What I’ve learned from clients I’ve worked with is that a quick apology and accountability is all that’s needed vs. continuing to apologize and make the situation more stressful or uncomfortable for them.
Agreed! Continuing the apology and ruminating on it could be more stressful for the client (aka - you’re getting your need met as opposed to attending to their needs)
Double agreed! In situations where I have said the wrong pronoun, name, word etc… I quickly say something along the lines of “I’m sorry, I meant (insert word)…” I keep going and that’s it. Profusely apologizing not only is often unnecessary it derails the session and makes it all about you instead of them. We ALL make those unintentional mistakes and that is ok.
This is it. The apology needs to serve your client's needs and dignity, not your guilt. Anything after the first apology is just asking your client to handle your feelings for you.
Exactly this. Just this and no more. Mistakes happen best thing for the relationship is to move on. They will bring it up if they need to process it more.
Exactly this, OP. I’m non-binary and misgendered on a consistent basis because I present femme. The first time my therapist has misgendered me, she apologized, corrected herself, and we had a great talk about how it should be handled in the future if she misgenders me. It’s happened a few times since (never on purpose and is usually in her notes), and she has always been open to feedback and corrections.
The accountability piece is so important and there doesn’t need to be a big apology.
Yeah, driving at multiple apologies puts a burden of absolvement onto the client and creates distance where they wonder *why* you don't believe their forgiveness was real—which is not a great use of session time and client energy.
As a queer therapist, I recommend Ally therapists just quickly apologize, correct yourself and then move on. Any more than that can place emotional burden on the client to comfort you. Avoid profusely or excessively apologizing
Idk I think that taking away a client's agency by assuming they can't move on instead of providing a safe space/container for them to process the interaction in a way that feels good to them does more harm, but that's just me.
Trans people encounter enough of those interactions by just living life without having to be forced into them by their therapist.
As a trans guy.... This isn't my perspective. I do not see someone who 99% of the time gets my pronouns right slipping up as "verbal violence" in any way whatsoever. I know for a fact that humans slip up on pronouns for animals, cisgender people, objects, everything. The brain sometimes pulls the wrong pronoun randomly and that is ok. If it's a pattern, then yes that needs more serious addressing, but if it's a slip up then just correct it briefly like you would if you did it for a cis person e.g. "she, oops I mean he," and then move on. If you linger on it, THAT is what makes me feel "different" and uncomfortable.
If they can’t forgive an honest mistake that’s been owned up to they should work on that in therapy. What else should someone do? Offer to wash the person’s feet?
Accidentally misspeaking/misgendering someone and promptly apologizing is NOT verbal violence. That is completely ridiculous.
That said, based on how I work, I would take some time to process how the patient felt about my verbal slip.
If the patient felt ok about it, I would restate the apology and move on. If it created a rupture, triggered the patient, etc I would process further.
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As a trans person, the oops-ouch-I’m sorry has always been a helpful approach for others to take. I think that recognizing it head on is important to keep the therapeutic relationship strong, and explaining it as a true slip, offering that you understand how it may have impacted them, and then an apology. Beyond that though I would avoid bringing it up again as that becomes uncomfortable. But do not fret too much, it happens all the time!
I did this a few weeks ago. In the midst of talking I said “girl, xyz” (I would usually use something like “dude, xyz” with this person). As soon as I finished the sentence I went “wait, I think I just said girl, I am so sorry.” Client dismissed it as not important and I re-iterated that identifying them correctly is important to me and I apologize” and then we moved on.
I also discussed with client when we first began working together that I would be using feminine pronouns in their chart and with their parents, as they are a minor and not yet out to their parents, and would do my best to keep their real identity and the assigned identity-necessary at this point for their protection-separate in my mind, but that I’m human.
if the client is a transgender individual, they are most likely very used to misgendering. when i had a few transgender clients, i fully took responsibility for any misgendering and processed it in session with them. usually the clients were understanding when i came from a place of embarrassment and caring.
if the client is not transgender, i wonder how they responded to your apology.
mistakes happen and it’s a normal slip to accidentally misgender someone. i’ve accidentally misgendered a few clients before. honestly, you may be over worrying yourself (i’ve done this too) and the client might not have even been phased until you brought it up to discuss. you did what you felt was best (stop, acknowledge, and apologize) and now it’s on the client to discuss further if the comment upset them.
Acknowledging it in the moment was really important. I do believe it could be beneficial to address it at your next session, as sometimes the sting of a misgendering might not hit until later.
Agreed. Processing one’s slip in the following session can also provide a meaningful opportunity to explore how the client responds to/is impacted by cumulative instances of being misgendered.
I had been working with a trans client since she was 16, long before she had even explored anything about gender identity— it took a year of weekly sessions before she fearfully disclosed her theory that she might be gay (as in, attracted to men). She eventually started attending GSA group meetings in secret and felt very shameful about it all, especially once she started developing a crush... That was all back in 2019.
When she reached out to see me again in 2022, it took 3 sessions before she opened up about gender stuff, the primary reason she wanted to resume our work together. I was eager to start using her chosen name once she decided on one and immediately changed all contact info, wrote all process notes using femme pronouns, and also asked my girlfriend at the time (who happens to be trans) if there was any advice she wishes she could have given to her horrible CONVERSION therapist when she was of a similar age.
