Longitudinal Final Draft

HALLIE FUNK JKX COMICS STEPHANIE BUDGE



THIS COMIC IS DEDICATED TO ALL OF THE
PARTICIPANTS IN THIS STUDY WHO DEVOTED TIME IN THEIR DAILY
LIVES TO ENGAGE IN THERAPY IN ORDER TO IMPROVE FUTURE THERAPY FOR
TRANS, NONBINARY AND GENDER NONCONFORMING PEOPLE. THIS COMIC

AND RESEARCH WOULD NOT BE POSSIBLE
WITHOUT THEM.

INTRODUCTION

THIS COMIC WAS FACILITATED BY GAINING STEAM, A PROGRAM
DEDICATED TO MAKING SCIENTIFIC RESEARCH ACCESSIBLE TO THE GENERAL
PUBLIC BY USING ART AN STORIES. THE SCIENTIFIC RESEARCH THIS COMIC
IS BASED ON FEATURES HOW TRANSGENDER, NONBINARY OR GENDER
NONCONFORMING INDIVIDUALS RESPOND TO SPECIALIZED PSYCHOTHERAPY
SESSIONS. THE FOLLOWING PAGES THE STORY OF TAKODA GARCIA, A PERSON
OF COLOR WHO IDENTIFIES AS NONBINARY AND USES THEY/THEM PRONOUNS.
TAKODA IS A FICTIONAL DESCENDANT FROM THE HO-CHUNK PEOPLE ON THEIR
MOTHER’S SIDE AND LATINX ON THEIR FATHER’S SIDE. TAKODA STRUGGLES
TO DEAL WITH MINORITY STRESSORS IN THEIR DAILY LIFE AND WONDERS IF
THERAPY COULD HELP THEM DEAL WITH THE STRESS IN HEALTHIER WAYS.

THIS STORY WAS CREATED BY TWO QUEER, CIS, WHITE WOMEN.
STEPHANIE BUDGE IS AN ASSOCIATE PROFESSOR IN COUNSELING PSYCHOLOGY
AND THE DIRECTOR OF ADVANCING HEALTH EQUITY AND DIVERSITY IN THE
SCHOOL OF MEDICINE AND PUBLIC HEALTH AT THE UNIVERSITY OF WISCONSIN
- MADISON. HALLIE FUNK IS AN ART GRADUATE FROM UW MADISON AND A
GRADUATE FROM THE ANIMATION PROGRAM AT MADISON COLLEGE. A LOT
OF RESEARCH AND CARE WENT INTO CRAFTING THIS STORY AND ORGANIZING
SCIENTIFIC DATA. DRAFTS OF THE STORY WERE SENT TO VARIOUS PEOPLE
WHO IDENTIFY AS TRANSGENDER, NONBINARY OR GENDER NONCONFORMING
FOR CRITIQUE AND FEEDBACK, WHICH IMPACTED THE STORY VASTLY. BUT
APPROPRIATION IS NOT VOID IN REPRESENTATION WHEN A PROJECT IS
ORCHESTRATED BY PEOPLE WHO DON’T EXPERIENCE THE IDENTITY THEY ARE
REPRESENTING.

WE WOULD ALSO LIKE TO ACKNOWLEDGE THE THERAPISTS WHO
VOLUNTEERED THEIR TIME TO PROVIDE FREE THERAPY FOR THE STUDY.
WITHOUT THEIR DEVOTION AND EXPERTISE, THIS STUDY WOULD NOT HAVE
HAPPENED.

1

GENDER DYSPHORIA

GENDER DYSPHORIA CAN MEAN SOMETHING DIFFERENT TO EACH PERSON WHO
EXPERIENCES IT, SO IT IS DIFFICULT TO DEFINE, HOWEVER, THE MAJORITY OF
PEOPLE WHO DESCRIBE EXPERIENCING GENDER DYSPHORIA INDICATE THAT
THEY EXPERIENCE A FOCUS ON NEGATIVE ASPECTS OF THEIR SELF AND/OR
BODY THAT CAN LEAD TO DISCOMFORT, DISTRESS, UNEASE, DISCONNECTION,
ETC.

THIS IS NOT
MY BODY..

