MovieChat Forums > Transamerica (2006) Discussion > Therapist - Question

Therapist - Question

posted 16 years ago by dancingjinn
6 replies | jump to latest

I know there are already a lot of questions about how realistic different aspects of this film are , but I have a question about the therapist that I have not seen asked yet.

I was wondering if anyone knows whether it was realistic for Bree's therapist to demand that Bree get to know her son before having the surgery. I know the therapist seemed to have the final say about when Bree could have the surgery,so I guess she could put conditions on her permission if she felt it was in Bree's best interest. But it seemed pretty heavy handed of her, considering all of the psychological testing that Bree had already been through before finding out she had a son. And the therapist had approved the surgery before that point.

So I can understand why the therapist thought it was a good idea for Bree to get to know her son, but I didn't quite see why doing it before the surgery was non-negotiable. If Bree felt like it would be better to get to know her son after the surgery, it seemed to me like the therapist should at least have respected her point of view and given her more say in the decision making process. Maybe they could have explored the options together and come up with a mutually agreeable decision rather than just dictating to Bree what she needed to do and when she needed to do it.

I am a therapist myself, and we are always taught not to try to change and control our clients based on our own beliefs but to do our best to help the clients grow and progress toward their own goals. Granted I work in an entirely different setting and I am not making that type of decisions for my clients (whether or not they can have sex re-assignment surgery - sorry if that's the wrong word), so maybe therapists in the position of Bree's therapist would be comfortable making such a huge life decision for Bree like telling her she must go meet her son at that exact time.

Anyway, I really liked the movie but this is just something I was curious about. There seem to be some people on this board who have first hand knowledge of these issues, so if anyone is willing to share their knowledge or experience regarding the role of therapists in this setting I would really appreciate it.

[–] jbjjunk 15 years ago

Yes and No. The therapist does hold veto power. But as you said, a therapist should not use manipulate the actions of their clients. Realistically, tho, the therapist would have sent copies to the surgeon long before. It's not like an ticket you hand in at the door!

[–] dancingjinn 15 years ago

Thanks jbjjunk, that's a great point I hadn't even thought of. Makes sense that the written recommendation would have to be made well in advance so that arrangements could be made for the surgery.

[–] seanspotatobusiness 15 years ago

But I imagine that the therapist could also withdraw consent? So even if it wasn't in the form of a letter which needed a signature as in the movie, she still had the power to deny the surgery if she felt it was in the interest of her client?

I also thought it was a reprehensible action as I watched the scene unfold, but, in calm retrospection, perhaps the therapist thought that the unexpected introduction of her son to her life could destabilise the situation and somehow cause Bree to regret the surgery, in such a case that it might make her more distant from her son. I'm not saying that it would necessarily be the case. I don't know what the statistics are in terms of regretting gender reassignment, nor do I know the various causes of the regret.

I will also say that I imagine the therapist is in an unenviable position - people working in bars and supermarkets sometimes have to make a decision regarding the age of the customer, with grave consequences to their own financial and job security if they make a wrong decision. Similarly, I should imagine that there are professional consequences to approving a gender reassignment which is later regretted (sure, it must be unavoidable in some cases, but if one therapist has a higher incidence than another, it will be assumed that they're not doing their jobs properly).

[–] radrobd 14 years ago

I'm thinking that the film took artistic liberty with the therapist making Bree visit the son. I agree that I don't think it's the therapist's job to make such demands and refuse to give consent to surgery unless the patient did what she wanted. That seems like blackmail or exortion. However, it was the whole setup for the movie. I guess the writer could not think of another way to force Bree to go to New York to see the son, other than blame it on the therapist, a supporting character. Without that setup, the rest of the movie wouldn't have happened.

[–] fidelio1980 14 years ago

In response to the question about whether the therapist could withdraw consent - if the therapist had told the surgeon, a week before the surgery, "Bree decided not to meet her son for the first time, just because she barely has any money and she wants to focus on the enormous transformation she's about to undergo, so stop the surgery now!" - the surgeon would probably just laugh, and continue with the surgery as planned.

He wouldn't be required to stop it - the therapist doesn't have last minute veto power after she's decided to give approval, especially not when the reasoning is as poor as what we saw. If, however, the surgery actually didn't happen, Bree would have probably have a great lawsuit against the therapist on her hands.

Don't get me wrong, I like this movie a lot. But there had to be a better way to get her to take the step of traveling across the country. The therapist could have convinced her that it was crucial for her to tie up the loose ends up in her old life before beginning her new one. Or maybe the boy's mother could have called her and pleaded with her to help her son.

[–] Violet_Loves_Iliona 13 years ago

I'm pretty sure it was stated a couple of times that Bree needed two "letters", and she only had the one (from the guy she gave the speech to at the beginning of the movie); that the letter from her personal therapist was the most important; and that Bree's appointment had been made pending final approval by her therapist.

In my experience, this is fairly common, and indeed surgery dates generally need to be booked well in advance, and are often made before the final approval has been given. With my surgery, everyone in the team was clear with me that there it was a slam dunk, but that they needed to follow the protocol, and my surgery was also booked months in advance, with my final letter being written either a week or a fortnight before the surgery, from memory. I asked why they held back the letter, especially since they told me that they were sure and that they were definitely going to approve me, but they said that's just what is done for legal reasons, and that the team had already met for the final evaluation and approved me a week and a bit before that day (which itself was, as I said, a week or two before they finally sent out the letter).

Also, in this film Bree's therapist is very relaxed and friendly with Bree most of the time, but there are a couple of examples of where she makes clear her position as "gatekeeper" and that Bree must do as she asks. Bree's therapist clearly needed for Bree to meet with Toby in order for her (the therapist) to feel comfortable signing off on Bree being ready for surgery, so I think it was entirely feasible that the therapist would insist that Bree meet her son before she would forward Bree's approval letter.

All this being said, I'm not saying I agree with this "gatekeeper" model, but it is the model many, probably the most, people must follow in order to get the genital surgery. I, and I would suggest most specialists in the field, would say that this model is disempowering and paternalistic, as we are already women even before we have our surgery, we are just women with the wrong genitalia, and so the surgery, while being major surgery, is really somewhat cosmetic in nature, and as such we should not need to be approved by gatekeepers (indeed, other surgeries such as breast implants don't need to be approved by a "gatekeepers", people just go to a surgeon and book themselves in)... But as everyone is aware, there are mentally ill people who, for whatever reason, try to pass themselves off as us, insist on the surgery, and then turn around and sue the surgeons for doing exactly what they themselves begged the surgeons to do, so this "gatekeeper" model remains, in order to protect the surgeons and other specialists from being sued.

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