Experiences of trans people in mental health. Encounters, morality and conflicts in the therapeutic device

Abstract

Since the international struggle for depathologization, in Spain trans identities have been dissociated from the paradigm of “mental illness” eliminating the requirement to be evaluated by a psychologist or psychiatrist to access the bodily changes. However, to ensure adequate healthcare, some psychologists consider it necessary to accompany the person, especially when they have mental health background. Based on the assumption that the relationship with the professional is part of what we call here the ‘therapeutic device’, we seek to understand how the subjects themselves, considered ‘patients/users’, experience the therapeutic encounter. This article collects the experiences of six trans people who have sought mental health services for some reason. As part of ongoing ethnographic research, six participants (three men, two women and one non-binary transgender person) were selected, and one interview was conducted with a clinical psychologist in the cities of Madrid and Barcelona between January and June 2024. Three locations stand out in the subjectivity of the actors: places of adherence, places of accommodation and places of contestation with regard to this services. What is at stake are the encounters, disagreements and struggles of the subjects in the ‘therapeutic device’ within a broader change in morality and legitimacy on the part of its elements and functions.