THESE FEELINGS ARE USUALLY RELATED TO HOW SOMEONE IS TREATED BASED
ON THEIR PERCEIVED OR ACTUAL GENDER IDENTITY OR BY EXPERIENCING AN
INCONGRUENCE BETWEEN THEIR SEX ASSIGNED AT BIRTH AND THEIR GENDER
IDENTITY.

FOLX

AN UMBRELLA TERM
USED FOR LGBTQ INDIVIDUALS,
SPECIFICALLY TO DE-GENDER LANGUAGE
WHEN REFERRING TO A GROUP OF PEOPLE.

2

MINORITY STRESSORS

EVERYONE EXPERIENCES STRESS DURING LIFE, BUT MEMBERS OF DISADVANTAGED
GROUPS MAY EXPERIENCE A UNIQUE TYPE OF STRESS: MINORITY STRESS. FOR
EXAMPLE, TRANSGENDER, NONBINARY, AND GENDER NONCONFORMING (TNG)
INDIVIDUALS HAVE BEEN FOUND TO HAVE HIGHER RATES OF DEPRESSION AND
ANXIETY THAT MAY OCCUR BECAUSE OF HOW SOCIETY MISTREATS THEM.
MINORITY STRESS COMES FROM TWO DIFFERENT STRESSORS:

EXTERNAL STRESSORS ARE STRESSFUL EVENTS THAT HAPPEN TO YOU.
EXPERIENCING HARASSMENT BECAUSE YOU ARE TRANSGENDER IS AN EXAMPLE
OF AN EXTERNAL STRESSOR. ANOTHER TYPE OF EXTERNAL STRESSOR IS
DISCRIMINATION. DISCRIMINATION MAY BE OBVIOUS, LIKE NOT BEING ALLOWED
TO ENLIST IN THE MILITARY BECAUSE YOU ARE TNG. DISCRIMINATION MAY
ALSO BE LESS OBVIOUS.
THIS TYPE OF DISCRIMINATION IS SOMETIMES CALLED A MICROAGGRESSION.
THIS TYPE OF DISCRIMINATION MAY BE INDIRECT AND SUBTLE, AND THE
PERSON DOING IT MAY NOT EVEN REALIZE IT. THEY MAY EVEN HAVE GOOD
INTENTIONS. ONE EXAMPLE OF A MICROAGGRESSION WOULD BE IF SOMEONE
APPROACHED A TNG INDIVIDUAL AND SAID: “I WOULD NEVER GUESS YOU ARE
TRANS! YOU LOOK LIKE A REAL WOMAN.” THE PERSON MAY INTEND TO OFFER
A COMPLIMENT, BUT IT IS ACTUALLY A HURTFUL STATEMENT. TRANS WOMEN
ARE REAL WOMEN.

INTERNAL STRESSORS ARE SOURCES OF STRESS THAT COME FROM WITHIN
YOURSELF. INTERNAL STRESSORS INCLUDE FEELING LIKE YOU HAVE TO HIDE
YOUR TNG IDENTITY, EXPECTING TO BE STEREOTYPED OR DISCRIMINATED
AGAINST BY OTHERS, AND HAVING BAD FEELINGS TOWARD YOURSELF BECAUSE
YOU ARE TNG. ITS IMPORTANT TO REMEMBER THAT INTERNAL STRESSORS
HAPPEN BECAUSE OF EXPOSURE TO EXTERNAL STRESSORS.
3

ANGLO HOMOPHOBIA

THE COLONIAL PRACTICE OF EXERTING POWER AND CONTROL BY EUROPEAN
COLONIZERS OVER INDIGENOUS PEOPLE, SPECIFICALLY RELATED TO SEXUALITY.
THIS WAS ESPECIALLY DESTRUCTIVE TO TRANS FOLX BECAUSE SEXUALITY AND
GENDER WERE SEEN AS BEING THE SAME CONSTRUCTS, THUS ERASING THE
BEAUTY, DIVERSITY, AND FLUIDITY OF GENDER.

CONTENT WARNING

LONGITUDINAL EFFECTS OF PSYCHOTHERAPY WITH TRANSGENDER CLIENTS: A
RANDOMIZED CONTROLLED PILOT TRIAL COVERS EMOTIONAL AND POTENTIALLY
UNCOMFORTABLE CONTENT. HERE IS A BREAKDOWN AND PAGE NUMBERS OF
THAT CONTENT FOR VIEWERS WHO ARE WORRIED ABOUT READING SENSITIVE
TOPICS.