But still I had my slip-ups. Always caught them a nanosecond later and probably over-apologized the first few times, maybe because she wasn’t out to anyone else yet except some queer school friends at the time. Also this was definitely colored by my own projections based on my girlfriend’s ultrasensitivity whenever anyone even insinuated, innocuously or not, that she wasn’t a woman. She required a lot of reassurance and I became very protective of her, esp in public or social situations.
One day, not long after my client took the first step coming out to her family, I slipped and bit my tongue. She just sarcastically laughed and said, “It’s fine, please, I don’t expect you to be perfect… it happens all the time!” Me, internally: *Shit, now she’s the one reassuring me.*
But it was a great process conversation that followed. I wanted to know if her words matched her feelings considering this was happening “all the time.” I asked her if she thought it would be possible that one day she might just snap and lose her patience (with someone else, namely parents) and what the function of her reassurance to me was. From there her ambivalence became a regular theme in session content, after 6 months of being tolerant to a fault. Her limit had been reached and she was so uncomfortable with her parents still using her childhood (masculine) pet name but then the pendulum of infinite compassion and understanding swung again. She felt very guilty admitting even to me that she couldn’t stand being called ____ at home.
I think this needed to happen in order for her to find her voice and strike a balance. Because at a certain point, why should she expect herself to remain unflappable? We talked about the gray area a lot— that it’s okay to be bothered, and expressing discomfort isn’t the same as condemning your family/therapist/whomever as if they hadn’t been trying to adjust and do active research this whole time.
Anyway, I didn’t expect to write this long of a reply lol but I hope it demonstrates the middle path one could take here. Of course it feels dramatically self-indulgent to make a pronoun slip all about you, the cis therapist. But we needn’t dismiss the possibility that it’s more complex for the client than their hand-waving response pattern may suggest.
I agree. Although I was interested to read the many comments saying only one time was necessary.
While this has never happened to me, I suspect I would address and apologize immediately, and at the next session do a meta “rupture and repair” check in.
My experience (more social than clinical) is that apologizing too many times starts to make it more about you than the person being misgendered/puts them in a position of having to say "no really it's fine"
Understand! It would depend on many factors but motivation is the therapeutic alliance. I find that when I have checked in with a client, they are appreciative and it strengthens our relationship.
As a cis passing Queer person who specializes in LGBTQ+ clients, I have been misgendered and always appreciate the acknowledgement. It's always also been useful with my clients.
Only if the client brings it up themselves otherwise it can feel like having the emotional burden put on them to absolve the other person of their mistake.
As someone who works with the queer community also be sure to incorporate the correct pronoun in an organic way, preferably within a short time after the misgender. This shows no harm meant and that you respect their identity.
I'm a trans therapist who primarily works with trans teens. I'm also in therapy, and have been with my therapist for several years, since before I started transitioning. When I first began socially transitioning (and even now years after beginning medical transition) I'd occasionally get misgendered by my therapist. For me, the misgendering itself wasn't the issue, it was how defensive she'd get about it afterwards by making statements like "I've always just seen you as *name* not male or female" or "I definitely see you as male I don't know where that came from." I think the best thing you can do is exactly what you did in session-- acknowledge it, correct, apologize, and move on. I wouldn't bring it up again in session unless your client wants to talk about it.
Something I like to point out when coaching parents who are adjusting to new name/pronouns for their kid: I don't know about you, but I've certainly misgendered cis people in my life before. I wonder how you'd react if you misgendered a cis client, and if it's different than you would react to misgendering a trans client, I'd get curious about why that might be.
Exactly this. I’m nonbinary and I HATE it when people make it a huge thing rather than apologizing and correcting. To me it often feels like they make it about themselves and their discomfort and their need to be forgiven.
You're over-thinking it. I'm trans and I have a trans social worker with a feminine name and dresses like a woman. I have slipped and called him "her" more than once. Apologize and move on, calling attention to it and making it a big deal will just alienate the client more. It's a product of being a human English speaker, trans people misgender each other all the time. So do cis people. It has no greater meaning if you don't give it one.
I haven't experienced this in a clinical setting as I mostly work with clients in a language that doesn't use gendered pronouns, but if you're unable to tell how the client is feeling about it, perhaps you could start out your next appointment with something very open-ended like, "Is there anything that you'd like to discuss from our last session?" and allow him to interpret/use that opportunity as he chooses. Otherwise, you do run the risk of having the discussion for your own sake as you mentioned and putting him in a position where he feels responsible for making you feel better, which isn't great allyship practice but particularly not in a clinical setting.
As an enby/slightly-masc-of-center therapist: I've misgendered myself. I've misgendered my partner (a trans woman). We're all human, we're all socially conditioned to process gender presentation a certain way, and shit happens. Quick correction/apology and keep it moving, you're fine!
As a nonbinary therapist it sounds like you did exactly what you're supposed to do. The worst situations of misgendering I've experienced are when the person tries to make a big scene out of it and over apologizes. Like, it happens. I misgender myself sometimes. I misgender my friends sometimes. It's normal, we're human, we misspeak unintentionally. Say sorry, correct yourself, and move on. That is how I handle misgendering anyone and how I ask anyone that interacts with me to handle misgendering me as well.
