Cory Nichols is the Executive Business Director of the Institute for Personal Growth (IPG). Cory’s mom, Dr. Margaret Nichols, founded IPG in 1983, the same year that he was born. He talks about how, in some way or another, IPG has always been a part of his life. He discusses how IPG has become a safe haven for trans people and how he can continue to support the mission of the organization as well as the LGBTQ+ community.
“I think we’ve expanded and gotten more diverse in terms of the kinds of therapists we have and the perspectives they bring to the table, which is really cool, and maybe a little bit of change in our identity over the years but I think in a good way. IPG has been part of my life and I’ve been part of the IPG family, literally and figuratively, for my entire life.”
ANNOTATIONS
Annotations coming soon.
TRANSCRIPT
Interview conducted by John Keller
Highland Park, New Jersey
April 10, 2019
Transcription by Chrissy Briskin
00:00
Great, so this is John Keller with coLAB Arts. It is April 10th, it is about, uh, 1:20 or so in the afternoon. April 10, 2019 and I am here with–
Cory Nichols.
Right, Cory, just, kind of like, a little bit of background information, um, where are you from originally?
Well I was born here in New Brunswick, in St. Peter’s Hospital, but I was raised in Jersey City. I lived there until I was 17. I started Rutgers and came back to New Brunswick, was here for a few years, back and forth between Jersey City, and then I spent some time in New York, and now I live here 'cause I work here.
Great, what was the reason for moving to Jersey City?
It was never, I was just born in the hospital, so the reason– so my moms, as I’m sure will come out in the course of this discussion, I have two moms, and they, at the time in 1983, it was very– attitudes were a lot different, it was very important for them to find a doctor who was cool with the whole situation about two women having a kid and who wasn’t, you know, who wasn’t going to give them any sort of problems with it or that sort of thing. So they found a doctor they liked and trusted here at St. Peter’s Hospital. So they lived in Jersey City at the time, they just came here to have me and then took me back home to Jersey City.
Gotcha, so, um, why don’t we get into that? What was your, kind of like, your early childhood like, or growing up with two moms?
It was great. People ask me this a lot like, “Oh what’s it like to have two moms?” and I never know exactly what to say, because that’s the experience that I know. Um, I had a step dad and I have a biological dad, who I know, and we can get into that if you want those details, but I didn’t grow up with a mom and a dad in that role so I almost want to say– sometimes I say to people jokingly, “You tell me what it’s like to have a dad. You know what it’s like to have a mom, think about two of those.” But it was, jokes aside, I was aware that it was different. I– luckily my moms put me, in my younger days through middle school and stuff, put me in schools that were smaller and kind of lefty kind of alternative school kind of things where the teachers there were very progressive and everyone knew the situation, and I didn’t really get judged or picked on or anything like that because of it. Um, so, um, so yeah I knew. I mean there were a million other ways it affected my life, for example, a lot of my male role models growing up were gay men of my mothers’ generation, and a lot of them ended up dying of AIDS, so that had an impact. They ran an AIDS crisis center for a while that they founded, which is a whole other story, um, but being in that world, and growing up in the queer community, um, was very impactful, but I don’t know what to compare it to.
So in terms of– one of the reasons we are doing the interview is to get around to IPG, but, kind of like, earlier in your life did you have an awareness of some of the work that your parents were doing regarding mental health or the crisis center?
Not for a while. I don’t really remember when. I knew that my mom was a shrink, that she was a psychologist, and I kind of knew what that meant, um, I knew that she was a therapist and was sort of like a doctor, but not exactly, but she helps people and talks to them, but I don’t really remember the first time that, one, that I really sort of understood what she did, what that meant, but also what the connection and what the importance, what that sort of connection to the LGBT rights movement thing. I definitely– I think it was maybe one of these things I knew all along, so I don’t have a sense of a time when I sort of realized, but I knew that it was– I’ve known for a very long time that IPG was important in this way, it was special because it was founded specifically– it was founded in 1983, the same year I was born, so it’s been around as long as I have, and it was founded specifically to serve this sort of niche community. It was founded to be a safe and welcoming and affirming place for queer people, which at the time was– didn’t– was pretty rare outside of New York, which I’m sure in the West Village, at that time, you could find therapists who were queer friendly, but, sorry, it’s sort of a long-winded answer. You’ll find I’m very long-winded.
So when– did you ever– what was, kind of like, your earliest memory of interacting with IPG?
