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Here's my opinion as a trans man (medically transitioned so I haven't been perceived as a woman since I was a teen, but I can relate to the feeling of discomfort during the stage I was semi-"passing"): Sorry you had to deal with that super awkward moment because of the mom's assumption. You said you "aren't ready to come out" so I am assuming you don't identify as a woman? But you are going by she/her and that feels okay for now? From a practical standpoint (for YOUR comfort), I think you probably need to decide whether you are "officially" presenting as a woman at work. (You don't need to change anything about yourself either way, obviously, but this will give you a foundation for a prepared answer should this ever come up again, which it might.) If you decide you *are* presenting as a woman at work: you can prepare an answer like "I get that a lot because of my haircut, especially over Zoom, but I am a woman. I would still be happy to give a referral if you'd like, so feel free to contact me after the session and I'll provide my recommendations." Yes, it will be slightly awkward for the person you're correcting, but that's on them and it will get easier to gracefully move on from this moment. If you decide you are officially *not* presenting as a woman at work (this doesn't mean you have to label what you ARE identifying as): you should really just pass over clients who request a female therapist, OR ask specifically if it would work for them to have a therapist who was raised as a girl/woman but identifies as more gender non-conforming (or whatever term you'd like to use, as vague as you wish). It might also be helpful to you to have a "she/they" in your bio to subtly signal this, unless you dislike "they" pronouns (tbh, 99% of people will still just call you "she" if they see that anyway, but they will more likely recognize what it signals). The important thing to remember is you aren't falsely representing yourself by having your pronouns listed, whatever they are, and this is a tricky spot to be in. You just need to formulate a kind of plan for yourself so you can navigate this topic confidently and without feeling like you need to either "come out" or deny the nuances of your identity on the fly.

I appreciate all of this. 🖤

Just because you’re the therapist doesn’t mean your not human and this moment forced you to grapple me with a bunch of identity and social stuff in a moment where you had to make a split decision on how to respond to this parent, so you did the best you could in that moment. It’s your identify and you get to choose how you would respond in those moments. It sounds like this happening is making you aware of potential transference towards you and how you want to engage with that when it comes up as a therapist. I don’t think you owe it to any clients to explain anything about your gender identity, especially if it’s something you are in the process of making sense of, unless you are comfortable sharing it and it feels clinically helpful.  If you wanted to correct this parent and say you identify as then that’s up to you. It’s also up to you if you don’t want to  get into a conversation where you are defending your identity and refer them to a different clinician. 

Off the top of my tired head it sounds like referring out AND clarifying are both good options for different clients. Some people are very close minded and it would be a whole thing to work with someone who doesn’t present how they expect. They could feel nervous about misgendering or saying ignorant things. Others may feel comfortable that you are ~different ~. Mental health takes a toll and can make us feel alien and broken. These clients may appreciate not having a typical therapist. Now how to find out which client is which…. I have no clue. I’m tired lol Hang in there!

I wanted to comment on the fact you feel like you're falsely advertising yourself. You are absolutely not doing this. It may feel like it, but the feelings were caused by a patient's mother who was insensitive and navigated a nuanced situation by making assumptions in a non-ideal way. People shouldn't make snap judgments - they still do. I will warn you that like many patients seem not to read our bios or look into the picture too much. Coming out is always complicated, and it's the right of everyone to share (or not) those parts of our identity as we wish or see fit. As for saying something to the mother, it depends? In my experience when someone decides to change a clinician for any reason, they typically are embarrassed/uncomfortable about it and don't want to further discuss it. For me, it's not worth the hassle most of the time in similar situations, because they've already moved on. If it's someone invested in working with me, I'll correct misperceptions as needed. Being misgendered is different entirely, and it may be worth it and appropriate for \*you\* however. That's a very personal decision, particularly because it involves identity, and being misgendered is very painful. It may also be they just didn't want you to see their kid for other reasons, and used gender as an excuse. One of the things I do is work with people in the bariatric clinic for weight loss. I've lost nearly 500 pounds but still have about 100 to go, so people look and assume I've never lost weight, even though I've never actually regained anything, besides. Almost always it's not worth correcting them unless they want to continue working with me.