GENDER DYSPHORIA SURROUNDING FACIAL HAIR 07

PUBLIC MISUSE OF PRONOUNS AND GENDER BASED WORDS 08 - 09

BINARY BATHROOM SIGNS 10 - 11

PUBLIC MISUSE OF PRONOUNS AND GENDER BASED WORDS 13 - 14

VIOLENCE THREATS 18 - 19

DEPRESSION, ANXIETY, MURDER AND SUICIDE STATISTICS 20

FAMILY RELATIONSHIPS 25

ADDITIONALLY THERE IS A CHARACTER IN THIS STORY THAT IS A VISUAL
METAPHOR FOR THE MAIN CHARACTER’S MENTAL STATE WHEN THEY ARE
EXPERIENCING GENDER DYSPHORIA AND EXTERNAL/ INTERNAL STRESSORS.
THE DESIGN OF THIS CHARACTER
WAS INSPIRED DIRECTLY FROM THE
RORSCHACH TEST, A PSYCHOLOGICAL
TEST THAT WAS WIDELY USED TO
DETECT “THOUGHT DISORDERS”
AMONG PEOPLE IN THE 1920s. THE
TEST HAS SINCE BEEN DISPUTED
IN VALIDITY BECAUSE OF ITS LACK
OF STANDARDIZED PROCEDURES.
HOWEVER IT IS STILL USED TODAY
TO GAIN QUALITATIVE INFORMATION
ON HOW A PERSON IS FEELING AND
FUNCTIONING. THIS CHARACTER
(PICTURED RIGHT) WILL BE FEATURED
WHEN SESATIVE TOPICS WILL BE
COVERED.

4

5

6

HEY

SHAVING YOUR BUT MAY
FACE IS ONE EXAMPLE MAKE DYSPHORIA
OF AN EXPERIENCE THAT BETTER FOR OTHERS..
MAY CAUSE DYSPHORIA IF FACIAL HAIR IS
ASSOCIATED WITH
FOR SOME, SOMEONE BEING
MISGENDERED OR FEELING
LESS LIKE THEIR GENDER
IDENTITY, IT CAN OFTEN
CAUSE GENDER
DYSPHORIA.

7

..SHIT..

AHEM.. NOW

THAT MR. GARCIA

HAS DECIDED TO JOIN
HEUS, PERHAPS
CAN TELL

US THE CAVE COMPLEX

THAT PROVIDES PROPER

EVIDENCE OF HOMO

FLORESIENSIS?

8

LIANG I’M NOT
BUA GOING TO
WAIT ALL
IF SOMEONE
USES THE WRONG DAY YOUNG
PRONOUNS FOR A TNG PERSON MAN. DO
TO THEIR FACE OR IN A WAY THAT
THEY HEAR ABOUT IT, IT CAN YOU HAVE
OFTEN CAUSE FEELINGS THE ANSWER

OF.. OR DON’T
YOU?

ANGER, HURT, SHAME,
SADNESS AND INVISIBILITY..
THIS WOULD BE AN EXAMPLE OF
AN EXTERNAL STRESSOR WHEN

CONSIDERING MINORITY
STRESS EXPERIENCES.

I DON’T
KNOW...

YES LIANG
MISS DAY, BUA
DO YOU HAVE
THE CORRECT
ANSWER?

9

EITHER WAY...
SOMETHING BAD

IS GOING TO
HAPPEN...

THERE IS
NOT A PLACE FOR
THEM TO TAKE CARE OF
THEIR BASIC NEEDS. THIS CAN
IF A NONBINARY ALSO CAUSE FEELINGS OF BEING
OR AGENDER PERSON UNSAFE IF THEY ENTER A
IS IN A SITUATION WHERE SPACE THAT DOES NOT
THEY ARE FORCED TO CHOOSE FIT THEIR IDENTITY..
A GENDERED BATHROOM, IT
CAN OFTEN MAKE THEM FEEL
UNSEEN AND THAT...

10

HAH.. FOR

A SECOND I
THOUGHT I WAS

IN THE WRONG
BATHROOM! HAH..

FUNNY...
RIGHT!?

