself adapts that which you see, providing an ever-changing fluidic experience. It all in a larger river of feel, think, remember and being. In reflecting I can offer this picture – a picture I can create as I was given the opportunity to re-discover hope, to re-vision that which I believe I see and feel, new lenses to re-scope. My two MA years was a super boost in a re-new(al) process – that is how I experience my life now. It is maybe apt that some of my more recent dreams reflect the dawn – the beginnings of the renewed sun rising above the murky nutrient rich water.”

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My Practice Has Relocated To Table View

My practice has been servicing clients in the CBD and in Woodstock and the surrounding suburbs since I started in 2o15 but, after much deliberation, I have decided to close my practice in Woodstock whilst maintaining my current client relationships in the CBD and opening a new branch of my practice in Table View.

The new practice in Table View is situated at the Palm Tree Clinic in Flamingo Vlei. Palm Tree Clinic is an in-an-out patient psychiatric clinic with 15 beds. The clinic is supported by a wide range of psychiatric professionals including occupational therapists, psychiatrists, general practitioners, with the latest addition to the team of professional being myself and the Clinical Psychologist.

In addition to booking sessions with me, my clients are offered the ease of having other professionals that work closely alongside me in cases where other professional assistance or care is required, offered within the same facility on an in-patient or out-patient basis as each situation requires.

Patients that require sessions in the CBD branch can still book sessions with me by contacting me at [email protected]. All other customers can book sessions with me at Palm Tree Clinic by calling 021 556 5255 or emailing me on [email protected].

Seksuele jagters neem toe, sê sielkundiges

Health Professions Council of South Africa:
Registration number PS 0057843

Board of Healthcare Funders:
Practice number 0580635

Psychological Society of South Africa (PsySSA)

International Association of Applied Psychology

International Psychology Network