The Non-Binary Story and the Rescue of Self: Healing Stories of the Third Kind

Psychiatric TimesVol 37, Issue 2
Volume 37
Issue 2

A hypothetical first conversation with a non-binary person . . . One of us would be feeling nervous and the other certain-a phenomenon not unfamiliar to a psychiatrist, only here the roles would be reversed.

gender choice non-binary, mental health


The topic of sex has been much in the news, the issues ranging from abuse, bias, identity, and rights, to trafficking. The fact that people take sides with passion is not news.

What is news, at least to me, is that ever since the Straight Pride Parade in Boston last August 31st and the following news report-that counterprotesters outnumbered marchers; protesters were arrested on charges of disorderly conduct and resisting arrest; four police officers were injured; prosecutors asked the judge to dismiss the charges; the judge insisted they press forward with the charges; and pushback against such-I have found that positions and sides on sex-related matters are no longer predictable, let alone familiar, at least for me.1

It was in this context of controversy, unclear boundaries, and curious optics, that I found myself drawn to-and puzzled by-a totally unrelated news article having to do with sexuality: an op-ed interview with Camille Paglia.2 Paglia, a controversial professor of humanities and media studies at the University of the Arts in Philadelphia, is the author of Sexual Personae: Art and Decadence from Nefertiti to Emily Dickinson; the book is about the roles of men and women in Western civilization. In the interview, Professor Paglia revealed that she never, not for a moment, felt like a woman. She had never felt like a man either, and she called this lifelong reality her radical gender dysphoria. I had never heard of such a thing. So here I was, once again, trying to process a news story that combined an issue of sexuality, controversy, and unclear boundaries. I looked up the meaning of her words and found another term for this: nonbinary.

I was well acquainted with the meanings of lesbian, gay, bisexual, and transgender. These were all variations of a binary gender. I got that. People were, by virtue of either genitalia or feelings, either male or female, one gender or the other. A person born with features of both, the so-called intersex (formerly hermaphrodite), had a congenital condition wherein anatomy and genes did not match the definitions for bodies of males and females. I knew all this, too. The non-binary person was a total unknown, but I became informed. A non-binary is someone who feels that they are neither male nor female or a little of both, in which case they might move comfortably back and forth between the two identities.

To my knowledge, I had never encountered such a person. This led to my next question: What would I say if I were introduced to a non-binary person? What would I say after, “Hello”? Answer: I would look for common ground, of course, a topic that would bring us together. But, there was a problem. I knew in my gut that such an effort would invariably incorporate an irresistible albeit surreptitious effort on my part to spot visual indicators of original gender or try hard not to do so. Looking for common ground became too burdensome, especially given that the two people already viewed the other as-at least in one sense, a dominating sense-alien. And as much as I might want to know their story, I knew this, too, was a non-starter.

As a psychiatrist, leading off an introduction to a stranger with “tell me your story,” would feel demeaning to both of us. It would be as if I was looking at that person as a patient because I was either too anxious or too flustered as a psychiatrist to have a normal conversation; I felt I had to play therapist in my desperation (which was probably not far from the truth).

Anxious for at least some guiding insight into what this alien-to-me non-binary experience might be like, I went online. I looked for and found interviews with non-binary people that highlighted features of their experience.3 I read about knots in the stomach in childhood when expected to look and behave like a boy or girl and dismay over body changes at puberty. I read about anxiety associated with feeling stuck with a label of boy or girl and discomfort with expectations and social rules of gender.

There was much variety in these experiences but there was one common thread-a sense of genuineness and completion, a liberation of one’s self that came with the label non-binary. Those descriptive words caught my attention because this was the language of healing, the language of my profession.

My perspective immediately realigned. My notion of looking for common ground in any conversation, I could see now, would likely be ineffective and unappreciated. It could even be offensive. Identity shifting, like shape-shifting (or just being different), as I now understand it, is for some actually an asset. The non-binary identity can be a matter of pride. Pain and embarrassment, with this name, may have long ago been replaced by a proud dignity, according to the disclosures I read.

My new perspective centered around this revelation that, for the non-binary person, that name or title alone can stimulate such a positive sense of self that any prior sense of self as estranged, ill-fitting, embarrassing, problematic, or frightening is effectively deleted. That former sense of self as alien, incomplete, and trapped had been transformed and self-rescued. One’s self was now something to be celebrated, not contained or disguised.

So what I would say if were introduced to a non-binary person? What mattered now would not be what I might show, say, or do. It would be what I felt-respect, not just for their humanity but for what I have come to see as a single-handed rescue of a lost self by a determined first responder.

Which brings me to this final observation. Maybe my hypothetical first conversation with a non-binary person would not be so different after all. One of us would be feeling nervous and the other certain. A phenomenon not unfamiliar to a psychiatrist; only here the roles would be reversed.

(For related articles, see our Sex & Sexual Disorders Special Report at www.psychiatrictimes. com/special-reports-Ed.)


Dr Climois the author of Psychiatrist on the Road: Encounters in Healing and Healthcare, an account of his Locum Tenens experience.


1. Garrison J. Boston’s straight pride parade draws hundreds of marchers and even more counter protesters. USA Today. September 3, 2019.

2. Varadarajan T. A feminist capitalist professor under fire. Wall Street Journal. August 30, 2019.

3. Darom N. What It’s Like to Discover You’re Non-Binary. August 18, 2017.

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