11

12

IF A TNG PERSON IS IN THERAPY AND
THEIR THERAPIST DOES NOT SEEM
TO UNDERSTAND THEIR IDENTITY
OR GIVES THEM MISINFORMATION
ABOUT THEIR IDENTITY, THIS CAN
FEEL PARTICULARLY DIFFICULT. A
THERAPIST’S JOB IS TO SUPPORT AND
HELP THEIR CLIENTS, THUS WHEN
THEY DON’T UNDERSTAND TNG
IDENTITY OR HAVE AN UNDERSTAND
ANDING OF HOW TO PROVIDE BASIC
HELP, THIS CAN FEEL DISCOURAGING
AND ALSO CAUSE FEELINGS OF

HELPLESSNESS..

13

ARE YOU

A BOY OR A
GIRL?

UMM...

14

IF A TNG DON’T
PERSON IS AT A POINT AT
RESTAURANT AND THE
SERVER USES GENDERED HIM! ITS RUDE
LANGUAGE TO REFER TO
THEM, THIS CAN LEAD TO POINT. I’M
TO A HOST OF SO SORRY

FEELINGS.. SIR.

ANGEL! TAKE
A BREAK.
..FROM BEING I’VE GOT
MISGENDERED. FOR
EXAMPLE: IF A SERVER THIS.
SAYS TO A GROUP
“WHAT CAN I GET FOR

YOU LADIES?”
AND A

NONBINARY PERSON
IS IN THE GROUP OR
“HOW IS YOUR FOOD SIR?”
WHEN A PERSON IDENTIFIES
AS A TRANS WOMAN.

THESE SITUATIONS
CAN BE DEEPLY HURTFUL.
BUT ALSO CHALLENGING
BECAUSE THIS IS LIKELY TO
BE A ONE TIME INTERACTION

WITH THE PERSON.

15

16

THE NEXT EVENING

17

ONE YEAR AGO

18

HEY

SURE

CAN I HEY
BUY YOU A SAM..

DRINK? TWO
BETWEEN
SO.. THE SHEETS
WHAT IS PLEASE..
YOUR NAME?
WHAT DO YOU MY
DO FOR A NAME
LIVING?
IS
YOU’RE TAKODA
AND I’M
NOT A MAN STUDYING

RIGHT? TO B..

WAIT..

NO.. I AM IT MEANS
NONBINARY THAT I AM NOT

WHAT THE A MAN OR A
FUCK IS THAT WOMAN I..

SUPPOSED TO
MEAN?

19

HAH.. THANK YOU,

YA KNOW THE DRINKS
YOU ARE LUCKY
I DIDN’T TAKE YOU ARE ON
HOME WITH ME
HIM.
TONIGHT..

HAH
HAHAH...

I MIGHT
HAVE..

FUCKED

YOU.

20

THE PRESENT

ONE OUT OF

EVERY FIVE TNG PEOPLE

WILL EXPERIENCE POST

TRAUMATIC STRESS ONE OUT OF

DISORDER. EVERY TWO TNG

PEOPLE WILL EXPERIENCE

SUICIDAL IDEATION.

ONE OUT OF

EVERY THREE TNG

PEOPLE WILL EXPERIENCE

CLINICAL ANXIETY. ONE OUT OF

EVERY THREE TNG

153 TNG PEOPLE WILL EXPERIENCE
PEOPLE HAVE BEEN CLINICAL DEPRESSION.

MURDERED IN THE US

REPORTED BETWEEN

2010- 2018

90% WERE
TRANS WOMEN

72% WERE
BLACK TRANS

WOMEN

21

THE NEXT DAY HEY
TAKI!

I JUST KEITH, FOR ME,
CAN’T STOP I’M SO GLAD THE FIRST
TO SEE YOU. FEW SESSIONS
THINING ARE USUALLY THE
ABOUT I REALLY MOST DIFFICULT IN
IT. I FEEL THINK THERAPY THERAPY. YOU MAY
STUCK AND I COULD HELP YOU FEEL WORSE
DON’T KNOW BECUASE YOU
WHAT TO WITH THIS. WILL CONFRONT
SERIOUS EMONTIONS.
DO. DO YOU BUT IF ITS DIFFICULT
EVER FEEL BECAUSE YOUR THERAPIST
WORSE AFTER DOES NOT UNDERSTAND
ATTENDING? WHAT IT MEANS TO BE
ENBY, THEN YOU’RE
SEEING THE WRONG
THERAPIST.