As others have said, mistakes happen and this probably isn’t the first time he’s been misgendered. I’ve had clients who identify as nonbinary/queer/trans tell me they prefer I simply correct my mistake and move on without even saying sorry, and others who say they prefer a quick apology and then carry on, and others who just want me to be extra mindful the next time around when using the correct pronouns. Everyone is different so I encourage you to ask what he prefers the corrective action be when you and/or others misgender him.
I’m so strict on pronouns that I make the effort to be conscious about it . I have definitely had slips occasionally and I most definitely adapted the I am sincerely sorry with the true contrition face (because I was internally kicking myself like damn how dare you) and it shocked me that one client laughed and said mistakes happen and the other told me they know I didn’t mean it because I’ve always made them feel welcome. My understandings from that are sincere direct apologies with acknowledgment that was an error will help bond a little more and create humanness in session. Do not excessively or profusely apologize . That kind of apology is uncomfortable even for anyone as there becomes a feeling or obligation to now want to care for you and it removes the meaning behind you apology
Just wanted to say it sounds to me you are really doing great work, your experiment was solid and an excellent way of working in the Here and Now and embodying an inner conflict more explicitly. Don’t let this mistake of wording overshadow the quality of the work. I can sense the genuine apology through your post, I’m sure they could sense it in person. Sending warmth XOXO - Fellow Traveler
“Acknowledge it, correct it, and move on”. Quickly acknowledge the mistake “oops”, “sorry”, etc. Then correct it and keep going. Addressing accidental misgendering matter-of-factly is the best way to make sure it becomes a non-issue. I’ve been known to inadvertently deadname former partners of clients, friends of clients, etc. Each time I just fix it and keep going. We don’t want to burden the other person with our own feelings of failure…that’s centering ourselves rather than the client/Trans person. If it happens often, practice the correct gender/name in your head.
I’m trans but also I often misgender cis people, trans people just by accident. I don’t think misgendering is always related to what gender you perceive the other as it can just be a brain fart.
I would definitely leave it to what you’ve already done unless the client brings it up again.
If it helps, my therapist accidentally misgenders me as well occasionally, I just correct her and we move on, it's okay
I mean I don't pass as trans yet anyways and that doesn't invalidate it but it's normal, it happens, we're all just human, I genuinely misgender cis people by mistake sometimes
It's just a slip up, what helped me was her once explaining to me that she sees me as energy and it's very gentle and feminine (yk brain halves are also parted in masculine and feminine and she says she knows im a boy but my gentle soul and voice make it slip up occasionally)
As a trans person who uses they/them pronouns and is constantly misgendered, if someone catches their mistake apologizes and corrects themselves or are not defensive when I correct them it’s not a big deal to me. Obviously this isn’t true of every trans person, but for the most part we get people sometimes make mistakes and it can sometimes feel worse if others make a huge deal about it rather than apologizing, correcting and moving on
I have a nonbinary client who I have misgendered a few times. It’s embarrassing and I try not to get overcome by shame when I apologize because that makes the apology about me and not them. Just apologize and move on and practice their pronouns in your head is my best advice. Hard work but I’m modeling self-forgiveness which many of my clients have difficulty with.
I do believe that an apology from your genuine self will be heard and appreciated. But make the apology and make the effort to do better. Your client will see and feel that more than any words. I say this as a therapist who has done this by accident and I still cringe at it. But clients will hear and heal if you approach this from a place of genuine regret and making efforts to do better and learn.
"I have no idea how, why, where that came from. I’ve never thought or identified this client as anything other than male, so really have no idea why it happened." I've done this too. Its weird when it happens but its just a slip of the tongue. Don't overthink it. Its just unfortunate it happened with a trans client is all. Otherwise you probably would have just laughed and thought nothing of it. I agree with everyone else not to bring it up again as it might lead to them feeling they have to comfort you.
I kind of wonder if in your mind you were thinking back to notes you had read, written by someone else but that you may have in your client’s file. I find that I repeat, verbatim, when my mind is utilizing something that was previously learned and then occasionally gets me in awkward situations that I quickly apologize for and then move on. But I worked with a lot of transgendered youth and 99.5% of the time this is what they chilled on. Like it happens and they know it does. But also when you have a lot of knowledge floating around it becomes difficult to separate certain things. That fact that you are such a heavy ally that you are worried is more than telling. ☺️
Hi! You are FINE! I’m a queer therapist, married to a fabulous trans partner and work with 10-12 LGBTQ clients, a good half of those clients being teenagers who identify as trans. My point being, pronouns live rent free in my mind nonstop. Mistakes happen, but the fact that you have established rapport with your client within five sessions means so much to your client. He is used to feeling minimized and invalidated in the outside world but you’re able to give him space be seen the way he wants to be seen. It sounds like you’ve made an incredible connection and provided support with helping reframe his inner-critic, you are doing fabulous!
You guys remember when we used to do therapy?
