Queer and transgender people in Wisconsin and across the country often struggle to find mental health services that meet their needs and affirm their identity. At the Center of Community Healing, a counseling center dedicated to serving LGBTQIA+ individuals, practitioners understand the need for adequate support first hand.

Dean Dvorak, a counselor-in-training at the center, says the practice offers “an in-community space to process experiences related to our identities,” something they had trouble finding when seeking their own provider. “It feels important that I am able to do that work.”

“I think we’re trying to be the clinicians that we need,” says Shannon Neimeko, owner of the center and Dvorak’s supervisor.

In 2017, Chelsea and Owen Karcher co-founded the Center for Community Healing. When they relocated, they entrusted the practice to Neimeko, who had been working there part-time. Since taking over, Neimeko has carried forward the mission to provide high-quality therapy for LGBTQIA+ individuals across Wisconsin.

Importance of lived experience

The Center for Community Healing operates under the belief that queer people in distress deserve “access to skilled clinicians who understand their lived experiences and identities.”

While Neimeko acknowledges there are a number of providers with the clinical skills to address common concerns among queer and trans clients, they believe lived experience can provide insight to the suffering queer and trans people may experience while struggling to access the care they deserve.

When working with queer and trans people, Neimeko says “patterns emerge” in a way that may not be as visible to providers who only see a few LGBTQ+ clients or are not engaged in community with queer and trans folks.

“While my individual experiences certainly aren’t the same as every trans person, I think that there’s an easier bridge for me to connect with people around what those experiences might be,” Neimeko says, noting that there are many “relatively common” experiences for individuals who are deciding to come out or pursue gender-affirming medical care.

“Every queer and trans person is different, and yet I do find that we live in more similar worlds than I found when I’m working with cis and straight people,” Dvorak echoes, explaining queer and trans people navigate the world and think about safety similarly. “It’s a set of knowledge and experiences that you just won’t get from reading a book.”

Shared lived experience not only impacts the relationship between client and provider, but between colleagues. “I was excited for the opportunity to work solely or primarily with queer and trans people as clients and colleagues,” Dvorak says. “I so much enjoy getting supervision with another trans person. I think it makes such a big difference.”

Gender-affirming care 

Those seeking gender-affirming medical care must go through an assessment to obtain a letter in support from a mental health provider. The process can be a barrier for queer and trans people accessing the care they need. Some clinicians may want to protect their own reputation or have various ideas about “responsibility” that put the client at risk, says Neimeko.

At the Center for Community Healing, Neimeko says they have a lot of nuance around someone expressing anxiety, worry, or uncertainty about a procedure. “It’s not necessarily about the procedure itself,” they say. “Oftentimes, it’s about the reality-based stressors of undergoing a significant surgery, or about the awareness that might create a public-shifting perception that the person has to balance in order to live as joyfully as they’d hoped.”

Neimeko says that various feelings regarding “really big changes” don’t mean those changes will not be “beautifully life-altering” for the person experiencing them.

“It is protective, and a green flag, to be able to talk about the uncertainty that you have before you undergo a significant life experience,” Dvorak says, adding that even if someone has wanted a surgery for decades, it is a lot of trust to put into a medical provider.

Less than one percent of people who underwent gender-affirming surgery expressed regret, which is much lower than the regret rates for elective plastic surgeries, according to the American Journal of Plastic Surgery. Dvorak noted the low regret rates among people who have sought out gender-affirming surgery, saying the ability to share information within community, talk about doubts, and process and integrate after surgery contributes to those low regret rates.

Working toward collective resilience 

Though mutual lived experience creates a powerful basis for counseling, Neiemko says it can be challenging to know how to handle having similar fears about the world, especially as there has been increased threats to queer and trans rights. This past year alone, 15 different pieces of anti-trans legislation have been proposed in Wisconsin. Neimeko says they work to understand how to balance their own fears with a “sense of optimism and resilience.”

The Center for Community Healing works to “center and grow collective resilience.” Dvorak connected their work to grow collective resilience to a “radical healing approach.” This approach to therapy does not minimize the oppression and harm marginalized people face, but acknowledges that people have to have joy, pleasure, and connection happening at the same time. “You can’t focus on one reality, without acknowledging the other,” Dvorak says. “I think that shows up in our work a lot.”

“I think about sessions where we’re laughing and crying in the same 15 minutes. There’s a joke, and then we’re talking about something really serious. You have to go in and out to be able to tolerate really difficult conversations,” Dvorak says. “Queer and trans people, we’ve had to learn that skill.”

Building resilience is an expansive goal that practitioners at the Center work on beyond one-on-one therapy sessions.

“We don’t have to think of resilience as unidirectional from the therapist supporting the clients,” Neimeko says. “We can also think about it as constructing our own community of clinicians that can offer support.”

The future of the Center 

The Center of Community Healing offers psychotherapy for a range of issues including depression, anxiety, trauma, stages of life, neurodiversity, and other common therapeutic concerns. They also offer assessments and letters that are required by insurers and surgeons to access gender-affirming care. Beyond one-on-one support, the Center of Community Healing hosts a virtual support group for trans and nonbinary adults. They also offer expansive kink and nonmonogamy-friendly relational counseling.

Neimeko also hopes to offer care for adolescents in the future, as long as they find the right clinical match. They’d also like to find practitioners who have other specializations such as OCD or exposure therapy, so people don’t have to choose between receiving care for a common clinical need and choosing care within a clinical structure where they’ll feel most visible, they say.

One challenge Neimeko and Dvorak face is reaching the population they could best serve. “Trans folks are a really small percentage of the population,” Neimeko says. “If the people that we’re most likely to be able to serve really well are so spread out, how do we make sure to let them know we’re here?”

Dvorak is currently accepting new clients, and is working to reach new clientele.

The Center for Community Healing provides services that allow more queer and trans people to access the mental health support they need and deserve. “We offer the perspective that this is both a unique point in time and also not necessarily unique in terms of trans history that’s been erased and stolen,” Neimeko says. “One of the things we can do is help them reconnect with the fact that we’ve been here forever, we’re hella fierce, and we’re not going anywhere.”