Identity, Gender and Sex: Five Break-Through Moments to Look for in Therapy

by Catherine Morris | June 16, 2020

People go to therapy for all kinds of reasons—to deal with trauma, to heal a relationship, to get guidance on next steps. For some people the biggest reason of all is to reconnect with themselves, and to find a way to live their life that truly reflects their core beliefs, needs, and values. Identity is not a clear-cut thing. For young people who might be grappling with what the world or their family expects from them, and what they expect from themselves, that goes double. Coming to terms with your identity when perhaps you haven't felt supported or heard can be problematic, and can lead to long-term conflict with both yourself and those around you.

Sometimes a fresh perspective is what's needed and a good therapist, life coach or counsellor can guide a client’s gaze inward and help cut through the noise.

Here's a few things to look out for on your journey of self-discovery, things that may surprise and encourage you as you move forward into better mental health.

1. You Might not Fit Neatly into the Gender Binary—and That's Okay


Growing up means growing into yourself and sometimes that can feel like a one-step-forward, one-step-back kind of journey, especially when complicated issues like gender and sex come into play. For some people, their gender and biological sex match. For others, there's a discrepancy, and that discrepancy might become more apparent as they mature, leading to confusion, shame, depression and declining mental health.

“It is sometimes unexpected for people to discover their sexual preferences may be more fluid than they realize. Sometimes you take it for granted [that you'll follow the 'norm'],” says clinical counsellor Franya Jedwab of Arukah Counselling. “That realization might come from some feelings they have about a friend that they had not given themselves the space to consider. It can be very revealing in a way that might not be comfortable, but is important to the journey of self discovery.”


Youth coach Mallory Woods offers identity coaching for kids aged 12-19 and has helped many young people learn how to be true to themselves. They say—

So many young people are growing up in a time when gender is fluid, but that does not mean we have clear examples, clear ideas or even clear language around gender orientation and sexual expression. The first step is identifying it in yourself, and that can be very hard if it does not correlate to your understanding of yourself. 

“We are often playing catch-up with the shifts that happen in each of us and how we can incorporate them in a healthy way into our own loving sense of identity.

Woods says breaking down old ideas can help. In their practice at Into The Woods coaching, they encourage young people to be honest and open in a safe environment. Woods says coaches and counsellors can be a refuge for young people before they find their own support network. 


“There is a shift that happens when new perspectives are explored, and there is a re-framing of old patterns. There is a tremendous amount of vulnerability in looking past that and into something more true to yourself. They might have family members or others that do not accept them, but there will be a community that is loving and accepting for them. I'm happy to be a placeholder until they can find that or create it.”

2. Your Ideas on Gender and Sexuality Might Come from Some Surprising Sources

One of the best, but hardest, things you'll do in therapy is drag old beliefs into the light, holding them up and examining their source. Sometimes our core beliefs come from strange places. You may have absorbed cultural stereotypes from your favourite TV shows, you might get your sense of self from your social media profile, you might have taken your cues from a teacher, a family friend or your own parents. You might’ve been raised in a political, religious or cultural environment that imposed a very rigid set of socially acceptable behaviours.

Registered clinical counsellor Daisy Bai works with clients from diverse cultural backgrounds, some of which are intolerant of any sexuality outside of traditional and religious norms. She says—

“My background is East Asian and I work with people from those kinds of communities where there is a lot of discrimination and oppression and no education on sexuality. Those coming from families with a more strict religious or cultural background that does not have a lot of understanding, tend to suppress their sexuality for a lot longer.”


In those situations, it's not uncommon for people to absorb the discriminatory messages they see in their own households, and when they confront their identity truthfully, it can bring this to light. “When people are uncomfortable discussing identity issues, that resistance is interesting in itself. It can indicate there is some part of themselves that they are trying to fight,” says Bai.

In this way, sometimes our most fundamental beliefs about gender and sexuality come from an uncomfortable place—ourselves. “Sometimes we grow up in families or communities that are discriminatory, or prejudiced, so we have our own self-imposed prejudices. When that happens, people might turn inward and against themselves,” says Jedwab.

3. Examining your Identity can Bring up Some Scary Feelings


Fear, anger, shame, grief. A flood of very painful emotions can come bubbling to the surface when people confront their authentic selves, “A lot of people are really unsure and at war with themselves,” says Bai who sees many clients in her practice at Daisy Bai Counselling, who are so deeply in denial about their sexuality that they cannot even broach the subject. 

