Trans people’s accounts of psychological services: A qualitative cross-cultural comparison between Spain and Greece

Abstract

Background: Gender identity has been viewed in a restrictive way within psychological practice. The dominant discourses of intervention, evaluation and gatekeeping of gender diversity have had a long and severe impact on the well-being of trans people who access mental health services, resulting in distrust and discontent. It is fundamental to interrogate this unitary, Western paradigm of mental health care not only through non-Western alternatives but also from within the periphery of the West. Method: In the current study, Spain and Greece were compared as two non-equidistantly peripheral frameworks to investigate trans mental healthcare. Initial qualitative fieldwork from both countries was conducted from February 2020 to June 2021, using semistructured interviews with trans people (n = 17), with follow-ups in 2023 and 2024. Thematic analysis and interpretative phenomenological analysis were employed. Findings: Participants revealed the continuous presence of severe inequalities and microaggressions within psychological settings, which are aggravated by societal conceptions of transness as pathological, as well as by professionals’ lack of specialized knowledge. Interviewees also reported discrepancy between their accompaniment expectations and professionals’ requirements. Discussion: Experiences in the two countries differed in several of the themes, however, regional differences might potentially overshadow the cross-cultural ones. Future research should offer more qualitative inquiries to further dispute homogeneous and rigid conceptions of transness in psychology.