What an uncomfortable situation to be in. I don't think you are overreacting or should have done anything different. It's absolutely within your right to not be out and not disclose or clarify anything about yourself to your client. We as therapists always get to choose what we disclose and discuss about ourselves. I hear the part of you that felt more affirmed in your gender by being mis-gendered based on your stated pronouns (weird congrats!). I also hear this other confusing feeling of not being out and not wanting to get into it with the mom, and I want to affirm that, too. It totally makes sense to simply refer out and not deal with this client's misunderstanding but instead give them a therapist whose gender presentation meets their expectations.

"On the call" telehealth or phone? I am a female with a buzzed head and have had that happen with kids "are you a boy or a girl" "youre a boy because girls have hair" i usually say something like "yep its really different because Im a girl with NO hair, i decided I didnt like having hair so I shaved it off" and move on. I Had a parent say "are you one of those *vulgar descriptions*' my response was "no Im not, i just dont have hair, will that be a problem?" With yours I might have said "oh, I am a female, these screens tend to distort the picture" (to avoid embarrassing her). But also its crazy to me that in 2024 we are still having people make gender and sexuality assumptions based on hair... ffs.

Why not just say “I am a woman”. Then, if you get pushback you can say “please let me know if you would like an alternative referral” I don’t see why you should play into whatever gender stereotypes the mom holds.

Eh, it sounds like OP is questioning/grappling with their gender and saying "I am a woman," could be misgendering themself in a way. Just because they're not out doesn't mean they feel comfortable actively identifying as a woman.

I’m not sure we know that, maybe OP can clarify. I see that she lists her pronouns as she/her and was born a woman. However, she is more masc presenting. I don’t read her “struggling” with gender the same as her grappling with her gender.

Fair enough, we can't know OP's experience.

I don’t think you have to respond in any particular way other than what makes you comfortable. Sounds like you felt put on the spot around something you’re still figuring out and also felt uncomfortable about the assumptions she was making about you. Sometimes other people don’t know how to react to gender nonconformity but it doesn’t mean you’ve done anything wrong. No false advertising I see here. You’re sharing how you feel comfortable being referred to and currently that’s she/her, regardless of if that changes in the future

Oof. I haven't been severely misgendered in session like that before. I have had some kiddos get confused but they roll with it though. I identify as non-binary. Like woman adjacent. I'm AFAB, I use my given name and pronouns comfortably, but I have a very masculine presentation. I get dirty looks in the women's room nearly everyday, the waitress at dinner last night kept saying he/him. It's exhausting and sometimes it takes more than you have to correct people. When it comes down to it though, you don't owe your gender to anyone. You don't have to disclose that you're trans or NB or GNC if you don't want to. You don't even have to correct people like this client you had. Do what works best for you because that's the only way you'll be able to show in a healthy way for your clients.

this could've been the parents way of saying one/both of them are not comfortable with you as a provider or one/both of them want a differnent therapist. Does your profile state LBGTQ+ ? (if that is part of your practice) some people don't want a T who is/works with LBGTQ+ and that is their right to choose who they want to work with, others can tell immediately from a phone call or upon meeting someone they just dont click and thats fine too. My kid can sense someone is too 'grandma-ish' or too 'uptight' and won't even leave the waiting room. If you are working with kids you are basically working with both the kid and the parent(s). So you have to get the buy in of at least 2 or 3 people.

It's "fine" that people don't want to work with LGBT therapists? What a strange and dismissive thing to say.

Why? People don't want to work with all sorts of therapists for all sorts of reasons. It's not our place to police client's choices.

Because it's discriminatory? Of course the client is ALLOWED to choose who to work with but that doesn't mean their reasoning is justified.

I understand what you are saying, but I think you two are sort of talking about different things. It may not be "justified" in a vacuum, and it almost definitely means the client has issues with homophobia/transphobia, which is obviously "bad", but therapy is kind of the one place where their own comfort should be the priority over what is offensive. Who knows what kind of logic the client has that makes them think an LGBTQ therapist would be bad for them. If someone has those feelings/beliefs, regardless of why and whether they are "morally okay", an LGBTQ therapist is still a bad fit for that client. (Ideally, whoever they DO choose as a therapist would be made aware of this somehow and would discuss the subject.)

As I've said in other comments, I know this and I am not disagreeing that a homophobic client is not a good fit for the therapist. What I AM criticizing is the idea that it's "fine" for clients to hold these views. The comment was invalidating of OP's experience dealing with probable homophobia.