I remember, so IPG, for a while, was based in– the original office was– was it first in Highland Park? When I was a kid it was based here, a few blocks from here, I don’t remember exactly where before moving to Highland Park. I think it might have been in Highland Park first, then New Brunswick, then back in Highland Park. It's moved around a few times and now we have offices in Jersey City and Freehold, but the main one was the one located around here. That was the main one and has always been sort of the central office. I used to– my mom would bring me to work sometimes if I had the day off, and I remember here, then the office in Highland Park, being a kid and playing around and being in that space, and not knowing what it was or what was going on so much, um. I do remember my first acute awareness of IPG as an entity was just being in the office and playing around as a kid.
5:52
And just for the record, because we are referring to IPG, can you just articulate what IPG is, what it stands for?
Yeah, yeah, Institute for Personal Growth. This is a group mental health practice that was founded in 1983 by my mom Margaret Nichols, um, Dr. Margaret Nichols, I should say, I should give her that respect. And, um, it is now three offices throughout New Jersey. Highland Park is the main one, Jersey City and Freehold, as I just mentioned, and it was founded as– when I say group therapy practice, what I mean is several different therapists working under the same umbrella so to speak. The same place. So when someone calls up and says, “Here’s my issue, here’s my schedule,” we can pair them with someone who works for them both in terms of the type of therapy they need and the type of therapist they want to see. Some people have preferences for a male therapist or a female therapist or a queer therapist or whatever, so we can– the fact that we have a bunch of different therapists, that structure gives us the ability to better pair people with a therapist who works for them and a time schedule, that sort of thing. So basically we have almost thirty therapists working for us across all three offices and a handful of office staff, and I’m the one who runs the office and business and all that administrative side of things.
So in terms of being a kid in that space, and not really knowing what was going on, what you’ve heard from either stories or from talking with your mom, what was your understanding of how that all got founded or what the early days were like?
Um, that’s a good question and hopefully you’ll eventually interview Margie, um, 'cause she would obviously be able to give you a much richer account of that, my impression–
And just to clarify, this really is your perspective, whatever recollection you have, that’s what we’re interested in, your recollection, or what you’ve learned over time.
I think initially it was very small, just a handful of therapists, I think it was more or less a sort of diverse group of therapists in the sense. I think there were mostly they were queer people around my mom’s age, that generation, all with a kind of– and again, this is my impression so maybe she’ll correct me on this, remember they’re all a similar generation, hippies, they had this old hippy lefty, slightly new-agey approach to therapy, it was also very political and very progressive and now we’re– I would still describe our organization as very progressive and all those things as well. We’ve got people ranging in– we’ve got straight therapists and queer therapists, we had a trans therapist for a while, but she left us, and we’ve got people who are younger than me who are in their late twenties who are therapists, really great therapists. We’ve got therapists in their seventies, we’ve got people from south Jersey and north Jersey and people in New York for a while, so I think we’ve expanded and gotten more diverse in terms of the kinds of therapists we have and the perspectives they bring to the table, which is really cool, and maybe a little bit of change in our identity over the years, but I think in a good way. But my impression of the early days is a small group of, sort of like, older, sort of like, hippy generation therapists and, um, you know, just sort of, I don’t know how to expand on that more, but you get the kind of feel.
9:39
So when did you, as you were growing up and you had an awareness of what your parents were doing for a living–
Let me clarify that. It was Margie, at this point Nancy, my other mom, wasn’t involved in IPG at all yet. At this point Nancy was doing programming in an IT department for publishing companies and that sort of thing. It was only the last decade she was actually directly involved with IPG and working there. Just to clarify that.
So who was working– was Margie, kind of like, doing the whole thing on her own, or was she working with any partners?