I USED IS
TO HAVE A THAT
THERAPIST LIKE SO?
THAT, BUT THE CLINIC
I GO TO NOW IS MUCH 22
BETTER! THEY USE MY
CORRECT PRONOUNS.

IT FEELS VERY
VAILDATING.

BREATHE..

IT’S NOT
FAIR THAT CIS
PEOPLE ACT AS THE
GATEKEEPERS TO OUR
HEALTHCARE!

TAKODA
GARCIA

23

SESSION 1/12

HELLO, MY HI, I’M TAK.
NAME IS STEPHANIE, I USE THEY/THEM
I USE SHE/HER PRO-
NOUNS. I’M SO GLAD PRONOUNS.

THAT YOU CAME
IN TODAY.

TAK, WHAT
BRINGS YOU IN?

WELL, I WAS
DIAGNOSED WITH MULTIPLE
SCLEROSIS ABOUT TEN MONTHS
AGO AND I’VE BEEN EXPERIENCING
A LOT OF NUMBNESS IN MY LEGS

AND I’M EXHAUSTED ALL
THE TIME...

HOW HAS IT BEEN
MANAGING YOUR DIAGNOSIS
AND THE CHANGE IN YOUR

ABILITY STATUS?

IT WAS
DIFFICULT TO COME TO
TERMS WITH AT FIRST BUT
I’VE BEEN DOING A LOT BETTER
WITH IT. I WAS HAVING SOME
TROUBLE GETTING AROUND,
BUT MI PAPÁ CARVED

THIS WALKING CANE
FOR ME..

IT IS A BEAUTIFUL
CANE. YOUR PAPÁ IS VERY
TALENTED. PLEASE, TELL

ME MORE.

I’VE BEEN IT IS SO
HAVING A HARD FRUSTRATING
TIME GETTING AROUND THAT SOCIETY
BECAUSE MOST PLACES DOES NOT UNDERSTAND
I GO AREN’T VERY ACCOMMODATIONS
FOR FOLX WITH
ACCESSIBLE. DISABILITIES.

24

SESSION 3/12

I’M JUST

WORRIED ABOUT

WHAT DATING IS

GOING TO LOOK LIKE

FROM HERE

ON OUT. TELL

WELL.. ME MORE
I MEAN, I FEEL ABOUT THIS
LIKE I’M NOT
WORRY.

NORMAL.

WHEN I

SEE PEOPLE ON

DATING APPS, THEY

NEVER TALK ABOUT

DISABILITIES IF

THEY HAVE THEM.

AND THEY ALWAYS USE

GENDERED PRONOUNS

TO DESCRIBE WHO THEY

ARE LOOKING FOR. IT

MAKES ME FEEL

LIKE I DO NOT TAKODA, I
BELONG.
CAN SEE WHY THIS

HAS BEEN DIFFICULT FOR YOU,

NOT HAVING A MODEL FOR WHAT

DATING LOOKS LIKE AMOUNT PEOPLE

WHO SHARE YOUR IDENTITIES. THE

ITS NO CISNORMATIVE LENS OF DATING
WONDER YOU’VE PROFILES CAN BE HURTFUL
INTERNALIZED THAT AND ISOLATING.

INFORMATION.

WOW.. NO
THERAPIST HAS
EVER ARTICULATED
THOSE ASPECTS TO ME.
I’M NOT SURE HOW

I FEEL..

IT SOUNDS YES..
LIKE FEELING
VALIDATED IS AN
UNFAMILIAR

FEELING.

25

HELLO?

TAKI!
YOU HAVEN’T
BEEN RETURNING
MY CALLS.. ARE

YOU OKAY?

ARE YEAH..
YOU EATING I’M SORRY MAMÁ
I’VE BEEN REALLY
ENOUGH? STRESSED WITH

SCHOOL AND
WORK.

WHEN DO YOU YES..
PLAN ON COMING I’M NOT SURE
HOME? EVERYONE IS MAMÁ, I HAVE
COMING OVER NEXT EXAMS. I’LL LET YOU
KNOW WHEN I
WEEKEND.. KNOW. OKAY?

OKAY.. OKAY..
TAKODA?
WHEN YOU
DO COME HOME, CAN
YOU DRESS NORMALLY?
JUST BE YOURSELF, I DON’T
WANT TO UPSET ANY OF
THE RELATIVES.

OKAY TAKI?

I LOVE
YOU.. BYE.