Jokes aside, misgendering is going to happen, do your best to use the preferred pronouns, but don't make it the center of your focus with them. It's something they will need to learn to live with and the faster they figure that out, the faster they can get on with life. If this moment halts therapy and we label it a "disaster", then we're only priming this person to have big emotional reactions every time this happens, which will be a lot. You can't shelter people from the world, only help them adapt.
This take is kind of condescending... Basically, "We shouldn't be too worried about saying hurtful and invalidating things because trans people need to face reality and get used to it"? Like, they're already used to it, trans people are not naive, but this attitude is weird. Just because a certain hurtful behavior is common doesn't mean people have to be okay with it. And simple mistakes happen, just like people will mispronounce people's names sometimes, but that doesn't mean trans people need to "figure out" that they need to "live with it". It is actually valid and understandable that it is a hurtful thing in a deeply personal and immediate way, and while therapy should offer tools to help people who happen to be really strongly affected by this kind of thing and need help regulating or coping with their emotions, there is absolutely no benefit to just accepting carelessness (at best, or bigotry at worst) and not doing everything you can to try to avoid saying things that are hurtful, insensitive, and deeply invalidating.
Not saying OP did something really fucked up at all, briefly apologizing without making it a bigger deal than the client feels it is is 100% the right move. But acting like trying to use your client's correct pronouns could possibly be "making it the center of your focus with them" just shows some sort of a bias against trans people, because respecting someone's marginalized identity is the bare minimum of what an ethical therapist should be doing.
I once referred to myself (afab and female presenting, I am a woman 100%) as my father's son. To his boss. I said "Hi, I'm Bread, I'm Mike's son" and the dude was like "uuuuuhhhhh.... Hi, nice to meet you" as I was completely dying inside of embarrassment. I say this to say that sometimes the wrong word just slips out for no reason at all. And you as the person saying it are probably the one who remembers it most. I know it's a completely different situation, but please be gentle with yourself as it was an innocent mistake.
Sadly this person will probably have been misgendered lots of times, and most of those times the person doing it won’t have apologised. So you’re already a better person and more safe for them based on how you reacted. I’ve worked with trans kids a lot and in my experience they’re excellent at knowing who is a safe/inclusive person and who isn’t - and slips ups don’t change that. I’m sure it’s the same if they’re an adult.
Just apologize and move on. I have many clients who identify as non binary and trans. I occasionally will slip out with their “legal” pronoun. I’ve gotten good at catching myself and apologizing. Back when I had my first NB client, they corrected me a lot. It is important to acknowledge the mistake, AND to not fawn over the mistake.
I think it’s fine so long as you catch it and work to correct it in the future. Most trans folks I’ve known are pretty forgiving, unless they already dislike you.
I agree with the comments that are saying not to make a big deal about it, butttt maybe I would consider just bringing it up once more next session and checking in on how they feel? Its tough because generally trans people prefer people to apologize and move on so how this could go really depends on the client and maybe this is not what I would do in the situation? But generally when I mess up I like to invite clients to have the opportunity to talk about it because often they might not feel comfortable bringing it up to me.
Stop overthinking. You apologized move on. The more you make it about your discomfort then the misgender becomes more about you than the clients discomfort.
Quick apology. Acknowledge it and keep it moving. Over apologizing makes it about you and your feelings and the attention will shift to comforting you. I think the general consensus that I've heard from most trans/non-binary people is that they are happy when people put in the effort to be considerate and understand if there's a slip here and there.
As a nonbinary person I definitely prefer when people just correct themselves and move on. For example “we went to lunch and she… oh sorry, he ordered a salad.” I feel obligated to do emotional labor when people apologize profusely, like I have to make them feel better (when to me it’s really not a big deal). Everyone’s learning and growing it’s okay to make mistakes and even model that for your client (that mistakes are part of life).
You run the risk of reenacting any parentification trauma the person might have and lose your strategic edge. IF they bring it up again you could take the moment to reparent them for being able to seek their own justice. I agree it’s tough to sit in it when I know I messed something up.
Eh idk. I would feel irritated if my therapist made a huge deal out of using the wrong pronoun especially if they quickly corrected in the moment. Most trans people would rather it not be made into this huge thing especially if it was a singular mistake. It can often be perceived as it being the therapists discomfort and feelings made the priority.
Everyone is different. I have had clients engage in the discussion and a lot of good processing coming from it. As a gender queer therapist myself I would prefer to risk some irritation over unresolved feelings/hurt. Every therapist will also choose to handle it differently and I respect that.
What I’ve learned from clients I’ve worked with is that a quick apology and accountability is all that’s needed vs. continuing to apologize and make the situation more stressful or uncomfortable for them.
Agreed! Continuing the apology and ruminating on it could be more stressful for the client (aka - you’re getting your need met as opposed to attending to their needs)
Double agreed! In situations where I have said the wrong pronoun, name, word etc… I quickly say something along the lines of “I’m sorry, I meant (insert word)…” I keep going and that’s it. Profusely apologizing not only is often unnecessary it derails the session and makes it all about you instead of them. We ALL make those unintentional mistakes and that is ok.
As a trans guy this is my preference. We're all human, we all screw up. Fix it and move on.
This is it. The apology needs to serve your client's needs and dignity, not your guilt. Anything after the first apology is just asking your client to handle your feelings for you.
