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Gender Inclusivity in Music Therapy

Hey there, this is Jocie Purcell, MT-BC (they/them/theirs). I have been given the opportunity to address the wave of gender-affirming inclusion that many institutions of education and leadership have embraced recently. You may be familiar with the concept of preferred pronouns and gender identity. You alternatively might not understand the meaning or importance of stating one’s pronouns. As said by GLAAD’s Mary Emily O’Hara, "Pronouns are basically how we identify ourselves apart from our name. It's how someone refers to you in conversation." Stating your own pronouns is something everyone can do. It models authenticity, which can be highly valuable when building rapport with clients and encouraging them to arrive and participate with their whole selves. Offering the opportunity for participants to state their preferred pronouns allows them to share a part of their identity. We all experience gender identity as we interact with the world, and offering the option to share pronouns in a therapeutic setting is an easy adjustment that a MT can make in order to show empathy towards their clients, and create a LGBTQIA+ friendly and gender-affirming environment. 

Gender and Music Therapy

Research reveals that gender influences the experience of music therapy. Musical participation including choosing an instrument, vocal quality, and genre preference is affected by gender stereotypes. The phenomenological study by Cassidy Besse, MME, MT-BC presents the prevalence of cis-normative social cues and norms that influence the therapeutic relationship between the client and MT, and the music. The goal of this study was to ask questions regarding the influence of gender, to challenge norms, and seek to provide better music therapy practices.

Instruments such as the piano, violin, clarinet, and piccolo are seen as typically feminine instruments whereas the drums, trumpet, guitar, and tuba are seen as masculine. Within a singing context, stereotypes of vocal expression are also distinguished into the feminine (a light, high, and easy voice) and masculine (dark, low, and forceful). Additionally, preference of genre is assumed in binary terms with pop, electronic, and blues as feminine and rap/hip-hop and heavy metal as masculine. The conversation of gender stereotypes is very cis-normative, and ignoring these things or assuming a client’s gender may be harmful to individuals outside of the binary. These associations have been enforced and perpetuated by Western society, but they are penetrable. The key to becoming a gender-aware MT (GAMT) is learning and recognizing these associations in context, and rejecting them in order to create a therapeutic space that allows individuals to participate freely. Becoming a GAMT stresses the recognition of one’s own systemic privileges. For example, I identify as  white, non-disabled, middle-class, and female-presenting. Given my privileges, I can only understand a fraction of what others experience. However, I seek opportunities to learn about the perspective of other backgrounds. It's important to acknowledge that the music individuals choose and show interest in may represent the identity which they hope to reflect back into the world (Besse, 2021, page 153). 

Sharing pronouns

As a nonbinary person, I have faced challenges in various music therapy settings regarding gender-related issues, and I hope to provide insight for the network of professionals who read this article, in order for them to go forth as stronger allies and supporters of the LGBTQIA+ community. A great tool is offering clients in a group setting an appropriate number of opportunities to share their pronouns with the MT and the rest of the participants. Routinely sharing pronouns when learning names is to emphasize a judgment-free, accepting space for healing. Furthermore, sharing pronouns gives transgender individuals the option to exercise the self-advocacy that they might not be given in other environments. Associate Professor of Music Therapy at Berklee College of Music, Kei Slaughter (they/them/theirs), describes how they invite a gender-affirming environment in their work:

 “I ask participants how they'd like to be called (names, nicknames, etc) and do my best not to assume what someone's gender is based on physical traits, how they dress or choose to express themselves, etc.. I strive to acknowledge the existence and presence and relevance of trans, non-binary, and gender diverse identities when discussing a range of topics, whether in therapy spaces or the classroom. This could include things like talking about gender roles, relationship dynamics, or pronouns in song lyrics.”

The routine of sharing names and pronouns can be repeated long after the initial introduction at the beginning of each session, and can lead to an increased sense of trust between the participants and the MT.