26

SESSION 7/12 I’M NOT
EVEN SURE IF
I CAN TALK TO YOU
ABOUT THIS IN

HERE..

I HEAR
THAT YOU ARE
NERVOUS TO TALK TO
ME ABOUT SOMETHING. I
WOULD LIKE TO DO WHAT
I CAN TO MAKE YOU FEEL
MORE AT EASE

SHARING.

ITS JUST... IN MY
DAY TO DAY LIFE COLONIALISM
FEELS SO REAL AND I FEEL LIKE I’M
REMINDED OF WHY MY IDENTITIES DON’T
SEEM TO MATTER IN THIS CULTURE. MY
PEOPLE EMBRACED NONBINARY IDENTITIES
WAY BEFORE EUROPEANS INFILTRATED WHAT
IS NOW THE U.S. I SHARE ANCESTRY WITH A
CULTURE THAT HAS BEEN SEVERELY DAMAGED
BY COLONIZATION. THE CELEBRATED ROLES
PEOPLE WHO SHARE MY IDENTITIES ONCE

HAD WERE ATTACKED BY
ANGLO HOMOPHOBIA AND
ASSIMILATION. I DESERVE TO
LIVE A LIFE THAT IS CELEBRATED.
I FEEL ANGRY AND CHEATED AND I
FEEL LIKE I’M NOT SURE HOW TO
MAKE SENSE OF TRYING TO MAKE
MY WAY IN THE WORLD WHEN

I FEEL SO..
RESTRICTED.

THANK YOU SO MUCH WHEW.. IT IS
FOR SHARING THAT WITH ME. A RELIEF YOU
AREN’T REACTING
IT MAKES SENSE THAT YOU DEFENSIVELY.
FEEL ANGRY AND
CHEATED.

27

RELIEF..

MOST WHITE
PEOPLE WON’T JUST

LISTEN TO WHAT
I HAVE TO SAY..

I KNOW I CANNOT FULLY
UNDERSTAND YOUR PAIN. BUT I
RECOGNIZE THAT THE GENOCIDE IS
ONGOING WITH NON-NATIVE PEOPLE
APPROPRIATING WHAT IS LEFT OF YOUR
CULTURE AND HOW DIFFICULT THAT

MUST BE FOR NONBINARY
PEOPLE OF COLOR.

I’M SO GLAD
THAT WE’RE TALKING
ABOUT THIS OPENLY. I KNOW
IT CAN BE TOUGH TO HAVE
DIRECT CONVERSATIONS

ABOUT IT.

YOU KNOW..
JUST BEING DIRECT
ABOUT IT FEELS HEALING

IN A WAY..

28

GOING HOME

TAKODA
IS HERE!

29

SESSION 11/12

I WANTED TO MIXED.
MENTION THAT THIS HAS BEEN SO
THIS IS OUR SECOND MUCH BETTER THAN
TO LAST SESSION MY OTHER THERAPY
TOGETHER. HOW EXPERIENCES, BUT I’M
ARE YOU FEELING SAD IT IS ENDING
ABOUT ENDING
SO SOON.
THERAPY?

I CAN’T BELIEVE THE SOMETIMES

CHANGES I’VE BEEN ABLE TO IT STILL GETS ME

MAKE OVER THE LAST THREE MONTHS. DOWN, BUT I FEEL
I’VE NOTICED I’VE BEEN FEELING MORE LIKE I’VE BEEN
CONFIDENT AND THAT I’VE BEEN COPING WITH IT A
LEARNING MORE ABOUT HOW TO
LOT BETTER.
DEAL WITH MINORITY

STRESS.

TAK, YOU’VE MADE

HUGE STRIDES IN OUR

TIME WORKING TOGETHER,

I ALSO FEEL SAD WE WON’T BE

WORKING TOGETHER LONGER..

BUT I FEEL SO HONORED

I’VE BEEN ABLE TO BE

ALONG THIS CHANGE I DEFINITELY

PROCESS WITH FEEL LIKE I HAVE

YOU. MORE SKILLS IN HOW
TO REACT, COPE AND

PUT UP BOUNDARIES

YOU’RE FOR THE FUTURE
TAKODA
RIGHT? YEAH!
MY NAME IS
TAKODA AND I USE
THEY/THEM
PRONOUNS.