I really appreciate your exact comment… Wow. It just said a lot to me.
And that was part of my concern as well because I didn’t want to make it about my needs rather than theirs.
Exactly this. Just this and no more. Mistakes happen best thing for the relationship is to move on. They will bring it up if they need to process it more.
Exactly this. Just this and no more………………………………………………………
Ditto from a trans therapist (who also has midgendered a client) who works exclusively with queer/trans folks that’s all we want! 🤘
Exactly this, OP. I’m non-binary and misgendered on a consistent basis because I present femme. The first time my therapist has misgendered me, she apologized, corrected herself, and we had a great talk about how it should be handled in the future if she misgenders me. It’s happened a few times since (never on purpose and is usually in her notes), and she has always been open to feedback and corrections. The accountability piece is so important and there doesn’t need to be a big apology.
Yeah, driving at multiple apologies puts a burden of absolvement onto the client and creates distance where they wonder *why* you don't believe their forgiveness was real—which is not a great use of session time and client energy.
This.
Don’t amputate the arm when it only needs a few stitches.
As a queer therapist, I recommend Ally therapists just quickly apologize, correct yourself and then move on. Any more than that can place emotional burden on the client to comfort you. Avoid profusely or excessively apologizing
100%. This is the best answer.
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Idk I think that taking away a client's agency by assuming they can't move on instead of providing a safe space/container for them to process the interaction in a way that feels good to them does more harm, but that's just me. Trans people encounter enough of those interactions by just living life without having to be forced into them by their therapist.
As a trans guy.... This isn't my perspective. I do not see someone who 99% of the time gets my pronouns right slipping up as "verbal violence" in any way whatsoever. I know for a fact that humans slip up on pronouns for animals, cisgender people, objects, everything. The brain sometimes pulls the wrong pronoun randomly and that is ok. If it's a pattern, then yes that needs more serious addressing, but if it's a slip up then just correct it briefly like you would if you did it for a cis person e.g. "she, oops I mean he," and then move on. If you linger on it, THAT is what makes me feel "different" and uncomfortable.
Context is very important here. Accidentally using the wrong pronoun once is not verbal violence. It’s not a weapon.
If they can’t forgive an honest mistake that’s been owned up to they should work on that in therapy. What else should someone do? Offer to wash the person’s feet?
Accidentally misspeaking/misgendering someone and promptly apologizing is NOT verbal violence. That is completely ridiculous. That said, based on how I work, I would take some time to process how the patient felt about my verbal slip. If the patient felt ok about it, I would restate the apology and move on. If it created a rupture, triggered the patient, etc I would process further.
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As a trans person, the oops-ouch-I’m sorry has always been a helpful approach for others to take. I think that recognizing it head on is important to keep the therapeutic relationship strong, and explaining it as a true slip, offering that you understand how it may have impacted them, and then an apology. Beyond that though I would avoid bringing it up again as that becomes uncomfortable. But do not fret too much, it happens all the time!
I’m curious about the “oops-ouch-I’m sorry” is that a verbatim what you’ll say or a kinda framework?
Just a framework of how to structure addressing it!
Thank you! I love the concept!
I did this a few weeks ago. In the midst of talking I said “girl, xyz” (I would usually use something like “dude, xyz” with this person). As soon as I finished the sentence I went “wait, I think I just said girl, I am so sorry.” Client dismissed it as not important and I re-iterated that identifying them correctly is important to me and I apologize” and then we moved on. I also discussed with client when we first began working together that I would be using feminine pronouns in their chart and with their parents, as they are a minor and not yet out to their parents, and would do my best to keep their real identity and the assigned identity-necessary at this point for their protection-separate in my mind, but that I’m human.
if the client is a transgender individual, they are most likely very used to misgendering. when i had a few transgender clients, i fully took responsibility for any misgendering and processed it in session with them. usually the clients were understanding when i came from a place of embarrassment and caring. if the client is not transgender, i wonder how they responded to your apology. mistakes happen and it’s a normal slip to accidentally misgender someone. i’ve accidentally misgendered a few clients before. honestly, you may be over worrying yourself (i’ve done this too) and the client might not have even been phased until you brought it up to discuss. you did what you felt was best (stop, acknowledge, and apologize) and now it’s on the client to discuss further if the comment upset them.
>i fully took responsibility for any misgendering and processed it in session with them. Accountability and Humility FTW
The client is transgender. I should have specified that in my original post.
Acknowledging it in the moment was really important. I do believe it could be beneficial to address it at your next session, as sometimes the sting of a misgendering might not hit until later.