So she worked for a while– her main sort of office administrative type of person was this woman named Debbie who worked there for years and left us under sort of, they had a falling out, and she left abruptly, and at the time Nancy was looking for work because it was right around– shortly after the 2008 economic crisis and the housing crisis. Nancy had actually moved out to Arizona to flip houses. That was a dream of hers, to buy an old house, fix it up, and sell it again, and she did that, she had the worst luck, the worst timing right when the housing market crashed. So she bought this house and really made it really beautiful and it went back down in value to where it was before she started, and she lost all that time and investment, and she had been out of work for a while at that point, and being out of work is really tough to get back in, especially when you’re in your fifties or whatever, so, which I guess she was at the time. So she came back and was staying in, she came back here because there are more jobs here than there are in Arizona, so she was trying to figure out what to do, and Debbie left us and Margie was freaking out, like, who was going to run the company. It had been so long since Margie had done any of the office or administrative side of the business, and so Nancy, it just sort of fell in her lap, and she was in the right place at the right time, and then it sort of just clicked, and I don’t know if they actually had this thought, but why haven’t we been doing this for years, it makes so much sense. And sort of the same thing happened to me a couple years ago. I was an academic and wanted to go into academia, I got a PhD in philosophy and I wanted to– I never imagined working for IPG, but Nancy was ready to retire, now I’m getting ahead of myself a little bit. Nancy was getting ready to retire, so was Margie, they were going to sell the business to two therapists, um, Susan Menaham, who is currently the clinical director, and another therapist who had been at IPG a long time, but, for reasons I won't get into, that didn't work out and it ended abruptly, so they needed someone to step in and fill, once again, a business administrative role that Nancy had been doing for years, and I had been struggling to find an academic job, because the academic job market is really bad, so they said, “What do you think about doing this?” And I said, “I don’t know, it’s such a change from what I’ve been doing the last decade of my life.” But I did it and here I am, it’s working out. (laughter)
So what was the, I mean do you want to talk a little bit more about what it was like stepping into– I mean it’s twofold, right, stepping into a career that wasn’t something you had initially envisioned, but then it’s also taking over your mom’s business.
Yeah. It was weird. It’s still a little bit weird. Partly because, as we were starting to talk about before, IPG has been part of my life and I’ve been part of the IPG family, literally and figuratively, for my entire life, but I never, until very recently, thought of it as– thought of taking over the business. It was always like, “This is my mom’s business, this is my extended family,” because these are all. I mean some of the therapists there I’ve known since I was a kid and they’re still there, some of them I’ve known since I was very young. So it was very weird, it was such a change in roles because I would show up, prior to this, I would show up every now and then and it was, “Hey Cory,” it’s the owner’s son, and the relationship we have now, suddenly I’m their boss, and it’s kind of weird. I think compared to a lot of office environments it is very familial, because that’s just the way we are. It’s a big change to walk into a place that I had grown up my entire life as my mom’s business, as something I never saw myself being involved in, and suddenly I walk in and now I’m one of the main people. I’m not able to articulate that better off the top of my head, it’s a very strange experience, but a good one.
14:27
You said that the space is a little bit more familial than maybe your standard office–
Absolutely.
How would you– can you describe that? I don’t know what you mean by that.
I mean, um, that’s a good question. My experience– so I don’t have a ton of experience working in sort of standard, typical office environments, but my impression is that there is more of a sort of an apparent hierarchy, more of a clear sort of traditional boss, employer/employee relationship. I think, I’m sure the very fact that some of us have known each other for many, many years. One of our therapists, her name is Lauren, I’ve known her since we were both teenagers. She worked in the office doing typical office stuff and I worked in the office during high school painting the walls as a summer job kind of thing. So I guess I was working for IPG in a loose sense, so we both knew each other when we were fifteen, and now she is one of the main therapists and I’m the business director. She’s, in many ways, family and some of the therapists– and partly this is my experience because I’m coming in with the feeling like a lot of these people are my family, and they are, in the extended sense, because a couple of the therapists, like I said, I’ve known since I was a kid and they were family friends, that kind of relationship. So for me it is like walking into a room full of family, but I think the environment reflects that for other people, I would expect that other people at IPG would say they felt that way as well. We have staff meetings and everyone’s sitting around kind of joking and more comfortable in a way that a lot of places aren’t. This is very anecdotal, but every year we do this office party, a holiday party, like a lot of places do, and we do it at this place called Social in, is it Somerset, Somerville? Somewhere out a little further west, and they always tell us we’re their favorite party that comes in every year because we’re so much more fun, and we’re so much more– and I think it’s less sort of this stiff, “I have to impress my boss” kind-of-thing rather than everyone can kind of let their guard down a little bit and be congenial.
Um, great, yeah, I think just to say, we love anecdotal.
Sure.
What would you describe– what would be a typical, like, what is the sequence of things that happen? What is the experience of a patient, or someone who is coming in as a client with IPG, how does it– what is their initial interaction, all the way through the course of whatever services they are getting?
Yeah, so probably Susan would be a better person to answer that question in detail. Typically, what happens is a person, it depends on, to some extent, how the person is getting to us. If they were a previous client, are they returning, that happens a lot. They were a client for a few years, and then they feel like they don’t need therapy at that point in their lives, and then they go through a divorce, or they, whatever it is, and they come back a few years later. But for new clients, typically they find us online or by word of mouth. We get a lot of word of mouth clients because we’ve been around for a really long time, or professional referrals. Jackie Baras, who you guys know, refers us a lot of clients, that sort of thing. They usually call us up, and they’ll talk to our office staff first, and our office staff will try to get some sense to the extent that the client is comfortable sharing this information to a stranger on the phone who isn’t a therapist. They will get some sense of why they’re seeking therapy–
18:31
Who is the person on the phone with them initially?
