How one Ann Arbor therapist led the way in creating supportive services for local transgender people

Over the last 30 years, licensed therapist Sandra Samons has cared for hundreds of local transgender patients and also helped spark the referral network that became U-M's Comprehensive Gender Services Program (CGSP).


But none of that might have happened if not for a chance phone call that came soon after Samons first launched her own full-time private practice in 1989.


The University of Michigan (U-M) graduate had gotten into counseling to work with adolescents and families. While she loved her clinical work, her career had yielded long commutes, which she traded for a narrower field of care working with substance abuse patients at a hospital closer to home.


So in 1984 she began her own practice out of her home just outside Ann Arbor's west side, where she eventually went full-time.


"That was my idea: if I had a little practice on the side, I could get a little more diversity and variety in my work," Samons says. "But I didn't envision it becoming the practice it became."


Soon after going full-time, Samons got a call from a woman looking for marriage counseling for herself and her husband, whom the woman described as a "crossdresser." When Samons couldn't think of anyone better qualified to whom she could refer the couple, she agreed to see them.


"It was a slow day, and I very naively thought, 'How much could there be to learn?'" she says.


It turned out there was a lot to learn, and there weren't many resources available to help Samons at the time. But the couple was well-informed and helped point Samons to relevant information, and she did her best to study up quickly.


Samons soon had two more transgender clients who told her about a convention coming to Detroit in 1992. She was surprised to learn the transgender community was large enough to hold the event, but she saw it as a learning opportunity and attended.


"I don't really think I would be exaggerating if I said it was a life-changing event," she says. "There I was: me and roughly 250 people who were born with male bodies but who, at least for that long weekend, were spending their time as female."


It was more than a one-time, eye-opening experience, though. At the convention, Samons also met Sandra Cole, a professor of human sexuality at U-M, who eventually agreed to let the therapist "pick her brain."


Once word got out, Samons says counseling patients working through gender identity issues took over her practice in "no time at all."


"There was absolutely a crying need," she says.


As word spread, Samons took on patients from as far away as Lansing. When one of her clients told her about a stalled effort at U-M to respond to the health care needs of transgender people, she decided to call up one of the doctors involved to ask him why that project had stopped.


"I didn't know at the time he was chief of plastic surgery, but I grilled him," she says. "I was naive, and he was absolutely gentlemanly, but what he did was kindly tell me there was another doctor (an endocrinologist) who was better to talk with. So I called him and did the same thing."


When she told Cole what she'd done, Cole was appalled, but it also "got her wheels turning," Samons says. Little by little, Samons and Cole began developing a small referral network that, under Cole's direction, eventually grew into CGSP.


Samons continued her private practice and her education – she earned her Ph.D. from the Institute for Advanced Study of Human Sexuality in San Francisco in 2001 – while collaborating and referring patients back and forth through the program. Samons pulled away from CGSP for a while because she says it became more bureaucratic, but she returned to its referral network more recently after some changes were made.


"I think they really do offer the best hope for the future for transgender people in this community, and I think that program has the potential to become a national leader," Samons says.


Samons has seen some shifts in her home practice, where she continues to work primarily with transgender clients. In the beginning, most of her clients were transgender women in their forties or older. (Transgender men were an "invisible population within an invisible population" then, she says.) But today her clients are more diverse, and have gotten younger.


"With the advent of the internet, things really exploded, because people who had been living in isolation and didn't know how to connect to the underground community could," she says.


Awareness of – and acceptance for – gender diversity has grown in recent years. But Samons says there's still a definite gap when it comes to transgender people of color and for low-income people who can't afford the medical procedures needed to transition.


Many of her clients today have done their own research before seeing her and are primarily seeking the referral letters to begin their transition. But many are also uncertain and fearful about what comes next. Samons says sorting out people's legitimate concerns from years of social stigma is a challenge, but helping clients through them is very gratifying.


"Once they do a little reality testing and nothing terrible happens, it's like the sun comes up, and it's just a wonderful, wonderful thing to see," she says.


Eric Gallippo is an Ypsilanti-based freelance writer.


All photos by Doug Coombe.

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