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Episode 21 Transcript

LGBTQ and Gender Therapy with Katie Leikam, LCSW

Introducing Katie Leikam, LCSW

Erin Everett: Hey everybody. Welcome back to Exclusively Inclusive. I’m your host, Erin Everett. On today’s episode we’re going to be talking to Katie Leikam, who’s a LCSW gender therapist and LGBTQIA specialist. Katie is actually local to the Atlanta, Decatur area and specializes in more than just gender therapy. She also specializes in anxiety and depression, loved ones of transgender clients can reach out to her to help them navigate a person’s transition. She also offers secular therapy, also of course gender therapy and also relationship counseling. Currently Katie is providing online distance counseling too to make sure that her clients feel safe during the global pandemic. So without further ado, I would love to talk to you guys more about Katie and let her explain everything that she’s into and everything that she can provide to the gender community.

Erin Everett: All right, welcome to the show Katie. I’m so excited to have you on.

Katie Leikam: I’m excited to be here.

Erin Everett: Excellent. Before we get started, would you mind just introducing yourself a little bit? Letting us know what your preferred pronouns are and kind of what all your title means.

Katie Leikam: Sure. I’m Katie Leikam. I’m a licensed clinical social worker in Georgia and a licensed independent social worker, clinical practitioner in South Carolina. I’m also licensed in North Carolina and Florida. My pronouns are she and her. I have a private practice in Decatur, Georgia and I see clients who are part of the LGBTQ and transgender community. WPATH GEI Standards of Care Version Seven certified. And I work a lot with clients who are exploring their gender, transitioning, as well as anxiety, relationship stress, and religious trauma. And an LCSW is a licensed clinical social worker. So I’m a therapist. I have my masters degree in social work and then an additional three years of supervised training to get my licensure.

Erin Everett: That’s awesome. And I didn’t realize you were serving so many different states. That’s awesome. Does that mean that clients travel to you or are you doing online sessions?

Katie Leikam: I do video sessions in the other states. And I just got licensed in North Carolina like the day before yesterday.

Erin Everett: Ooh, congrats. That’s awesome though.

Katie Leikam: Thank you.

Erin Everett: Because I know that’s important because technically it’s just like … Well, pre pandemic I’m not allowed to do telehealth visits with people who have an out of state address. Is that the same for you unless you’re certified there or licensed there rather?

Katie Leikam: Yeah. That’s the same for me.

Erin Everett: Yeah. So that’s good.

Katie Leikam: So I had a client … Yeah, I had a client that moved from South Carolina to North Carolina so I had to get my license in North Carolina to continue seeing them.

Erin Everett: Oh wow. That’s awesome. What an advocate for you to be able to do that for them so that you could continue care with them. That’s amazing.

Katie Leikam: Yeah.

Erin Everett: That’s really cool. It’s the same for us. But now with the pandemic going on, we’re allowed to see clients out of state. And so now we’re kind of figuring out … I wonder what the Georgia medical board’s going to do after this and if they’re going to continue to allow us to do that with a face to face visit every six months or something. It’s going to be interesting so we’re navigating that process as well. But yeah, I guess that a good place to start would be, you offer a lot of different services and I’ve tried to emphasize that too in your introduction. It’s not just about gender therapy with you. But it is obviously one of your main focuses. But if you were a patient looking for a gender therapist, what tips would you have for them to kind of vet out or screen their therapist to make sure that they were actually affirming?

Katie Leikam: Yeah. Some tips I have is when you first reach out to a therapist … The first tip I would have is to read their website and make sure that they mention the trans community. And not just in passing. It’d be great if they had a page dedicated to working with the LGBTQ and trans community instead of just a little blurb, but a whole page. I know a lot of people find therapists through Psychology Today. So also on Psychology Today you can filter by the word transgender. And a lot of people click that they work the transgender community but they don’t mention it in their profile. So I would look for somebody who mentions it in their paragraph in their profile.

Erin Everett: Mm-hmm (affirmative). Yeah, that’s a good point. Because a lot of people will just click who they’re inclusive for but if they’re actually wanting to tailor care to them they’re going to have a writeup about it.

Katie Leikam: Right. So definitely, definitely look for the writeup. And then when you first email somebody I would ask how many people have you worked with that are part of the trans community or do you support informed consent? That’s a really big one. Because I think a lot of therapists are still stuck on the WPATH Standards of Care Version Six where they think that you need to be in therapy for six months before you get a hormone letter or things like that. So I think really screening your gender therapist to make sure that they support informed consent and if they do write letters that it’s the shortest amount of time possible per session.