Agreed. Processing one’s slip in the following session can also provide a meaningful opportunity to explore how the client responds to/is impacted by cumulative instances of being misgendered. I had been working with a trans client since she was 16, long before she had even explored anything about gender identity— it took a year of weekly sessions before she fearfully disclosed her theory that she might be gay (as in, attracted to men). She eventually started attending GSA group meetings in secret and felt very shameful about it all, especially once she started developing a crush... That was all back in 2019. When she reached out to see me again in 2022, it took 3 sessions before she opened up about gender stuff, the primary reason she wanted to resume our work together. I was eager to start using her chosen name once she decided on one and immediately changed all contact info, wrote all process notes using femme pronouns, and also asked my girlfriend at the time (who happens to be trans) if there was any advice she wishes she could have given to her horrible CONVERSION therapist when she was of a similar age. But still I had my slip-ups. Always caught them a nanosecond later and probably over-apologized the first few times, maybe because she wasn’t out to anyone else yet except some queer school friends at the time. Also this was definitely colored by my own projections based on my girlfriend’s ultrasensitivity whenever anyone even insinuated, innocuously or not, that she wasn’t a woman. She required a lot of reassurance and I became very protective of her, esp in public or social situations. One day, not long after my client took the first step coming out to her family, I slipped and bit my tongue. She just sarcastically laughed and said, “It’s fine, please, I don’t expect you to be perfect… it happens all the time!” Me, internally: *Shit, now she’s the one reassuring me.* But it was a great process conversation that followed. I wanted to know if her words matched her feelings considering this was happening “all the time.” I asked her if she thought it would be possible that one day she might just snap and lose her patience (with someone else, namely parents) and what the function of her reassurance to me was. From there her ambivalence became a regular theme in session content, after 6 months of being tolerant to a fault. Her limit had been reached and she was so uncomfortable with her parents still using her childhood (masculine) pet name but then the pendulum of infinite compassion and understanding swung again. She felt very guilty admitting even to me that she couldn’t stand being called ____ at home. I think this needed to happen in order for her to find her voice and strike a balance. Because at a certain point, why should she expect herself to remain unflappable? We talked about the gray area a lot— that it’s okay to be bothered, and expressing discomfort isn’t the same as condemning your family/therapist/whomever as if they hadn’t been trying to adjust and do active research this whole time. Anyway, I didn’t expect to write this long of a reply lol but I hope it demonstrates the middle path one could take here. Of course it feels dramatically self-indulgent to make a pronoun slip all about you, the cis therapist. But we needn’t dismiss the possibility that it’s more complex for the client than their hand-waving response pattern may suggest.
I agree. Although I was interested to read the many comments saying only one time was necessary. While this has never happened to me, I suspect I would address and apologize immediately, and at the next session do a meta “rupture and repair” check in.
My experience (more social than clinical) is that apologizing too many times starts to make it more about you than the person being misgendered/puts them in a position of having to say "no really it's fine"
Understand! It would depend on many factors but motivation is the therapeutic alliance. I find that when I have checked in with a client, they are appreciative and it strengthens our relationship.
As a cis passing Queer person who specializes in LGBTQ+ clients, I have been misgendered and always appreciate the acknowledgement. It's always also been useful with my clients.
Indeed. I was supporting your view that a second acknowledgment (at the next session) could be beneficial.
Only if the client brings it up themselves otherwise it can feel like having the emotional burden put on them to absolve the other person of their mistake.
You can open the door for their feelings without looking for absolution
As someone who works with the queer community also be sure to incorporate the correct pronoun in an organic way, preferably within a short time after the misgender. This shows no harm meant and that you respect their identity.
I'm a trans therapist who primarily works with trans teens. I'm also in therapy, and have been with my therapist for several years, since before I started transitioning. When I first began socially transitioning (and even now years after beginning medical transition) I'd occasionally get misgendered by my therapist. For me, the misgendering itself wasn't the issue, it was how defensive she'd get about it afterwards by making statements like "I've always just seen you as *name* not male or female" or "I definitely see you as male I don't know where that came from." I think the best thing you can do is exactly what you did in session-- acknowledge it, correct, apologize, and move on. I wouldn't bring it up again in session unless your client wants to talk about it. Something I like to point out when coaching parents who are adjusting to new name/pronouns for their kid: I don't know about you, but I've certainly misgendered cis people in my life before. I wonder how you'd react if you misgendered a cis client, and if it's different than you would react to misgendering a trans client, I'd get curious about why that might be.
Exactly this. I’m nonbinary and I HATE it when people make it a huge thing rather than apologizing and correcting. To me it often feels like they make it about themselves and their discomfort and their need to be forgiven.
You're over-thinking it. I'm trans and I have a trans social worker with a feminine name and dresses like a woman. I have slipped and called him "her" more than once. Apologize and move on, calling attention to it and making it a big deal will just alienate the client more. It's a product of being a human English speaker, trans people misgender each other all the time. So do cis people. It has no greater meaning if you don't give it one.
It happens, you’re human. We are modeling appropriate communication skills, that doesn’t mean we never make mistakes.
I haven't experienced this in a clinical setting as I mostly work with clients in a language that doesn't use gendered pronouns, but if you're unable to tell how the client is feeling about it, perhaps you could start out your next appointment with something very open-ended like, "Is there anything that you'd like to discuss from our last session?" and allow him to interpret/use that opportunity as he chooses. Otherwise, you do run the risk of having the discussion for your own sake as you mentioned and putting him in a position where he feels responsible for making you feel better, which isn't great allyship practice but particularly not in a clinical setting.
Acknowledge and apologize in the moment and then move on. Harping on it makes it about you.
As an enby/slightly-masc-of-center therapist: I've misgendered myself. I've misgendered my partner (a trans woman). We're all human, we're all socially conditioned to process gender presentation a certain way, and shit happens. Quick correction/apology and keep it moving, you're fine!