One of our office staff, so it’s either Artie, Lisa, or Amber are the people there now, and they are basically my staff. So I don’t do the intake process side of things.
Do they get trained to do that intake, or is it more general?
Yes, they do, but not in, like, it’s not like we have a rigid online training course. So I’ve only been there a couple years now, and we haven’t had to hire any new office staff since I’ve been there, so I’ll find out more what the training is the next time we have to hire someone. So basically, one of the first things we’ll do– the nice thing at IPG is we do assigned benefits for insurance, so we’ll take your information and we’ll deal with insurance for you. For a lot of people that’s really intimidating and overwhelming, and they don’t know how to– they don’t have the wherewithal to navigate, so that’s one of the things our office staff’s specialities is dealing with insurance companies, which many of us know can be a nightmare. So a lot of times an insurance company will just deny you for the hell of it when they don’t really have a good reason to and, if you fight it, if you have the wherewithal or the time or the energy to fight it, you can often get them to cover you for something they weren’t going to, but most people don’t. So that is a lot of our office staff’s job is dealing with insurance companies on behalf of the clients. So what they’ll do when the client first calls up is get a sense of the very basics, where are you located, so, okay, you’re between the Jersey City and Highland Park offices, which one is more convenient for you. Sometimes that may depend on what you’re looking for, if you’re looking for a specific therapist who does eating disorders, well we have someone here, but not in this office, so that sort of thing. And your schedule, and why you’re seeking therapy, are there specific needs, like an eating disorder kind of thing, or is it couples, or is it for young children? Most therapists don’t like to see young children because it’s very tricky. Or, you know, whatever, so they’ll get a sense of which therapist is most appropriate and get your schedule and that sort of thing, and the next step is getting insurance information because most people are concerned about what the price is going to be, and that varies a lot because of your insurance coverage, so the staff will then contact– once you give us your insurance information and consent to look this up for you, then depending on the situation we may be able to work something out if you can’t afford it. Especially with trans clients, we basically have a policy where we will, if we can, we will do anything we can to help a trans client. It’s our mission, it’s one of our main goals. The way I see it is, that’s sort of the avant garde of the queer rights movement today. We’ve made a lot of head ground, is that the turn of phrase?
Headway.
We’ve made a lot of headway, in general, and for the other letters in that acronym, but for trans people it’s still a real daily fight, and so if there is a trans client who can’t afford our rates we will do what we can to find someone for them. And, um, then– so that’s the whole intake part of that process, and then, when they first show up, the first session is always an assessment. They will see their therapist, the therapist will introduce themselves, and then they’ll spend the first session, maybe the first couple sessions depending on the situation, getting to know them and getting to know about them, and what their issues are, and why they are seeking therapy, and that will determine the course of therapy. It may even– the therapist may say, “Okay, there are issues here that didn’t come out on the phone, and maybe actually you’re better suited for this other therapist who specializes in these kinds of things.” Or occasionally someone will come in who needs a higher level of treatment if they have serious substance abuse problems, or something like that, that’s relatively rare. Usually you just come in and get– the therapist gets a sense of what you’re there for and they figure out a treatment plan for you. That’s the initial process: the phone call to the first session. Beyond that, I’m not a therapist and I’m not involved in the clinical side of things that directly, so Susan or Margie would be better to answer that.
23:13
How would you go about– I was curious if there was anything else you wanted to say about the progress that’s been made about the other letters of the LGBTQ– I’m curious how you frame that in your mind, what is the progress from the starting of IPG to where you are now, or even in your own tenure, what have you seen change for better or worse? What have you seen get better or what have you seen go backwards?