Erin Everett: Yeah. Yeah. And I’m sure that varies based on each client. So you’re definitely going to probably receive clients who are just now first exploring their gender identity and others who are like, “I’ve been feeling this way since the beginning of time, what’s my next steps?” Yeah.

Katie Leikam: Right. Right.

Erin Everett: And so when you say support informed consent, are you also delivering informed consent or do you mean when they land in a provider care setting?

Katie Leikam: When I say support informed consent, I just mean that when you’re looking for a therapist you want to find somebody that’s not so stuck on the fact that you need a letter for hormones and that they would refer you to an informed consent clinic as well as a clinic that still requires a letter.

Erin Everett: Okay. Yeah. I think that’s important too. Because often when I first establish care with a patient, one of the things I ask them … And I ask everybody this but particularly those in the gender community because I feel like there’s less support for them through their family and friend network overall, is if they have established care with a mental health provider? And a lot of them look at me sometimes in a little bit of fear. Like wait, I thought you did informed consent. I’m like I do, but I still think that that relationship is really important. And I tell them, it’s less about diagnoses, it’s more about transitional support and having a safe space to talk about things. And so then it’s kind of like … You can see a load off. And then they’re more willing to establish care with mental healthcare. Because I think sometimes they are afraid that they’re going to find a therapist who’s going to make them jump through multiple hoops and kind of prove their gender identity over several months of therapy. And so sometimes when they come directly to me and then I refer to you, they’re going with a different outlook of like, okay, this is actually something that I’m going to benefit from and not feel like I once again have to defend myself.

Katie Leikam: Right. And I think that’s a really big thing. And I think I say on my website in my about me is that I truly feel like my clients are the authority over their gender. I’m not the authority on who my clients are. My clients have the authority over who they are.

Erin Everett: Yeah, you do say that. Actually one of the things that you say is most importantly through all my training I believe when a person tells me that they’re transgender or gender expansive, I believe them. I think that’s really important.

Katie Leikam: Yeah.

Erin Everett: Yeah, awesome.

Erin Everett: Some of the questions that people have surrounding establishing care with a gender therapist are like, so if I establish care with Katie, do I just have to talk about my gender or does she manage other mental healthcare issues? How would you address that for somebody?

Katie Leikam: Well, with myself I would say I definitely manage other mental healthcare issues. I find that a lot of my clients have anxiety. So a lot of the things that I have found that clients have social anxiety. So a lot of what we talk about is social anxiety, we talk about depression, difficulty with family members. I work with clients who have autism. So we talk about executive functioning and just daily living, bills. Coming to therapy isn’t just about, “I think I’m transgendered this is what I think about it.” Coming to therapy is also, “I’m a whole person. And as a whole person I also have things like anxiety or depression or just general life things I want to talk about.”

Erin Everett: Yeah. Yeah. Yeah. That’s important. That’s kind of how I approach my patients too in wondering if they are establishing for just hormone or primary care because I try to take care of the whole person and I think sometimes they’re shocked by the attention to detail that we offer by going through their previous medical history and all those things. It’s like no, it’s not just about your hormones, it’s about all of you. You’re not just a trans woman or a trans man. You’re more than that. And I think that’s really important too, to find a therapist like yourself that also manages in that way too.

Katie Leikam: Right. Definitely. And also when I refer my clients to a doctor, like when I refer them to you, it’s really important. I’m like, this doctor can be your primary care physician as well. It’s also someone that you can go to when you have a cold or a sinus infection. You can get your whole body treated.

Erin Everett: Right. And especially with the current changes in some of the legislation that we’ve had, I think that’s really important that people can get full service healthcare at our clinic in a safe space.

Katie Leikam: Mm-hmm (affirmative).

Erin Everett: Now, you touched on taking care of clients with religious trauma and autism. Would you mind expanding on that?

Katie Leikam: Yeah, sure. I went to the Philly trans health conference a few years ago and I saw a presentation on religious trauma and it really spoke to me. I personally was raised southern baptist and now I’m a secular therapist. I’m registered with the secular therapist network, which is a great resource. If you’re looking for secular therapist you can go and search by your state. Then I started training other therapists. I teach a continuing education class about religious trauma and gender identity. But I found that a lot of people might … I’ve got clients that might have been raised independent baptist or catholic and their family members just are not affirming to them. And they hear things like, you’re going to hell, your god doesn’t love you because you’re trans or because you’re part of the LGBTQ community. And it really creates a lot of … I say the three things it creates is isolation, condemnation and abomination. So these feelings that bubble up in people when they were raised in a religion that isn’t supportive of them.