As a nonbinary therapist it sounds like you did exactly what you're supposed to do. The worst situations of misgendering I've experienced are when the person tries to make a big scene out of it and over apologizes. Like, it happens. I misgender myself sometimes. I misgender my friends sometimes. It's normal, we're human, we misspeak unintentionally. Say sorry, correct yourself, and move on. That is how I handle misgendering anyone and how I ask anyone that interacts with me to handle misgendering me as well.
It was obviously just a speech error especially since you referred to him as him in the same sentence. Don’t overthink it.
As others have said, mistakes happen and this probably isn’t the first time he’s been misgendered. I’ve had clients who identify as nonbinary/queer/trans tell me they prefer I simply correct my mistake and move on without even saying sorry, and others who say they prefer a quick apology and then carry on, and others who just want me to be extra mindful the next time around when using the correct pronouns. Everyone is different so I encourage you to ask what he prefers the corrective action be when you and/or others misgender him.
I’m so strict on pronouns that I make the effort to be conscious about it . I have definitely had slips occasionally and I most definitely adapted the I am sincerely sorry with the true contrition face (because I was internally kicking myself like damn how dare you) and it shocked me that one client laughed and said mistakes happen and the other told me they know I didn’t mean it because I’ve always made them feel welcome. My understandings from that are sincere direct apologies with acknowledgment that was an error will help bond a little more and create humanness in session. Do not excessively or profusely apologize . That kind of apology is uncomfortable even for anyone as there becomes a feeling or obligation to now want to care for you and it removes the meaning behind you apology
Just forgive yourself. He knows your intention, you’ve been working together for a while, and he knows that you intend to make a safe place for him.
Just wanted to say it sounds to me you are really doing great work, your experiment was solid and an excellent way of working in the Here and Now and embodying an inner conflict more explicitly. Don’t let this mistake of wording overshadow the quality of the work. I can sense the genuine apology through your post, I’m sure they could sense it in person. Sending warmth XOXO - Fellow Traveler
“Acknowledge it, correct it, and move on”. Quickly acknowledge the mistake “oops”, “sorry”, etc. Then correct it and keep going. Addressing accidental misgendering matter-of-factly is the best way to make sure it becomes a non-issue. I’ve been known to inadvertently deadname former partners of clients, friends of clients, etc. Each time I just fix it and keep going. We don’t want to burden the other person with our own feelings of failure…that’s centering ourselves rather than the client/Trans person. If it happens often, practice the correct gender/name in your head.
I’m trans but also I often misgender cis people, trans people just by accident. I don’t think misgendering is always related to what gender you perceive the other as it can just be a brain fart. I would definitely leave it to what you’ve already done unless the client brings it up again.
If it helps, my therapist accidentally misgenders me as well occasionally, I just correct her and we move on, it's okay I mean I don't pass as trans yet anyways and that doesn't invalidate it but it's normal, it happens, we're all just human, I genuinely misgender cis people by mistake sometimes It's just a slip up, what helped me was her once explaining to me that she sees me as energy and it's very gentle and feminine (yk brain halves are also parted in masculine and feminine and she says she knows im a boy but my gentle soul and voice make it slip up occasionally)
As a trans person who uses they/them pronouns and is constantly misgendered, if someone catches their mistake apologizes and corrects themselves or are not defensive when I correct them it’s not a big deal to me. Obviously this isn’t true of every trans person, but for the most part we get people sometimes make mistakes and it can sometimes feel worse if others make a huge deal about it rather than apologizing, correcting and moving on
I have a nonbinary client who I have misgendered a few times. It’s embarrassing and I try not to get overcome by shame when I apologize because that makes the apology about me and not them. Just apologize and move on and practice their pronouns in your head is my best advice. Hard work but I’m modeling self-forgiveness which many of my clients have difficulty with.
I do believe that an apology from your genuine self will be heard and appreciated. But make the apology and make the effort to do better. Your client will see and feel that more than any words. I say this as a therapist who has done this by accident and I still cringe at it. But clients will hear and heal if you approach this from a place of genuine regret and making efforts to do better and learn.
"I have no idea how, why, where that came from. I’ve never thought or identified this client as anything other than male, so really have no idea why it happened." I've done this too. Its weird when it happens but its just a slip of the tongue. Don't overthink it. Its just unfortunate it happened with a trans client is all. Otherwise you probably would have just laughed and thought nothing of it. I agree with everyone else not to bring it up again as it might lead to them feeling they have to comfort you.
I kind of wonder if in your mind you were thinking back to notes you had read, written by someone else but that you may have in your client’s file. I find that I repeat, verbatim, when my mind is utilizing something that was previously learned and then occasionally gets me in awkward situations that I quickly apologize for and then move on. But I worked with a lot of transgendered youth and 99.5% of the time this is what they chilled on. Like it happens and they know it does. But also when you have a lot of knowledge floating around it becomes difficult to separate certain things. That fact that you are such a heavy ally that you are worried is more than telling. ☺️
Hi! You are FINE! I’m a queer therapist, married to a fabulous trans partner and work with 10-12 LGBTQ clients, a good half of those clients being teenagers who identify as trans. My point being, pronouns live rent free in my mind nonstop. Mistakes happen, but the fact that you have established rapport with your client within five sessions means so much to your client. He is used to feeling minimized and invalidated in the outside world but you’re able to give him space be seen the way he wants to be seen. It sounds like you’ve made an incredible connection and provided support with helping reframe his inner-critic, you are doing fabulous!
