Abstract
Although nascent literature finds higher rates of suicide among older TGD adults than their cisgender peers, research about suicide and suicidality in TGD populations emphasizes the experiences of younger adults and adolescents, while the experiences of older adults remain largely unexamined. Although minority stress theory emerged as a necessary departure from psychoanalysis’ emphasis on individual pathology and played an instrumental role in the widespread recognition of the impacts of societal oppression on the mental health of the TGD community, the minority stress model does not clearly suggest strategies to heal from these accumulated traumatic experiences. There is merit in the work of some psychoanalytic theorists for working with TGD populations, despite the rejection of psychoanalytic theory for its pathologization of TGD identities. For example, the works of Donald Winnicott and Phillip Bromberg compliment minority stress theory because they see social conditions and internal experience as inseparable, providing a useful guide for clinical practice with adults who have experienced trauma over the course of a lifetime. This paper uses case vignettes from the author’s clinical experience to demonstrate the application of these theories in therapeutic work with TGD older adults who experience dissociation and suicidality. Recommendations are provided for clinical practice that integrate both minority stress model and Bromberg and Winnicott’s theories about healing from trauma.
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Smith, E.K. Strategies to Survive: Engaging Transgender and Gender Diverse Older Adults Experiencing Suicidality and Dissociative States. Clin Soc Work J 51, 262–272 (2023). https://doi.org/10.1007/s10615-023-00867-1
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DOI: https://doi.org/10.1007/s10615-023-00867-1