30

OH COOL, MY
NAME IS SAM, AND I
WAS WONDERING IF YOU
WANTED TO SIT WITH

ME AND MY
FRIENDS.
OKAY,
THAT SOUNDS
NICE.

HEY FRONDS!

THIS IS TAKODA,
HE--I MEAN THEY ARE

GOING TO SIT
WITH US.

31

SOME OF THE STUDY RESULTS

1. IN THIS STUDY, THERAPISTS WERE ALL TRAINED IN WHAT WE CALLED
“TRANS AFFIRMATIVE THERAPY.” ALL OF THE CLIENTS INDICATED THAT THEIR
THERAPISTS WERE AFFIRMING AND PROVIDED A GOOD EXPERIENCE. OVER
ALL, IN THERAPY.

2. 100% OF THE CLIENTS IN THE STUDY INDICATED THAT THEY WOULD
PARTICIPATE IN OUR STUDY AGAIN.
3. WE HAD TWO SEPARATE GROUPS RECEIVING THERAPY IN OUR STUDY-
ONE GROUP OF CLIENTS WAS GIVEN SPECIFIC TRAINING IN WHAT MINORITY
STRESS WAS AND ENCOURAGED TO TALK ABOUT MINORITY STRESS IN THEIR
SESSIONS WITH THEIR THERAPISTS. THEIR THERAPISTS PROVIDED TRANS
AFFIRMATIVE THERAPY. IN THE OTHER GROUP (WHAT WE CALL A “CONTROL
GROUP”), THE CLIENTS WERE ONLY GIVEN THE TRANS AFFIRMATIVE THERAPY
AND NOT THE MINORITY STRESS TRAINING.

4. BOTH GROUPS SHOWED IMPROVEMENT WITH THEIR MENTAL HEALTH
THROUGHOUT RECEIVING 12 SESSIONS OF THERAPY OVER 3 MONTHS.

5. THE GROUP THAT RECEIVED TRAINING IN WHAT MINORITY STRESS
WS SHOWED ADDITIONAL IMPROVEMENT- THEY REPORTED EXPERIENCING
LESS INTERNALIZED STIGMA AND NON-AFFIRMATION BY THE END OF THE
STUDY. INTERNALIZED STIGMA IS WHEN SOMEONE LEARNS OR HEARS THAT
THEIR IDENTITY IS BAD/WRONG/SHAMEFUL/ NON-AFFIRMATION IS BEING
MISGENDERED OR FEELING LIKE ONE HAS TO PERFORM THEIR GENDER IN A
SPECIFIC WAY FOR OTHER PEOPLE.

32

6. THE CLIENTS IN THE STUDY ATTENDED ALMOST ALL OF THEIR SESSIONS
(ON AVERAGE, 11/12 SESSIONS)- AND INDICATED THAT THEY WISHED THEY HAD
MORE SESSIONS AT THE END OF THE STUDY.
7. THERE WAS ONLY ONE CLIENT WHO INDICATED THAT THEY DID NOT FEEL
THAT THEY HAD IMPROVED BY THE END OF THE STUDY AND THIS WAS DUE TO
FEELING AS THOUGHT THEY WERE IN THE MIDDLE OF FOCUSING ON TRAUMA
WHEN THE STUDY ENDED- THEY INDICATED THAT THEY THOUGHT THEIR
THERAPIST WAS “THE BEST THEY’D EVER HAD” AND THAT THEY WISHED THEY
COULD HAVE CONTINUED WITH THEIR THERAPIST. QUOTES FROM THE CLIENT:

8. CLIENTS RATED HOW WELL THEY THOUGHT THEIR RELATIONSHIP WAS
GOING WITH THEIR THERAPISTS ON A WEEKLY BASIS. OUR STUDY SHOWED THAT
WHEN CLIENTS RATED A BETTER RELATIONSHIP WITH THEIR THERAPISTS FOR
THAT PARTICULAR WEEK, THEY ALSO SHOWED BETTER MENTAL HEALTH FOR
THAT PARTICULAR WEEK.
33

PARTICIPANT QUOTES

I GUESS
THAT YOU’RE SHARING
YOURSELF WITH SOMEONE SOMEBODY
THAT YOU DON’T REALLY KNOW. YEAH,
I THINK I’M MORE NERVOUS ABOUT
THE FACT THAT I MIGHT DISCOVER
THINGS, THAT’S LIKE MORE

WHERE MY NERVES
COME FROM.

