ABSTRACT
Diane Ehrensaft argues that psychoanalysis has simultaneously been at the forefront and behind the times when it comes to the mental health treatment of gender-nonconforming children and adolescents. Summarizing the need to relearn gender as we have been taught it, this chapter outlines a gender affirmative model that can better inform our clinical practices with children of all genders. Applying the theory to the consultation room, the relational techniques of creating a holding environment, listening, mirroring, play and translation, along with exploration of our own countertransference gender angst, are offered as pathways to providing children with the opportunity to work through their gender stress or distress, discover their true gender selves, and fortify gender resilience in the face of a world that is not always so welcoming of gender diversity. The chapter finishes with a description of Ehrensaft’s therapeutic work with a gender-exploring child over the course of four years, from the child at age seven to age eleven, to demonstrate the gender affirmative approach to therapeutic action.
