Changing names is often a pivotal point in the coming out process for trans and gender-diverse individuals, and the conversation around the importance of a name in one’s identity is universal. Mental health professionals and those who provide gender-affirming care agree that the act of changing your name to something that matches better with who you understand yourself to be is a key pillar when it comes to mental healthcare for these individuals, and its significance should not be overlooked.
The Importance of a Name
Dr. Aude Henin, PhD, is co-director of the Child Cognitive-Behavioral Therapy Program at Massachusetts General Hospital for Children. She confirms that names are a core part of someone looking to understand their shifting relationship with gender. “Names are critical to our identities, and they’re often the first thing that people see on paper. And so being able to change your name to something that reflects your identity is essential,” she says. Henin works with people under age 25, and says that finding a name that fits well differs significantly depending on a number of factors, including a person’s age. For younger children, a parent may have input, but for others, this is a lengthy process that has likely started long before the medical system came into play. “It’s important to remember that even for children and adolescents, before they come out and tell other people, they’ve been thinking about this for a long time. And so, although it may seem like something new to other people, this is not new to them. And so it’s not unusual for kids or teens to have already identified their name [prior to an appointment].” Recent research in SSM Population Health points to the fact that making legal changes to name and gender markers is linked to lower rates of various mental health effects, including depression and anxiety. Outside of the research realm, essays by writers like Mackenzie Casalino and R.C. Woodmass show the life-changing value of a name change.
Deadnaming: What Are the Effects?
It’s almost impossible to talk about name changes within trans and gender non-conforming care without talking about the notion of deadnaming—where a person’s former name is used, whether intentionally or not. David Cato, LCSW, TCT, SEP, who is an associate clinical director of trauma services at Sierra Tucson and a certified transgender care therapist, says that those who change their name have differing relationships to the name(s) they no longer use. While for others, he says, it’s more complicated. “I’ve also worked with trans and non-binary individuals who have said that they kind of honor the name that they were given at birth, and yet, even though they’ve changed their name and their pronouns are different from the gender that they were assigned [at birth], it still has some kind of meaning for them.” In terms of the effects of deadnaming, Henin says that while the context of someone being deadnamed may shift—being called it accidentally without malice versus being purposefully invalidated by non-affirming family members, for example—the real-world consequences can be severe from a mental health perspective. “We do spend a lot of time, if and when that happens, talking about the impact on the person. How they can cope with it, what they want to do to try to address it in the future, because it can be so, so distressing in the moment and so difficult to address,” she says. Henin helps patients work with tools including self-soothing techniques, mindfulness strategies, as well as having a network of people to reach out to to do what Henin calls “run interference.” “I think part of what is so hard is having the transgender or gender-diverse person have to constantly be the one to call out everybody. And we do practice doing that in session…But we also discuss asking other people to do that for you in a sort of a low key, but kind of consistent way so that the burden is shared.”
Building a Culture of Care
So, what does care look like for someone looking to change their name? For one, family can play a key role throughout a transition such as a name change. For many trans and gender-diverse people, relationships with parents and siblings can feel strained when a name change is in the cards. Henin says families who work through their own concerns about a name change prepare themselves better to be a good support system. “We recognize that parents, caregivers, and families have their own process of understanding and thinking about all of this. And so we try to provide them with resources so that they can go through their own process without imposing it on the child,” she explains. Biological family aren’t the only ones who can provide support, however. Chosen family—those who take on family roles outside of a traditional family tree—can include the person who can drive people to appointments, regularly schedule mental health check-ins, or perform any number of other support tasks. At the end of the day, Cato says that name changes are an important way for people to settle into themselves in a way that may not have been possible before. “If you feel like a certain name or a gender different than the one you were assigned resonates with you, then it’s about going for it and allowing yourself the permission to be who you are.”