Yeah, um, that’s a good question, because there are so many aspects of life that are sort of affected by this. The one for me that has been the most– especially because I haven’t been involved directly in this way at IPG until fairly recently, of course I’ve had an awareness of all this stuff, but haven’t had my hands dirty doing that kind of work. To me the aspects that I’ve noticed are general attitudes and acceptance and that sort of thing, and I can even– here’s another anecdotal sort of thing. I mentioned that I went to middle school up until high school, I went to these smaller, alternative, kind of progressive schools, and then for high school I went to a big Catholic school in Jersey City, because Jersey City at the time didn’t have charter schools or private schools that were better. Jersey City public schools are really struggling and have for many years, they’re known as some of the worst in the state, whatever that means, and so my moms didn’t want me to go to public school. So the options were to go to a really expensive private school in the city and commute into the city everyday from Jersey City, which wouldn’t have been that bad, or go to Catholic school because the Catholic schools offered a decent education that was pretty cheap. So I ended up going to a Catholic school, but it was this big, all-male Catholic school, kind of a jock school, and very sort of macho, and I was just not that person as I’m sure you can imagine. So the contrast at the time between that– this isn’t really showing you a change over time in the attitudes, but in the smaller schools that I was at before high school, everyone knew my situation, everyone knew that I had two moms. I never got made fun of about it, one time there was a kid who picked on me a little bit and one of the teachers noticed and, like, shut it down, right? Like, that was never a thing I had to worry about, and then high school only my closest friends knew. I wasn’t comfortable with other people knowing, I don’t know exactly what would’ve happened but, like, you know, teenage social dynamics are so complicated, but I worried that if it got out, if everyone in the school knew I had two moms, I would be picked on and people would be, it would be a hostile environment for me. It was something I never had to worry about at the schools before, and so at the time, again this is very anecdotal because this is my experience as a kid with two moms, and this doesn’t reflect necessarily the political stuff going on or that sort of thing, but at the time, it was that– still that sort of hostility towards queer people, and not that there still isn’t in a lot ot ways. Another anecdotal thing to tack onto that, I remember somewhere somebody has a copy of a tape of an interview on one of the local news networks where my moms were interviewed. I guess they were doing a story on same-sex couples having kids because that was a very new phenomenon then. And my moms had been interviewed, and Nancy actually requested to have her face blurred and her voice altered, and this is 1983, you know, Reagan administration, Anita Bryant, very conservative values are very popular, and so Nancy wanted to have her face blurred because she thought if people at her work found out, she would get fired and they probably would have been able to legally do that at the time. And, um, and, um, and then I remember them telling me that after that they got some hate mail from people at some point, and it was a very controversial thing, and the way that it was presented in the news at the time was like, it was presented in a way that takes the attitude that this is a moral outrage seriously. It’s almost like somehow now we suddenly have, you know, these white supremacist people on TV having their voices heard again because of the Trump craziness. That’s a voice, that for a long time, that hasn’t gotten a platform, so now if you went on a national news network and did an interview, you’d get a harder time from people if you said something like, “Lesbians or gay male couples shouldn’t be allowed to have kids.” There are places where you can still say that for sure, and our vice president believes that, but at the time it was like the idea that they should be allowed to have kids was this wild alternative idea. There are these lesbians who want to have kids. Isn’t this crazy? Is this okay? And that was sort of the presentation of the argument. Of course we all know homophobia is still alive and well. But one of the things that has changed, and one of the key victories of the LGBT rights movement, and of any civil rights movement, is that it's no longer as acceptable, and it’s no longer seen as the unproblematic, mainstream, "default" view. To take an anecdotal case-in-point: I remember back when Mitt Romney had the Republican nomination and was running against Obama in, what, 2012 I guess? There were a few videos leaked of Romney speaking to groups of his wealthy elite donors behind closed doors, and in one of them he's talking about gay marriage, gay adoption, queer people, queer couples, etc. And he says something like, "some of these people even want to have children," with "these people" of course meaning LGBTQ people. I'm paraphrasing him here, not verbatim. And of course, that made me really mad, and I posted something on Facebook about how I couldn't wait to watch him fade into political and cultural obscurity, and of course, thank God, that's what happened, and now he's one of those, "Oh yeah, remember that guy?" people. But the point is, in 2012 even Mitt Romney knew that this wasn't the kind of thing you could say out loud in public in most settings. And when the tape was realized it was a scandal. Compare that to 1983, when the story on prime time major network news,NBC or something, is basically "Should these women even be allowed to raise a child together?" And it was the news anchor who was viewed as somewhat radical or controversial when she implicitly answered, "Yes". We have video footage of this somewhere, but I remember her closing words in the segment being something like, again, paraphrasing, "Some say he [meaning me] will be scarred for life. But some say he will have two loving parents, which is more than many children have." That's change.
29:01
What’s the– how would you describe how, kind of like, you touched very briefly on the phone the other day how IPG has become your work, you’re committed to it, you have found yourself in that space. How would you articulate how that came about or why you feel that way?