Erin Everett: Mm-hmm (affirmative). Yeah. I mean, that is so right. Especially for people who really value their family’s opinions and that’s really hard for them to move past that. To not have that level of acceptance just because it’s religious based.

Katie Leikam: Right. Definitely. I see clients who … I say that all … I’ve never met a child or … And everyone’s a child. I don’t mean child. I mean a person with a parent. I’ve never met someone that didn’t really want their parents’ approval. So all of my clients in some aspect want their parents’ approval and love and belongingness. So if they’re not getting that love and belongingness from their parents, especially if it’s religious based, it’s really hurtful to my clients.

Erin Everett: Mm-hmm (affirmative). Yeah. I would agree. It’s just ingrained in us and that’s part of the reason why children are so vulnerable and susceptible to abuse because they’re constantly seeking acceptance from their abusers usually as well. And a lot of people don’t understand that what you’re talking about, religious trauma, can be classified under that as well.

Katie Leikam: Right. Right.

Erin Everett: So that’s awesome because I actually encounter a lot of patients who struggle with that too and to have somebody specialize in helping them heal those wounds is really important. Because not a lot of therapists are really talking about that in general.

Katie Leikam: Yeah definitely. In my sessions a lot of the people have … We talk about things where people have left the church and their whole belief system has changed because they’re being told that who they are is not correct and isn’t in line with their higher power. And we talk about that and we talk about whether or not they want to go back to the church. And there are affirming churches in Atlanta and throughout the USA. There’s several congregations that I do refer people to if they decide that they really are religious, they were just raised in the wrong church. And so I don’t try to steer people away from being spiritual if that’s what they want to do. I just try to help them recover from how they were raised.

Erin Everett: Mm-hmm (affirmative). Yeah. So you try to meet them where they’re at and help them achieve their goals.

Katie Leikam: Right. Right. Right.

Erin Everett: Awesome. Oh cool. And so you also do a lot of work in the community when it pertains to autism and some of the social anxiety issues. And it’s not just for helping those patients too. You also do other education to therapists. Is that right?

Katie Leikam: Yeah. I teach continuing education to therapists about people who are working with their gender identity, people that are transgender and also have autism and how that presents itself. And a lot of what we see or what I see is maybe a therapist or a doctor will say, “Well, if they have autism then maybe being transgender is just something that they’re stuck on.”

Erin Everett: Mm-hmm (affirmative).

Katie Leikam: They’re not really transgender, it’s just part of their autism that they’re kind of ruminating on this. Which of course I don’t believe in. So a lot of it is education to other therapists and education to the medical profession that you can have autism and be transgender and have fully thought out thoughts of who you are and know your identity.

Erin Everett: So that’s interesting. So why do you think that people form that opinion of people diagnosed with autism versus people with anxiety who also ruminate?

Katie Leikam: I think it’s because at least … Especially when I talk to parents, I will have parents who say, “Oh, last year they were stuck on wanting a cat as a pet and they thought about that for a whole year and that’s all they thought about and so I think this year, this is just what they’re stuck on. So next year it’ll be something different.” And I’ve had parents who have said things like that to me about their kids with autism. And I think it’s just because they have this previous experience with their children and they don’t understand that identity is … There’s a big difference between wanting a cat and who you are as a person.

Erin Everett: Absolutely. Absolutely. I couldn’t agree more.

Katie Leikam: And so some of the parents just don’t understand that this is an intrinsic part of who these children are. It’s not just something else that they’re interested in.

Erin Everett: Mm-hmm (affirmative). Yeah. It’s because people who aren’t really struggling with dysphoria or gender identity, they’re not ruminating on those things. They’re not talking about it, they’re not thinking about it, it’s not on their mind. They might be thinking of other reasons that make them feel uncomfortable in their body but it usually doesn’t pertain to their gender. There’s obviously different types of body dysmorphia that people might obsess over. But if you’re not actually entertaining your gender, it’s not something that people think about.

Katie Leikam: Right. Right. Exactly. And that’s something that I think especially parents don’t understand because parents are saying … I’ve had parents before say that, “Well, when I was a teenager I didn’t really like my breasts. I was a little confused. I didn’t like them. So maybe this is just a phase.” Because as people I think we try and … Honestly, I think we try to make things about ourselves. So when someone tells us something about themselves we automatically think about our lives and try and find sameness. But a parent who doesn’t have gender dysphoria, it’s just so difficult for them to recognize what their child is experiencing when they just didn’t go through the same thing.