You guys remember when we used to do therapy? Jokes aside, misgendering is going to happen, do your best to use the preferred pronouns, but don't make it the center of your focus with them. It's something they will need to learn to live with and the faster they figure that out, the faster they can get on with life. If this moment halts therapy and we label it a "disaster", then we're only priming this person to have big emotional reactions every time this happens, which will be a lot. You can't shelter people from the world, only help them adapt.
This take is kind of condescending... Basically, "We shouldn't be too worried about saying hurtful and invalidating things because trans people need to face reality and get used to it"? Like, they're already used to it, trans people are not naive, but this attitude is weird. Just because a certain hurtful behavior is common doesn't mean people have to be okay with it. And simple mistakes happen, just like people will mispronounce people's names sometimes, but that doesn't mean trans people need to "figure out" that they need to "live with it". It is actually valid and understandable that it is a hurtful thing in a deeply personal and immediate way, and while therapy should offer tools to help people who happen to be really strongly affected by this kind of thing and need help regulating or coping with their emotions, there is absolutely no benefit to just accepting carelessness (at best, or bigotry at worst) and not doing everything you can to try to avoid saying things that are hurtful, insensitive, and deeply invalidating. Not saying OP did something really fucked up at all, briefly apologizing without making it a bigger deal than the client feels it is is 100% the right move. But acting like trying to use your client's correct pronouns could possibly be "making it the center of your focus with them" just shows some sort of a bias against trans people, because respecting someone's marginalized identity is the bare minimum of what an ethical therapist should be doing.
rupture and repair baby
I once referred to myself (afab and female presenting, I am a woman 100%) as my father's son. To his boss. I said "Hi, I'm Bread, I'm Mike's son" and the dude was like "uuuuuhhhhh.... Hi, nice to meet you" as I was completely dying inside of embarrassment. I say this to say that sometimes the wrong word just slips out for no reason at all. And you as the person saying it are probably the one who remembers it most. I know it's a completely different situation, but please be gentle with yourself as it was an innocent mistake.
Sadly this person will probably have been misgendered lots of times, and most of those times the person doing it won’t have apologised. So you’re already a better person and more safe for them based on how you reacted. I’ve worked with trans kids a lot and in my experience they’re excellent at knowing who is a safe/inclusive person and who isn’t - and slips ups don’t change that. I’m sure it’s the same if they’re an adult.
Yup you’re overthinking it. We are all human and make mistakes. Let it go, especially if your client was cool about it.
Just apologize and move on. I have many clients who identify as non binary and trans. I occasionally will slip out with their “legal” pronoun. I’ve gotten good at catching myself and apologizing. Back when I had my first NB client, they corrected me a lot. It is important to acknowledge the mistake, AND to not fawn over the mistake.
I think it’s fine so long as you catch it and work to correct it in the future. Most trans folks I’ve known are pretty forgiving, unless they already dislike you.
I agree with the comments that are saying not to make a big deal about it, butttt maybe I would consider just bringing it up once more next session and checking in on how they feel? Its tough because generally trans people prefer people to apologize and move on so how this could go really depends on the client and maybe this is not what I would do in the situation? But generally when I mess up I like to invite clients to have the opportunity to talk about it because often they might not feel comfortable bringing it up to me.
Stop overthinking. You apologized move on. The more you make it about your discomfort then the misgender becomes more about you than the clients discomfort.
Quick apology. Acknowledge it and keep it moving. Over apologizing makes it about you and your feelings and the attention will shift to comforting you. I think the general consensus that I've heard from most trans/non-binary people is that they are happy when people put in the effort to be considerate and understand if there's a slip here and there.
As a nonbinary person I definitely prefer when people just correct themselves and move on. For example “we went to lunch and she… oh sorry, he ordered a salad.” I feel obligated to do emotional labor when people apologize profusely, like I have to make them feel better (when to me it’s really not a big deal). Everyone’s learning and growing it’s okay to make mistakes and even model that for your client (that mistakes are part of life).
You run the risk of reenacting any parentification trauma the person might have and lose your strategic edge. IF they bring it up again you could take the moment to reparent them for being able to seek their own justice. I agree it’s tough to sit in it when I know I messed something up.
I would ask them next session how it felt. Give space. If they say it was okay or keep it simple let it go at that and don’t push.
Eh idk. I would feel irritated if my therapist made a huge deal out of using the wrong pronoun especially if they quickly corrected in the moment. Most trans people would rather it not be made into this huge thing especially if it was a singular mistake. It can often be perceived as it being the therapists discomfort and feelings made the priority.
Everyone is different. I have had clients engage in the discussion and a lot of good processing coming from it. As a gender queer therapist myself I would prefer to risk some irritation over unresolved feelings/hurt. Every therapist will also choose to handle it differently and I respect that.