Mark, 36 years of age, is directed to counselling by his doctor after Mark decides he wants to transition from male to female, undergo sex reassignment surgery, and change his name to Sonia. Mark reports he has suffered for a long time trying to live as a man when he in fact feels like a woman.

Mark is currently experiencing feelings of sadness, anxiety, stress and anger about the way he has been treated by his family and certain friends because of his gender identity. He has started drinking alcohol on daily basis as a way to numb his emotions and fall asleep at night.

What important factors does the Counsellor need to take into consideration when working with Mark? What topics do you think that the counsellor should concentrate on?

For example:

  • Exploring his personal history, including the origins of his feelings of being a woman
  • His struggles to live as a man
  • His expectations for living as a woman.

Do you think the doctor should have checked with the counsellor before referring Mark? Finally, should Mark have a say in choosing his own counsellor given that he is in a unique situation or should he leave it up to the professionals involved?