Erin Everett: Right. Right. And I was going to say … And we talk about those at several … I don’t know if you’ve ever gone to the Fenway transgender excellence conference. It’s a wonderful conference.

Katie Leikam: I haven’t. I haven’t been to Fenway. I’ve been to so many but not Fenway.

Erin Everett: Yeah. Yeah. I highly recommend it. It’s a great conference and actually part of the reason I liked it so much is because there were more people from the community actually speaking rather than just … My experience with other conferences were a lot of the people were cis, which nothing against cis people but I want to hear from the community. But one of the topics that they talked about was implicit bias and how we all do that. And I think that parents are doing that too. Implicit bias. They’re putting their own personal experiences into the care of their child rather than separating themselves from it. And as providers, whether you’re a mental healthcare provider or a healthcare provider, we have to be more aware of that so that we don’t do that to our patients and our clients. But as parents, we’re not really aware of that. Unless you really seek it out, people don’t go to conferences on parenting and how to be a better parent and put away those biases. So I think that’s part of it.

Katie Leikam: Yeah. Definitely. Implicit bias is huge. It’s absolutely huge. And then even me as a practitioner, I’m a cis gender practitioner, I have to put away my implicit bias. I can’t think well, when I was growing up it wasn’t like this.

Erin Everett: Mm-hmm (affirmative). Yeah.

Katie Leikam: You have to put it on the table.

Erin Everett: Yeah. That’s really interesting. And so we keep talking about how you’re also talking to parents. So what age ranges of clients do you see?

Katie Leikam: Generally I start seeing teenagers when they’re around 13. But I’ve recently started opening up my practice to kids who … I put it this way. I say as long as they can have conversational therapy and don’t need play therapy. So I’ve seen children as young as nine or 10 here recently because it’s harder to find a gender specialist for elementary school kids in Atlanta. So I’ve tried to open up my practice a little younger. But generally I see teenagers starting around age 13 and I see adults as well. It just tends that my clients are between 13 and maybe 35.

Erin Everett: Mm-hmm (affirmative). Awesome. And so when you have those younger clients I know it’s harder to find a good gender specialist for those age ranges, are you establishing care also with people who aren’t having gender dysphoria? So perhaps younger clients who just need help managing their anxiety or social anxiety?

Katie Leikam: I don’t really work with people unless … I can’t really think of a time that I’ve had a cis gendered client that wasn’t queer unless it was a parent, because I do see parents of kids who are part of the LGBTQ community. Yeah, all of my clients are part of the LBGTQ community or transgender.

Erin Everett: Okay. Awesome. That’s good to note as well for any listeners out there that even if their children are cis and they’re not, that they can still get support.

Erin Everett: One other thing I wanted to touch on with you too is, I have a lot of patients who have never sought out a therapist or mental healthcare provider until time for surgery arrives. So obviously that’s an opportunity too for not just you to write a letter but establish care with clients. What does that look like with you and what kind of process do you walk them through?

Katie Leikam: Yeah. When it comes to writing surgery letters for clients the first thing I do is write the surgery letter because I don’t ever want to hold … I guess I don’t ever want to hold therapy over someone’s head in order to get a letter. So I’m hoping that through writing the letter the client and I will form a connection and they will want to continue therapy if they need to. But I do write the letter first. And I’m going to talk about two things. I’ll talk about what getting a surgery letter is like and then I’ll also talk about what continuing therapy is after a surgery letter.

Katie Leikam: The first thing that happens with a surgery letter, there’s three parts to a surgery letter that I really ask clients. There’s the gender dysphoria diagnosis in itself, and to get that gender dysphoria diagnosis I ask clients about their background. Which I kind of call it, your gender history. So I ask them to kind of just tell me their story. Maybe when they first started exploring their gender, when they first started having thoughts of gender dysphoria and how the gender dysphoria makes them uncomfortable in their lives right now. I always ask people who their emotional support system is while they’re transitioning.

Katie Leikam: And then we go through a mental status exam which is basically just talking to me about maybe if you have depression or anxiety or panic attacks or things like that. Do you hear or see things that aren’t really there? And then we also go over what the surgery is because part of writing a surgery letter is informed consent. So I want the clients to know what surgery they’re having. To have researched it and be able to kind of tell me what’s going to happen to their body. As well as we talk about a recovery plan. So what is recovery going to look like for you? Who’s really going to help you when you can’t pick up gallon of milk? Do you know how long you’re going to be out of work for? Have you talked to your bosses? Like that.