It’s all very new and I’m sort of still settling in. It's been a little bit over a year since Nancy left and I’ve been taking over her job myself and I’m still growing into it. I mentioned that I was in academia before, and I started grad school in Princeton in 2009 for Philosophy, and at the time I was really gung ho about Philosophy. I was really excited by it, and now ten years later, it took me– I finished in, what, 2017, 2018? I finished up my doctorate and I’ve been teaching part-time, so I still have my foot in academia, so to speak, but in the intervening time, my sort of– my priorities and my values, to some extent, have changed in that I thought philosophy– let me put it this way, I thought at the time when I started grad school that philosophy would be something very fulfilling for me in a sort of big picture, end of the day, what am I doing with my life, what am I contributing to the world, kind of way. And I think for a lot of people it is and that’s great. For me, I sort of got to the point, especially because the stuff that I do is very specialized and very obscure and sort of esoteric for most people. It’s not the kind of philosophy where someone outside of the field is going to pick up something I’ve written and get something out of it, if you know what I mean. I felt very unfulfilled by it, and I felt philosophy and academia and linguistics, I do philosophy of language, so there is a lot of overlap with linguistics, it’s actually what I’m teaching right now is Intro to Linguistics. I find it very intellectually stimulating on a day-to-day basis for sort of private, personal reasons, but I didn’t feel like I was contributing or doing anything important in the world, um, and coming from two moms who have spent the bulk of their lives doing activism, first for women’s rights in the ‘70s, for LGBTQ rights and AIDS activism in the ‘80s, and trans rights more recently, coming from two women with a very, very strong social sense of social justice and politics and activism, who have done all this great work in their lives, I felt like I wasn’t directly comparing myself to them or anything, but being raised with those sort of values, I started to feel like the fact that this philosophy and linguistic work that I’m doing is personally intellectually stimulating is not enough. And I was starting to think about ways, and I do enjoy teaching a lot, and teaching is contributing something in a way that satisfies those values I was just talking about, but I wanted something that was more. At the end of the day I felt like I was doing something really good in the world and, um, IPG, even though I’m not a therapist and usually I’m not the one directly providing the service, you know, helping people, the fact that I am helping oversee all of it and making it happen feels really, really good. Even though a lot of days I go in and it’s like I’m just paying bills and doing some mundane shit, (laughter) it’s sort of the opposite of philosophy, like, day-to-day I’m stimulated, but when I sit back and look at what I’m doing, what I’m contributing to the world, it’s kind of like hmm. But now when I go in day-to-day, and some days it’s very interesting and some days I’m doing really menial stuff, but now when I sit back, and I’m greasing the wheels of making this giant beautiful thing happen, it feels really good, so yeah.
How would you articulate– what are some of the biggest challenges facing IPG or, kind of, the work that’s being done in the organization. What are some of the biggest things you are kind of dealing with right now?
That’s a good question, um, these are all good questions (laughter). That’s a tougher to answer question, is what I think I mean, but again, I’m still relatively new to this and figuring some of this stuff out. One problem, the most immediate thing that comes to mind is the cost of healthcare and the fact that a lot of people– health insurance costs go up and insurance companies don’t– insurance companies are just the worst, and that’s obviously a very editorial comment. We were meeting with a doctor recently, and I won’t say who, 'cause I don’t want to get anyone else on the hook for my attitudes towards insurance companies (laughter), but he said something about like, “Well insurance companies are in the business of not providing coverage, that’s how they make money.” So insurance companies– we’ve had just a lot of examples of insurance companies just, like, messing with us and not providing the coverage that they are supposed to provide and not, you know, we had one insurance company suddenly started paying us as though we were in network, and the rates are much lower and it took us forever to sort this out. Nancy had to finally get in touch with the VPs of the company and get into it with him, and so there are all these details about the insurance industry and the healthcare industry that I am just starting to learn, because I am very new in this career, and I’m just starting to learn this stuff, and one of the things that we’re– you should ask Margie a similar question about HMOs in the ‘90s because she– there was a while where IPG was on very shaky ground because of a lot of changes in healthcare in the ‘90s, that I don’t understand that much because I was pretty young then, but she will, but worries that people can’t afford– Part of our model, so to speak, not to sound all business and markety and corporate, so part of our model– so we’re out-of-network with everyone. We’re not in-network with anyone, but we’ll fight on your behalf to try to get your insurance company to pay, to cover you as much as we can, and we’ll work with you on fees if we have to, and part of that is because we– it’s always been one of our core values is that we’ve always had high quality therapists, and high quality therapists are hard to keep, especially ones who have been around for a while, and they get referrals from word of mouth and that sort of thing, and they can have their private practice and not have to share the rates with us and that sort of thing, and so our rates are higher than they would be if we were in-network, which means that there are some people who can’t afford to pay for us, and we will work with them when we can but sometimes people say, “I can go in-network and get therapy for cheaper than that.” And sometimes it doesn’t work out, and that’s kind of a sacrifice that we have to make because we’d like to help those people and we’d like to have those clients, but it would be hard paying the rates for– that would be really hard for us to keep high quality therapists. And I know all that stuff is so subjective, and you don’t want to say people are bad therapists, but. And so because that’s sort of our model, if things get worse with insurance companies and healthcare costs and that sort of thing, and again, I’m just starting to understand all this stuff, then that could mean our model doesn’t work as much anymore, and that’s kind of what happened in the ‘90s, to my knowledge, but