IT IS NICE
NOT HAVING TO WORRY
ABOUT BEING MISGENDERED OR
HAVE PEOPLE PUSH WEIRD STUFF AT
YOU, OR HAVE CONVERSATIONS ABOUT
YOUR GENDER BE LIKE WELL WHY
DO YOU FEEL THAT WAY.

ARE YOU SURE?

AND I WANT TO
TALK ABOUT MY IDENTITY
AND MY EXPERIENCES WITHOUT
BEING MICROAGGRESSED THE WHOLE
TIME. IT WAS A REALLY GOOD EXPERIENCE
AND ITS ALWAYS SO HARD TO FIND TRANS
FRIENDLY THERAPISTS AND ACTUALLY
HAVE THEM BE TRANS FRIENDLY.
IT IS REALLY COMPLICATED/

I WAS SURPRISED
AT HOW HARD IT WAS [TO
DELVE INTO ISSUE IN THERAPY].
BUT I WAS REALLY EXCITED HOW HARD
IT WAS, BECAUSE THEN I KNEW IT
WAS SOMETHING THAT WAS
IMPORTANT TO LOOK AT..

34

I HAD JUST STARTED HRT
[HORMONE THERAPY] AND I FEEL
LIKE THAT PLAYED AN INTEGRAL ROLE IN
HELPING ME FEEL MORE COMFORTABLE IN MY
OWN SKIN. I THINK THINGS SNOWBALLED. HRT
PAIRED WITH THERAPY, AND SOME SKILL SETS
I COULD USE TO ALLEVIATE THE STRESSES
AROUND MY GENDER IDENTITY KIND OF
COMPOUNDED AND THE MORE I OPENED UP,

THE MORE POSITIVELY PEOPLE
RESPONDED TO ME, AND
THE EASIER IT WAS
TO OPEN UP.

A SENSE OF HER

[THERAPIST IN THE STUDY]

POLITICS ESPECIALLY AROUND

DISABILITY THAT ALSO HELPED ME

FEEL MORE COMFORTABLE BECAUSE I

COULD FEEL CONFIDENT THAT I WOULDN’T

HAVE TO LIKE REFRAME OR TRANSLATE

WHAT I MEANT INTO SOMETHING THAT I,

THE WAY THAT I KNOW THE MEDICAL

SYSTEM RECEIVES THESE

EXPERIENCES,

I THINK THAT THAT HELPED.

I FOUND THIS EXPERIENCE

TO BE VERY HELPFUL. I FOUND

MY THERAPIST TO BE A VERY

HELPFUL. AND I FOUND ALL OF THE

PEOPLE WORKING IN THE STUDY TO BE

CULTURALLY COMPETENT AND IT SEEMS

LIKE EVERYONE WORKING ON THE

STUDY IS WORKING ON IT FOR

THE RIGHT REASONS. I MEAN

THERE’S THE

CONSTANT BACKGROUND

RADIATION ANXIETY WHEN

WORKING WITH PROFESSIONALS

THAT THEY WOULD, EVEN IF THEY’RE

TRYING, THEY WOULD SLIP UP

SOMEHOW AND SHOW

ANTI TRAN-NESS.

35



GENDER EUPHORIA

EXTREME HAPPINESS, OR COMFORTABILITY, EXPERIENCED BECAUSE A PERSON’S
GENDER IS BEING AFFIRMED.

THANK YOU

ZAK REDDELL ALINA BOYDEN KATKA SHOWERS-
@EARLTEALORD JOYCE WU CURTAIN
JARO ROMANESKO BB & BB SERGIO

KHOA TRAN JAYE GARDINER DOMÍNGUEZ JR.
LUCY FUNK MY BODY
MORGAN SINNARD
TRL LAB MEMBERS

THIS PROJECT WAS MADE POSSIBLE BY FUNDING FROM THE
INSTITUTE FOR CLINICAL AND TRANSLATIONAL RESEARCH AT
THE UNIVERSITY OF WISCONSIN-MADISON
(NIH GRANT: UL1TR002373).

TO LEARN MORE ABOUT THIS STUDY, PLEASE CONTACT
STEPHANIE BUDGE OR VISIT HER LAB WEBSITE FOR THE
SCIENTIFIC STUDIES.

(608) 263-3753
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