Erin Everett: That’s awesome. That is really important too because I think I try to touch on those things and mostly I try to talk to them more about the actual surgical procedure. But I don’t always have time to go through everything like to the extent that you are. But it’s also really important that they’re thinking ahead for those things and not just left in the lurch.

Katie Leikam: Right. Definitely. Definitely. And I think it can be therapeutic for people to tell their story to a therapist. Sometimes by the time they get to a surgery letter they’ve already told their story to a therapist before. But it can be therapeutic to just tell your story and then read it back in a succinct paragraph form. To kind of hear who you are and how you got to be where you are.

Erin Everett: Right. Yeah. Agreed. I do think that that is really important. And a lot of people, like you said, they don’t have that outlet or they don’t always … Even if they’ve told their story before they haven’t told it in as much detail because they’re always worried that someone might share details. But having that safe space where they know that nothing they say to you, unless it’s thought of hurting themselves or somebody else, is ever going to leave that area. I mean I try and emphasize that to people. I’m like, “When have you ever had a relationship where you could just sit there and talk all about you and somebody else isn’t going be like, ‘Well when I felt that way.’ It’s just going to be about you and you can say whatever you want and no one’s going to judge you. And then you get to leave and you get to leave it all there.” That alone is therapeutic sometimes.

Katie Leikam: Oh certainly. Certainly. It’s funny, sometimes I’ll have a session with a client and they’ll just talk and talk and talk and talk and talk. And I can barely get a word in. And at the end of the session I’m thinking to myself I’m like, was this even helpful to them because I didn’t say hardly anything?

Erin Everett: And it probably was.

Katie Leikam: Yeah. They’ll tell me … They’re like, “Oh my gosh, this was just fantastic. This was so great.” And I’m sitting there thinking, I didn’t really do anything. And they’re like, “This was great.” And it’s just because people need that space where, like you said, nobody’s talking … Like I don’t talk about myself in therapy, I don’t take up their time. And that’s one of the great things of therapy.

Erin Everett: Yeah. Yeah. And patients will tell me, “It’s fine. I don’t need a therapist. I talk to my best friend about it.” And I was like, “Yeah, but when you’re talking to your best friend, again, there’s that implicit bias. They’re not objective. They’re going to listen but then they’re also going to somehow … Even something as simple as talking about losing a pet when you’re sad about it. Your best friend’s still going to be like, ‘Oh, I remember when I lost my dog. Yeah, it really sucked. Sorry you feel that way.’ Like it’s still going to be about them to an extent. It’s never going to be fully just about you. And not only that, you don’t want to burnout your friendships with all of your baggage sometimes. You want to be able to talk to a therapist and then use your friendships for actually supporting each other and having fun together and making it more of a positive thing and not a therapeutic relationship.

Katie Leikam: Certainly. Certainly. And then also if my clients are in a partnership or have a romantic partner, a lot of times therapy can be great for them because either they want to talk about their relationship with their partner and some things that aren’t going great. Or they just feel like they’re overburdening their partner and they need somebody to talk to that’s just not putting their stuff on their partner every day.

Erin Everett: Yeah. You sometimes don’t want to talk about those intimate relationship details with a friend because you don’t want them to dislike your partner. Because again, they’re going to be biased.

Katie Leikam: Right.

Erin Everett: Yeah.

Katie Leikam: Right. You don’t want to say bad things about your partner to your best friend because then they’ll not like your partner.

Erin Everett: Yeah, exactly. Exactly. Yeah, that’s true. But you also do offer relationship counseling as well. Is that right?

Katie Leikam: Yeah it is. I offer relationship counseling to people who are maybe lesbian or gay or bisexual or pansexual. And I also offer relationship counseling if one partner is transitioning and the relationship is trying to figure out what that’s going to look like throughout the transition of the partner and afterwords. Especially if there’s children involved or just where that relationship is going to go.

Erin Everett: Yeah. Yeah. That’s awesome. I also often … People, when they’re establishing care they’re like, I’m really nervous to tell my boss, my employer, family, whatever, about their transition and will refer them to you to help them kind of navigate that. What are some … I know this a little bit more of a shift in topic, but it was something that I wanted to ask you about. What are some of the ways that you kind of give tips and tricks on how to come out to family members and employers?

Katie Leikam: With employers I tell my clients that there’s kind of two avenues to coming out to employers. You can come out to your immediate boss or you can come out to your HR department. A lot of times I ask clients what kind of company do you work for? Is it a small company? Is it under 50 employees? Is it a major corporation? Read your employee handbook. Every employee handbook has a nondiscrimination policy in it. And it’s optional for employers to add gender identity to a nondiscrimination policy. So if an employer has added gender identity to their nondiscrimination policy then that means that they’re probably a little bit more affirming than other employers.

