46th ATPPP Scientific Session

46th ATPPP Scientific Session

Increasing Clinical and Cultural Competency in Psychotherapeutic Work with Transgender Patients

Presenter: Jack Pula, MD

Discussant: Christopher McIntosh, MD

Saturday, March 4, 2017: 9:00 am – 12:00 pm

Cost: $90

Open to all by registration. Preregistration is required.

The recent rise in people coming out as transgender, genderqueer, or some other gender identity than those of the traditional gender binary, challenge mental health clinicians and psychoanalytic psychotherapists to find new ways of understanding non-normative gender identity and expression. The psychoanalytic literature historically has offered pathologizing or limiting theories and formulations of transgender identities and has privileged cisgender and heteronormative identities. This has left many therapists unable to approach patients from an affirming perspective and too many at risk for overtly pathologizing transgender patients, or more subtly causing iatrogenic trauma.

There are many factors that need to be considered when working with transgender patients. Some fall under the rubric of cultural and clinical competency- the bare minimum that clinicians should know in order to avoid harmful pitfalls. These include standards established by WPATH (World Professional Association for Trangernder Health) that lead medical clinicians in decision making about transitioning treatments, side effects of hormone treatments, and factors important when considering surgery. For those doing psychoanalytic therapy, countertransference and the therapist’s subjectivity must be considered. Because gender itself is usually an unanalyzed part of the analyst’s identity, the analyst can be vulnerable to disturbances that require self-analysis, consultation, or supervision.

Learning Objectives:

At the end of the session participants will be able:

  1. To recognize the historical and contemporary sociopolitical factors that impact the emotional and mental health of transgender and gender non-conforming people in psychiatric and psychotherapeutic care.
  2. To identify the current clinical consensus and trends of treatment that promote a solid therapeutic alliance, and clinical challenges that may emerge for the patient and clinician and ways to prevent them.
  3. To learn about clinical challenges that may emerge for the patient and clinician.
ATPPP Scientific Committee

Marco Posadas, MSW, RSW Chair
Doron Almagor, MD, FRCP
Claire Lunney, MD, CCFP


Jack Pula, MD

Dr. Pula has taught numerous mental health professionals since coming out as a transgender psychiatrist and psychoanalytic candidate five years ago. He is a psychiatrist in private practice in Manhattan, on the American Psychiatric Association Working Group for Gender Dysphoria, and an assistant clinical professor of psychiatry at Columbia College of Physicians and Surgeons. Dr. Pula’s affiliations and talks span across the psychiatric, medical, and psychoanalytic arenas. He considers himself an advocate for transgender people, and more specifically for transgender patients in need of mental health treatment at any level of care.

Christopher McIntosh, MD

Dr. Christopher A. McIntosh is a psychiatrist at two Toronto hospitals. Michael Garron Hospital (formerly Toronto East General Hospital) where he practices general adult psychiatry and the Centre for Addiction and Mental Health where since 2011 he has been the Head of the Adult Gender Identity Clinic. He is the Co-Editor of the Journal of Gay and Lesbian Mental Health and an Assistant Professor in the Department of Psychiatry at the University of Toronto. He is a candidate at the Toronto Institute for Contemporary Psychoanalysis.

Continuing Medical Education (CME) credits are available. This event is an accredited group learning activity (section 1) as defined by the Maintenance of Certificate Program of the Royal College of Physicians and Surgeons of Canada, approved by the Canadian Psychiatric Association (CPA). The specific opinions and content of this event are not necessarily those of the CPA, and are the responsibility of the organizer(s) alone. As per the Royal College standard, each presentation provides a minimum of 25% interactive learning.

Full-time students in universities and colleges, and mental-health trainees are eligible for a 25% reduction in course fees. Proof of 2016/2017 status needs to be provided. Please contact the tps&i directly to register at a discount.

Refunds must be requested in writing two weeks prior to the beginning of a course. A handling fee of $30 will be retained. After these two weeks, fees cannot be returned.

For more information about and for registration in the tps&i Extension Programs, Scientific Meetings, Training Programs, Study and Supervision groups and Special Presentations, please visit our website: torontopsychoanalysis.com or email info@torontopsychoanalysis.com