Failing to ask the ‘bare minimum’: Why do NHS Mental Health Professionals lose therapeutic curiosity when gender diversity enters the room?

This thesis explores how transgender and gender diverse (TGD) people feel their gender is understood in UK mental health services (MHS) and how Mental Health Professionals (MHPs) consider gender and its influence on the experience of the service users (SUs) they support. The thesis focuses primarily on TGD experiences, but also how cisgender and normative gender narratives influence interactions with MHS. Drawing from social constructivism, Queer Theory, and Minority Stress Theory, the study uses Reflexive Thematic Analysis to analyse two rounds of 1:1 interview with SUs and MHPs. It incorporates autoethnographic reflections of the lead researcher, a non-binary clinical psychology trainee navigating TGD research and starting their medical transition amongst the increasing hostility against TGD in the UK. The Findings explore TGD participants' experience of rigid gender norms and the stifling impact of rigid gender norms on TGD identity actualisation. Pathological norms are frequently tightly upheld by MHS, which has an inhibiting effect on gender curiosity in MHPs, even among self-identified allies. MHPs’ reflection of their own experience of gender identity, in and outside of professional contexts. Significant improvement for the inclusion of TGD voices in MHS training and training development is needed, advocating a shift away from didactic and categorical models of teaching toward a more socially constructed, flexible, and intersectional approach to gender. MHPs need to be taught to respect the testimony of TGD people’s description of their identity so that they might provide their TGD clients with the bare minimum of non-judgment and empathic understanding.