Erin Everett: Mm-hmm (affirmative). Yeah. That’s a good tip.

Katie Leikam: Yeah. So I tell my clients to read their employee handbook, read their nondiscrimination policy and kind of figure out whether or not they should go to their immediate boss or if they should go to the HR department first. The HR department can help come up with a plan for changing your name in the computer system or changing your email or when you can change documents. Sometimes companies have … Like I had one client recently that their employer sent out a company wide email about their transition. And that was my client’s choice and they wanted to do that. I would say that not everybody has to put themselves in the spotlight that much.

Erin Everett: Right. Right. That can be nerve-wracking.

Katie Leikam: Yeah. But that’s what my client chose to do and it worked out well for them. And other people just start by telling their coworkers and their boss in their team. If they choose to tell other people in a bigger company then they do that later.

Erin Everett: Yeah. Yeah. I’ve had a lot of people kind of broach it that way because their team knows them more intimately and is more supportive, rather than going with the whole company base depending on the size of the company as well.

Katie Leikam: Right. Right. It really depends on the size of your company. Some companies don’t even have an HR department. Some companies it’s so small that you really are just telling your boss. And the boss might tell the owner of the company. Some companies are more affirming than others. Some companies will say yeah, I’ll change your name in the system. Some companies will say no, it has to be changed on your social security card before we’ll change your name in the system. It really just depends on their policy and that can be hurtful if they’re more rigid.

Erin Everett: Yeah, for sure.

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Erin Everett: Have you noticed much of a change in the amount of people reaching out to now during the pandemic? Do you think that’s impacted people in their mental health?

Katie Leikam: I do think it has. I’ve certainly had a lot more relationship counseling during the pandemic. Clients are working from home and they’re around their partners and spouses 24/7 and they’re kind of realizing things about their relationship that they didn’t realize before. So they’re seeking out relationship counseling. I’ve also had clients who … In the very beginning of the pandemic I’ve had clients who might have been furloughed or off work for a few months. Kind of put them in their own head space. And because they were in their own head space they started thinking about their own gender identity and came to the conclusion that they were transgender and sought out a therapist.

Erin Everett: Mm-hmm (affirmative). Yeah. And that makes sense too. To finally have the time to kind of work on yourself. And it’s probably something that they’ve always pushed to the side.

Katie Leikam: Yeah. Yeah, people just … You live your life and you go through the monotony of the day by day and it’s fast paced and you’re always moving and people just don’t have the time to think about themselves.

Erin Everett: Mm-hmm (affirmative). Right.

Katie Leikam: Yeah, then suddenly the world stops and you’re left in your own thought.

Erin Everett: Yeah, exactly. And I actually have had a lot of people too reach out because they’re working from home now so they’re like, this is the perfect time for me to start my transition hormonally because I’m working from home and I don’t have to worry about if I’m uncomfortable at work with somebody noticing that I’m getting breasts or facial hair, whatever it may be. So they feel more comfortable now that they can just be at home and some of them are going to be at home indefinitely. Some offices have switched to virtual with no end date right now. And so they’re like, this is the perfect time.

Katie Leikam: Mm-hmm (affirmative).

Erin Everett: Yeah.

Katie Leikam: Mm-hmm (affirmative).

Erin Everett: So that’s been interesting. But I have definitely had more patients in the community, and those not too, reaching out for more mental health services as well for depression, anxiety as it pertains to COVID and being fearful and social anxiety’s gone up and then you have people who already had underlying mild agoraphobia and now they’re being allowed to stay at home all the time and now they really don’t want to leave. And trying to manage those as well.

Katie Leikam: Definitely. Definitely. Because when you’re put into a position where you get more comfortable, especially if you have agoraphobia and you’re able to stay home, then your boundaries aren’t pushed so you want to stay home a lot more.

Erin Everett: And I definitely encourage those patients to establish care with a mental healthcare provider because any work that they had done on their agoraphobia … Which for people who are listening, it’s severe social anxiety and don’t want to leave the house. They have a lot of anxiety about leaving the house and leaving their immediate environment. So if they’ve already done a lot of work to kind of combat those, then something like COVID could really cause them to regress. So whether they’re in the LGBTQIA community or not, it’s really important that people continue to work on their mental health goals. Especially during COVID.

Katie Leikam: Definitely. Definitely.

Erin Everett: Yeah. Cool.