again, you should ask Margie or Susan, they’ll know much more about it because they were therapists at the time. The fact of the healthcare industry and the insurance industry is one of the things that we’re always worried about for the future. Another thing that– another challenge that we’ve had for a while, but this is sort of a good problem or a good challenge, is that we’ve had to adjust to find the niche group of people that we serve that makes us sort of distinct, as that’s sort of changing, but for good reasons. So in the 1980s there’s a good chance that if you went to a– or picked a random therapist out of the phone book and you told them that you were gay, they’re either going to tell you that was your problem or you had a disease or something like that, or at least they would think that that was whatever problem you had was related to that. “Oh you got anxiety? Oh it’s got to be because you’re gay and something connected to that. Oh you’ve got some sort of depression?” Whereas you can be gay and have problems that have nothing to do with that, and that’s– Anyway, the attitude in the mental health community was so different then, and now it’s changed so much that, at the time, it made us very special that we were queer-affirmative, queer-positive, queer-owned, queer-oriented. We had therapists that were queer, and at the time that was a big deal, and we were special, and now not as much, because attitudes have changed so much and there are lots of queer therapists. And then I think we had– for a while there were very few– we’ve been working with the trans community since the ‘90s, since before this was even a conversation most people were having on a larger scale, whereas now it’s a very sort of mainstream conversation to have so to speak. I think that’s the best way to put it, and so for a while we were one of the only places that specialized in working with trans people and had experience in it. Now that’s not as much the case anymore, which is a great thing because it means that we’re making progress, it means that trans people have more options, and have– and are more accepted and that things are changing very rapidly. It does mean that we constantly have to shift and change our identity, alright what’s the next group of people who we can specialize in helping, and it’s very– there’s both an aspect of us providing a service and also an aspect of us retaining some sort of edge as a business, which it sounds weird to put it in those terms but we don’t want to lose. I feel like we felt for a very long time that there is something distinctive and very special about us, we have a special identity, IPG does, and we don’t want to lose that. Um, it sounds a little weird to put it that way, but I think we’re always looking for what is the next thing we can do that is going to be ahead of the curve a little bit, you know what I mean?
40:33
Yeah, and kind of relating back to that, you had said earlier that the transgender community is still kind of– is still a little bit in the avant garde in the civil rights movement. What do you think is the work that is left to be done, or how– I don’t even know how IPG fits into that, I think you’ve already articulated that, but what is the work? How would you articulate what is the work to be done culturally?
Yeah, culturally, but even legally and politically, so recently, don’t ask me for the details on this because I’m not remembering, there was a law passed recently, I believe it was at the state level, a New Jersey state law, I could be mixing up a few different laws, part of the job that I’m trying to improve on now is getting to know– now that I know how to run the business, I’m trying to get to know other peripheral stuff that’s relevant, like the laws for transgender health care for like HIPAA regulations for patient privacy. I’m now at the stage where I’m trying to learn this stuff. I keep making excuses for myself, but, so there was a law passed within the last couple of years that says that insurance companies, I believe in the state of New Jersey, I believe it was a state law, can’t deny coverage for transgender issues. It doesn’t mean they have to necessarily cover everything. So if there’s some purely cosmetic surgery or something that somebody wants, I don’t remember exactly the details, it doesn’t require them to cover everything that’s related to transgender issues or care, but they can’t deny somebody on the basis that it’s related to transgender health. Of course it’s much more nuanced than what I’ve just articulated, but, like, this is a big deal, and there’s the Babs Siperstein law, which was fairly recent. And there’s frequently, um, there are– even if they are small victories here and there, and this idea of incremental change, from all things happening all over that still need to happen, because there are lots of ways in which trans people are not protected or recognized. I mean, I’ve been trying to ignore the nightmare of politics, of Trump politics that have been happening lately, just for my own sanity to the extent that I can, but he’s very, very not trans friendly, and it’s still a very, very active political battle, and I should know and I hope to hear more of the details of that. That’s not exactly the question you asked, but in a very, very concrete, clear cut way there are still a lot of political battles to be fought. Culturally, I’m trying to think of what a good anecdotal thing in terms of the cultural shift. I think now, again, Margie would be a good person to ask this question to because she’s seen, just in terms of having trans clients, from the ‘90s ‘til now, and trans youth and trans kids or trans teenagers and the level of acceptance in school, and having friends, and not being totally ostracized, and being out as trans. There was, what was the name of the client, oh, I shouldn’t, there’s some HIPPA issues there. I should redirect my thought, anyway, you know you hear about these cases of kids coming out in high school or something and having this really supportive group of friends? Of course there are going to be the kids that are the assholes and call them names and mess with them so, but I think the level of support and acceptance and willingness to have a conversation about it, the way people are learning to– even the language that we use to talk about trans issues is developing, people are more receptive than they were before, and that’s– I see this even in terms of conversations people are having on Facebook, which is I think a really bad venue to iron out the details of this movement, but that’s what we’ve got, it’s part of what we’ve got. Just the way that people are talking about it, the way that people are thinking about it, people’s willingness to have a conversation about it, to take transgender people seriously, and to take transgender identities as real, legitimate identities, I think this is, I wish I had better concrete examples, but I think this has evolved a lot in the last decade or last few years.
