Rosanne (32) is a healthcare psychologist in trans care

‘The most important thing is that you listen properly. That sounds obvious and easy, but it is not.’

Autism spectrum disorder in women

When I had just graduated, I worked in addiction care. I was treating a young woman, and her file contained all sorts of diagnoses, including borderline personality disorder. Almost every day, she would call the front desk to ask for more medication, and she had all sorts of questions. The whole team found her coercive and manipulative. Until a doctor suggested that she might be autistic. It cast a whole new light on her behaviour.

Stuck in a diagnosis

The medication she requested might not have to do with her addiction but with the fact that she was over-stimulated. And maybe she was asking so many questions because she needed clarity. During training, you learn about the symptoms of autism in men, but in women, it manifests itself differently, and I did not learn anything about that during my psychology studies. Through this experience, I learned how you can get stuck in a diagnosis, and how you can interpret behaviour differently if you choose to look beyond that.

Own prejudices

Now I work in transgender care. The other day, I was talking to a doctor about the fact that our team has no trans people. He laughed and said, ‘I am trans!’ It was a funny moment. Before I had this job, I thought that gender care would be very binary: you ‘choose’ to be a man or a woman, and then there is a certain path you follow. Fortunately, that is not the case. Someone has a say in what their transition looks like. We are progessively considering gender and sex as a spectrum, with many different variations.

Importance of diversity

Various studies have shown that diverse teams perform better in the workplace. The gender team I work with is quite white, while our target audience is very diverse in many ways. I would like our team to be a better reflection of society. Of course, you do not have to look like your patient or client to provide good care, but it is good to be aware of differences and of your own – perhaps unconscious – biases. I think those are more likely to surface in a mixed team.

Mentioning and listening

The most important thing, of course, is to listen properly. That sounds obvious and easy, but it is not. As a psychologist in gender care, I have a complicated position. People have often been on a waiting list for years and view me as someone who will decide the rest of their lives: transition or no transition. I understand very well that this inequality can be unpleasant. So I always mention it straight away and ask how the person opposite me experiences it. Acknowledging this is necessary to get through to someone. That is how we will have a real conversation. It is part of listening well and essential for good care.