Katie Leikam: I’m also seeing … This is a little off topic but in the beginning of the pandemic I saw a lot of college students and their roommates just left. They went to stay with family. They had supportive people to go home to. And some of my clients, especially college students, were left at home alone with no roommate because they didn’t have the supportive family to go home to. And that created a lot of loneliness and isolation. When your roommates have just kind of jumped ship and you’re there.

Erin Everett: Yeah. And probably feeling abandoned.

Katie Leikam: Mm-hmm (affirmative).

Erin Everett: Yeah.

Katie Leikam: Mm-hmm (affirmative).

Erin Everett: Yeah, that’s horrifying because there’s a lot of people that couldn’t go home.

Katie Leikam: Right.

Erin Everett: Yeah.

Katie Leikam: Right.

Erin Everett: Or that were actually forced to and then they’re back in this hostile living environment.

Katie Leikam: Yeah. That’s definitely been an issue.

Erin Everett: Mm-hmm (affirmative). Yeah.

Katie Leikam: People who were forced to move back home.

Erin Everett: Mm-hmm (affirmative).

Katie Leikam: Especially clients who had just gotten to the point where they were ready to transition and then they moved back home and they had to put things on pause.

Erin Everett: Mm-hmm (affirmative).

Katie Leikam: That was really hard for people.

Erin Everett: Mm-hmm (affirmative).

Katie Leikam: Speaking of being forced to move back home, we’re kind of approaching Thanksgiving holidays. I know it’s going to be a little different this year with COVID, but traditionally the week after Thanksgiving is one of my busiest weeks of sessions. Because clients have gone back home for their family and they come back and they’re just super stressed because of things that have happened, things their family have told them or being with people who are unsupportive. Or even if their family is supportive, maybe they chose Thanksgiving as the time to come out.

Erin Everett: Mm-hmm (affirmative). Yeah, sometimes people forget, the holidays are not fun for everybody. They can be really stressful.

Katie Leikam: Definitely. So I don’t know what it’s going to be like this year with Thanksgiving and COVID, but I do know that I wrote a blog several years ago about coping skills during the winter holidays and I know one of the things I said was that it’s okay to leave the table if you’re with your family members and the conversation goes astray and you’re not comfortable. It’s okay to get up and say, “I need to be excused for a few minutes,” and just be in your own space and calm down.

Erin Everett: Yeah. Absolutely. I think that’s really important because sometimes you can forget just that little piece of freedom to get away from an uncomfortable situation, you feel kind of trapped. Like it’s okay. Get up and walk away and take a breather. Yeah.

Katie Leikam: Yeah, definitely. Don’t keep yourself in a miserable situation. I think a lot of times people forget that they need to protect their own mental health. Especially people when they’re talking about their parents. They feel bad about how their parents feel about their transition, but in reality they need to put themselves first and protect their own mental health.

Erin Everett: Mm-hmm (affirmative). Absolutely. But then again, that goes back to constantly wanting parental acceptance and them approving of their decision to transition, and when you don’t have that it can, again, cause turmoil. But especially around the holidays. Especially too when you’re going to be seeing potentially extended family. That might happen less this year. But in general you’re going to be seeing extended family who have just heard about your transition but maybe haven’t seen you since you started. It can be extremely nerve wracking to be around those people and maybe feel like you’re on parade.

Katie Leikam: Oh, certainly. Yeah. Again, I don’t know what it’s going to be like this year, but with my clients I usually start prepping clients for Thanksgiving in October. We start talking about coming home, the expectations of family, how they feel about how their extended family feels. I have clients that say that it’s okay if they don’t see their extended family again and that kind of hurts me because I’m pretty close to my family. So I hope families can come around that clients can experience family togetherness. But I know that it’s the reality that sometimes they can’t.

Erin Everett: Right. Yeah. Sometimes they’re just never going to be able to get to a mutual place where they can respect each other.

Katie Leikam: Mm-hmm (affirmative).

Erin Everett: Unfortunately.

Katie Leikam: But then again, on the opposite spectrum, if a client comes home to their family and the extended family are all affirming and it’s just like, “Oh, okay. That’s good to know now. That’s great.” And they start using the name, pronouns, or at least they try. If at least they try, then that’s a great experience for clients. So I don’t always want to paint it in this negative picture. Sometimes I do have clients that come home for Thanksgiving and everybody’s surprisingly cool.

Erin Everett: Yeah. Exactly. And obviously that’s best case scenario.

Katie Leikam: Yeah. That’s best case scenario. It’s funny, a lot of my clients are worried about telling their grandmother. And it’s funny because there was a time where every so often I’d have a client that was just worried about telling their grandmother and worried about telling their grandmother, and it turns out that their grandmother was the most affirming person in their family. The grandmother would be like, “Oh honey, I love you anyway. Don’t worry about that.”