“A lot of clients do not really talk about their sexuality until later, when we have a really solid therapeutic relationship. Sometimes it can take a year. These clients struggle a lot more with mental health issues like depression. I normalize their experience, no matter where they are in their journey, so they can see those are all really valid feelings. If they are in denial you do not want to challenge them or be confrontational.”

Therapy is rarely comfortable. It takes honesty and vulnerability to look inward, especially against a backdrop of rejection and loneliness. Woods encounters this often with the kids they work with and says, 

“That pain of rejection is a really hard thing to go through. There's a lot of anger with that—anger as they do not understand why they are this way, anger at society for making them feel like this, anger at their parents. There's often a lot of grief too. There's grief as people mourn an identity that they can't subscribe to, or mourn a person they cannot be any more.”

A trained therapist, counsellor or life coach can help with that pain—no matter how it manifests—and Woods says it can ultimately lead to a deeply fulfilling revelation— “Once you have gone through that and healed, it opens this beautiful door into a world where you are able to authentically be yourself. There is so much joy in that.”

4. Your Sexual Relationships Don't Define You


We are not our desires. We have them, we act upon them and sometimes we regret them, but they don't make us 'good' or 'bad', 'normal' or 'abnormal'.

“There is so much confusion over the separation of gender expression and sexuality,” says Woods. “They are two very separate things but the way society correlates them compounds the lack of clarity. Young people struggle to define their identity when they are being told they need to define their sexuality.”

Tie your whole being to a sexual relationship and your self-worth will lack a stable foundation, making it very vulnerable. If that relationship succeeds then great—great so long as you’re not consistently looking to your partner for personal validation. If the relationship breaks down, you'll likely internalize those feelings of shame and failure so the effects linger long after you've gone your separate ways. If the relationship floundered because your sexuality changed, that's not something to be ashamed of. Human desire is not fixed. It's okay, especially when young, to explore in order to find what feels right, natural, and authentic.

Whatever form they take, relationships are one of the ways we learn about the world and how to navigate our place in it. Don't feel valued in a relationship? It's okay to call it quits. That regrettable one-night stand? Learn from it and move on.

Bottom line—you are more than the last person you went to bed with. 

5. You're Enough


Negative self-talk is everywhere. From people on social media comparing themselves to airbrushed supermodels, to the LGBTQ+ blogger who starts to internalize some of the hateful comments they’ve received.

How many times have you told yourself— ‘I don't deserve that because I'm not straight enough/ attractive enough/ successful enough/ skinny enough/ popular enough.’

That internal monologue can be vicious and relentless, but in therapy, you soon learn that the things you tell yourself aren't always the truth. 

Woods says negative self-talk is a particular issue for LGBTQ+ kids who are already at the age when there are so many insecurities and the “fish bowl” of high school can heighten those perceived inadequacies. “There is all this internal monologue of 'how do I present authentically?' and 'what does it mean to be a socially acceptable presentation of myself?'. It has been so deeply ingrained and we are always having to measure up against it.”

A therapist or counsellor can show you that you are enough, and perhaps you're stronger than you think.

Using techniques like Cognitive Behavioural Therapy, which focuses on examining and reframing negative thoughts, those suffering from negative self talk patterns can see that they are doing their best, and are as deserving of compassion and self-care as anyone else.

Woods encourages their young coachees to question themselves when doubts arise, saying,

 “When that negative script starts running through your mind just ask yourself point blank: 'do I believe this?' We subscribe to it so heavily but we might not even believe it and we have to ask — why do we hold ourselves to this standard? We have to replace it with something more empowering and fulfilling. We look at reframing it and being aware of the script we run and how we speak to ourselves. It is life changing.”

If you’re grappling with any of the above issues, Which Doctor can connect you with a professional life coach, therapist or counsellor for in-person, virtual or group sessions at discounted rates. Check out our free clinic or browse our practitioner database to find the help you need.

Catherine Morris


Catherine Morris is an award-winning journalist with a bad case of wanderlust and a passion for all things health and wellness. Originally from Northern Ireland, she worked as a news and feature writer for media outlets in the UK, South Africa, France and the Caribbean before settling in Canada. Catherine now lives in Alberta with her husband and rescue mutt and spends her time happily exploring the great outdoors with both.