45:46
Are there any other questions you assumed I would ask you or haven’t yet or any other questions that you would ask you?
Um, that was not one of them (laughter). I don’t know, I guess I thought maybe you would ask me more about the– some specific mental health-specific questions about treating trans people, which I was prepared to defer you to Susan about, but maybe you figured out that that would be a better question for her or for Margie because they’re the clinicians. I was also surprised you didn't ask me about my own identity, sexuality-wise, gender-wise, etc. In case you'd like to include it, I identify loosely as either queer or bisexual, but there are issues with both of those terms. The issue with "queer" is just that it's so vague that it doesn't tell you much. The issues with "bi" are numerous, including: one, it assumes, at least superficially, a gender binary; two, it conflates sexual and romantic attraction, which for me and some others come very much apart; and three, people tend to assume you're more or less in the middle of the Kinsey scale when you say you're bi, rather than somewhere leaning towards one of the extremes. But people understand "bi". If I say "pansexual" or something like that, most people, even most LGBT people, look at you like you're speaking Greek. But anyway, I'm sexually attracted and involved with both men and women, and in principle anyone anywhere else on the gender spectrum, but romantically, pretty much exclusively interested in women/femme presenting people. Don't know why, it's just what I like. I sometimes jokingly tell people I'm bisexual, heteromantic. I could say more about this, but that's the short-ish version of it!
I also think, what I am interested in is the perspective you have about running an operation, which you talked about a little bit in terms of healthcare, and how do you fight those battles, and how do you also– what is the kind of business model for an organization like IPG? And you talked about being on the leading edge of where service is needed and so those were all things I think I had curiosity about in terms of how do you frame that. I mean the clinical stuff I think I am reserving for the individuals who are doing the one-on-one consultation.
I think Susan, and especially Margie, and there is another therapist who is one of our main therapists who works with trans people named Lauren who you might want to interview as well, I think she’d be really great, and she and especially Margie can give you a sense of how health care has changed and some of the laws in terms of what people can get coverage for. And there’s a lot of stuff that I’m just learning myself in terms of what standards of care are in the profession, when you have a ten year old who comes in and says, “I’m trans,” and maybe not in that language, but what are the standards of care? What do you do with that? And then people talk a lot about people detransitioning, the way it’s described as people think they’re trans for a couple years and then they’re not, that’s pretty rare, but it does happen, and then how do you deal with that, and what does it tell us about the nature of a transgender identity, and what does it tell us about the practical treatment protocol, and Margie knows a lot about that stuff.
Do you deal with– have you had much interaction with WPATH in terms of–
Margie has and we– she actually, she was involved with, I should know this off the top of my head, she was involved with AASECT, AASECT is the American Association of Sex(uality) Educators, Counselors, and Therapists, I think I got that right. I might have messed up one of them, and she wrote something, some statement for them recently, she’s on the board for them, this is a new development, and they’re– I think she wrote some sort of release statement for them recently endorsing the WPATH standards or something. Again, this is an area I need to know more, and I’m still learning about. She’s had some involvement with that whole aspect of mental health care, she’s a great person to ask about that, unfortunately I don’t know as much as I should about it.
Anything else? The other thing I would say is that this doesn’t have to be the only time, if anything comes up and you think, “Oh I want to say more about THAT,” we can set up another time to chat too, so I’ll go ahead and stop the recorder now.