Erin Everett: Right. Or I’ve often had clients who worry about the same thing and then they come back and they’re like, “Yeah, I told my grandma and they said that they already knew.”

Katie Leikam: Yeah.

Erin Everett: Because they just know them that well that they weren’t surprised. Like, “I already knew. I wasn’t surprised. I’ve known you since you were a baby. I was just waiting for you to tell me.” And that is even more heartwarming because it’s like, not only are they affirming, but they also know the person so well that they knew and they were just waiting until they felt comfortable to come out. You know?

Katie Leikam: Yeah.

Erin Everett: That’s awesome. Cool.

Erin Everett: Before we wrap up, do you have anything that you want the community to know or any words of wisdom or anything that you want to share with them?

Katie Leikam: Let me think. I mean, there’s a few things that come to mind. The biggest thing, you touched on it a little earlier and I touched on it a little earlier, is that you are your own authority of who you are. And even if a client is coming to me for a letter, I don’t look at it as a judging process. I don’t look at it as I’m judging this person to see whether or not they’re transgender. Because that’s not what it is. I’m making sure that the person is mentally stable enough to make involved consent. But I accept and I affirm and I welcome and I’m happy about clients knowing who they are. So that’s a really big thing.

Katie Leikam: And then also, like you said earlier, therapy doesn’t necessarily have to be about you discovering your gender identity. Therapy can be about who you are as a whole person. It might take time to find a therapist that clicks with you. It might take a time or two. If someone goes to a therapist and maybe they’re not quite affirming or they just weren’t a good fit, I want people to know that that’s not the time to stop the process of finding a therapist. Keep working at it. Keep trying to find a good fit.

Erin Everett: Yeah. Because in the long run it will be worth it once you do find that person.

Katie Leikam: Right. I mean, I have clients that have been in therapy for a year or two with me and that’s because we’re a good fit and things come up throughout the year. Once you work on one thing you discover something else about yourself that you want to move towards. Goals always change and people grow. And as people grow, they can grow through therapy.

Erin Everett: Right. Yeah, I think that’s important.

Katie Leikam: But I don’t know if this episode is going to air before Atlanta Pride this year but it’s my fourth year sponsoring Atlanta Pride so I’m really excited about that.

Erin Everett: What does that look like now this year?

Katie Leikam: Oh. It’s going to be virtual. It’s going to be over Saturday and Sunday. The weekend of Saturday and Sunday. And they’re going to have events. It’s all going to be through Zoom and there’s going to be events. They’re still going to have the fun events and the music and whatnot. And then the marketplace booth that I usually have set up, I’m usually in Atlanta Pride with a bunch of narwhals at my booth. And it’s going to be virtual so I’ll have a commercial and some virtual brochures. And then Saturday from 1:00 to 5:00 p.m. people can pop in a Zoom room and talk to me.

Erin Everett: Oh, that’s cool. I’m glad you brought that up. I didn’t realize … I mean, I knew that they had gone to a virtual platform but it’s kind of hard to imagine how that was going to be executed.

Katie Leikam: Yeah. I’m really glad that they’ve been able to do that. It looks really cool. I’ve seen the backend of what the virtual pride is going to look like this year and it’s really cool.

Erin Everett: That’s awesome. Yeah. Well, definitely make sure you send me information to that so that we can put that at the end of this episode so people can find out how to connect with you on the virtual pride.

Katie Leikam: Yeah. And then I guess the other thing to say is that if anyone wants to reach out to me, email’s a great way. People can make appointments anytime in the day or night on my website online. And I’m always willing to hop on a brief phone call with people to see if we’re a good fit.

Erin Everett: Awesome. As kind of a screening process for both of you?

Katie Leikam: Yeah. And that’s harking back to the how do you make sure somebody’s an affirming gender therapist. Any therapist should be willing to hop on a five-, 10-minute, 15-minute phone call with you so that you can ask them questions and not maybe interview I guess is a good word, but see if they’re a good fit for you.

Erin Everett: Mm-hmm (affirmative). Yeah. I think that’s important. Well, thank you so much for your time today Katie. I really enjoyed speaking with you and I think that everyone’s going to really love everything you had to say and offer a lot of really good information for people.

Katie Leikam: Yeah. I appreciate it. Thank you for having me.

Erin Everett: Yeah, it’s no problem.

Erin Everett: Remember everybody, stay fierce and live your truth.