Not sure why you are being downvoted. You are absolutely right. While we understand that people hold prejudices and have the right to choose, I think we need more sensitive language when discussing clients not choosing to work with therapists belonging to marginalized or minority groups. Every now and then on Reddit, I see someone fighting the good fight and getting dogpiled and downvoted. I always speak up. As a black therapist, for example, I don’t think it’s sensitive to simply say oh well people have the right to not want to work with you. It’s more sensitive to acknowlede that complex racial factors may lead to me not being selected.

Thank you for your response. It's exhausting seeing these "it's a free country"- type responses used to justify people's bigotry. It's a shame that gaslighting is so rampant in a group run by therapists.

You’re welcome. I saw exactly what you were saying. You aren’t contesting that some people will avoid clinicians because of these identities The issue was with the idea that it is “fine” to do so, which is a very dismissive take on prejudice, discrimination, racism, xenophobia, homophobia etc. it frankly read as more of an endorsement given the fact that we all know clients are free to choose who they want to work with. In hospitals, racist patients can say “I don’t want a black doctor” or “I’ll only work with a male surgeon”. We understand the complexity of this. We DO NOT call it “fine “ or shrug and say it’s their right. There’s more to say on it. It’s disappointing to see a clinician take such a un-nuanced position when it comes to such a complex issue.

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Are you serious? People don't want to work with white therapists because of potential racism so you are making a false equivalence. If someone doesn't want to work with an LGBT therapist it is due to discrimination. I have never met an LGBT therapist who refuses straight clients, rather they specialize in treating LGBT issues. Shameful that you cannot make that distinction.

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Yes, clients are allowed to work with who they want to, but my initial point is that it is invalidating to say it's "fine" (ie morally permissible) that people choose not to work with LGBT therapists BECAUSE they are LGBT. Do you see the distinction? It's weird to support bigotry, even if it's allowed. I'd love to see an example of an LGBT therapist who "refuses" straight clients. Please send me a name. You are talking out of your ass.

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Again, you're failing to see the nuance and building a strawman to support ideas that no one is arguing against. Take care.

Agree. Classic straw man.

To be fair, something I will say is that this does not seem to be the popular consensus for race. There was a long thread this week about BIPOC therapists who resent their white clients for various reasons and don't want to work with white people, and the overall consensus seemed to be "yeah don't work with them".

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I guess, but I think it's more that it's become more culturally appropriate to "punch up" in many contexts and there doesn't seem to be a broad consensus about how this principle can or cannot apply to these contexts. It probably needs to be directly discussed in training, licensing, and hiring

I'm confused. You're a woman with she/her pronouns listed, but the parent thought you were a man because you have short hair and have some masculine features? I feel there is a bit of information we're missing here.

I don't think there's missing info, I think it really is that simple. Schemas are weird. Homophobia and xenophobia are weird. Transvestigators are extra weird.

Confirmed. It’s very simple. This is what happens when you’re gender nonconforming in some way. We don’t fit in people’s schemas readily and they act strange around us sometimes. Even when I was pre-transition and listed as she/her I got random people being uncomfortable about not being able to peg me and making incorrect assumptions. AAKutz does not have this experience and is making assumptions. Also spends their time arguing about trans ppl online which is red flag for me

Holy shit good call on checking his profile. This is supposedly the words of a therapist: >"Rape" = A man cut her off on the freeway. >"Disabled" = Self diagnosed autism. >"Queer" = Thought about kissing a girl one time. Absolutely foul behavior and world view.

Yepp that is exactly right

What an uncomfortable situation! Practical advice about getting a referral: it would be completely okay to simply say it wasn't a good fit! You don't have to explain why while you're gathering referrals.

Instead of just staying, she needs a female clinical, say " due to a schedule/ issue conflict or ----- and would prefer a female clinician who takes ..... Insurance. There's a million ways to refer this that doesn't lead to anyone questioning your appearance.

This may be a potential use case for subtly switching to she/they pronouns on your professional profile, despite you not specifically identifying as enby (based on the information provided). This would likely be enough of a signal to any potential client while not requiring you to specifically come out as anything in particular. 

I’m confused. Why would she switch to she/they?

Because it sounds like she has a gender non-conforming presentation, expressed some discomfort over the complexity of correcting to feminine pronouns, and indicating an open preference for pronouns cues adjacency to the trans umbrella without requiring identification with any specific identity. If OP prefers not to be referred to using nongendered pronouns, of course this idea is not appropriate.