Field Experience

At an eating disorder recovery program’s music therapy sessions during 2023 in Moss Beach, CA, I would always offer the opportunity for participants to state their pronouns every session, regardless of whether they had attended the group before. While some participants did not know what it meant to do so, others willingly shared and even stated new pronouns throughout treatment as they built a new relationship with their identity and developed the courage to share it with their peers. Humans are ever-evolving beings, and this tool encourages an accepting environment that recognizes the complexity of identity and self-image. Here are some examples of responses that may be useful when discussing this topic.

Human First, Music Therapist Second

When I’m working, I understand that not everyone I meet is going to understand how I present myself to the world, nor will every setting be a safe space for me. I take time to recognize when it is relevant for me to involve my pronouns. Professor Slaughter shares: “It doesn't always feel emotionally safe for me to explicitly disclose my gender identity in the classroom space or in my clinical work and I try to sort that out on a case by case basis.” 

As mentioned before, welcoming gender expression may contribute to a sense of trust in the therapeutic relationship. I typically will only share my pronouns in groups of young adults (age 18-35). When I share my pronouns, it is with the purpose of building safety in the room, as if to say, ‘Here’s my vulnerability; we are in this together.’ Slaughter discusses the role that cisgenderism plays in daily life and in work settings, and how it intersects with racism: “I've certainly had to be aware of power structures that privilege cisgender identities or heterosexual or heteronormative identities or white bodies in my workplaces and have encountered various microaggressions on account of these things.” The GAMT study participants all identified as white, which proposes the need for research covering the intersectionality of gender and race within the therapeutic relationship and music therapy practice. Kimberlé Crenshaw is a pioneer in the research of intersectionality, and her book can be found at the end of this blog under ‘References’. The biases of nonbinary and transgender identities have daily impact on professionals who identify as such, and I believe increasing awareness of these biases will lead to growth in the music therapy field and beyond. I have found that having openly LGBTQIA+ mentors and authority figures in my life has increased my sense of pride and bravery in my personal and professional life. Now that I have the responsibility of creating a safe space for my clients, I try my best to be a strong advocate for them in this area. 

I don’t always share my gender identity with my clients because the sessions aren’t about me. I try to maintain a client-centered approach in my field work. When working with older adults, I expect people to misgender me based on how I look. However, I don’t correct them or even address it because it has nothing to do with the therapeutic goals within that setting, nor is it within my role as a MT. However, in assisted living homes I may offer male seniors the choice between one orange and one pink (a color societally associated with the female gender) instrument, rejecting societal gender norms. When I establish a therapeutic relationship with my elementary-age individual clients, I’m focusing on their development and their relationship with music. At the same time, I encourage my individual clients to vocalize in whatever way they are capable; soft, loud, airy, guttural, etc, without gender expectations. On another note, I agree with the implications in Besse, 2021 that gender may not directly affect the development of the therapeutic relationship. There are many other aspects of an individual’s identity that come up in sessions. This is merely a Post-it note of information to consider when approaching music therapy.

It has been my experience that most often in music therapy settings where mental health is a larger topic of discussion, sharing pronouns has positive benefits for the client and the therapeutic relationship: “Individuals should be encouraged to engage with music in a way that frees them from strict societal expectations, and oppressive systems to ensure a salient, therapeutic experience” (Besse, 2021 page 158). Slaughter states that sharing pronouns helps to facilitate a stronger sense of community in any space, it challenges binarism, cisgenderism, other forms of gender-based oppression. Their hope in their academic and clinical work is to “leave space for some of the new, hidden knowledge that they/we have yet to encounter or that has yet to be revealed to us.” As a Black non-binary AFAB MT, Slaughter is made constantly aware of the narrow, oppressive ideologies and practices that pervade the music therapy field, and they are navigating the learning process of creating safe spaces where they can acknowledge gender stereotypes and sociological impact of gender. They say, “A long term benefit of sharing pronouns among other gender-affirming practices is that it enriches that quality of living in the present and as we authentically are.” Insisting upon a gender-affirming environment emphasizes “autonomy, agency, and co-constructed safety among therapists and clients, instructors and students.” It is important to be intentional when encouraging gender-expression; allow others the opportunity to completely be themselves without forcing them to. We should encourage authentic, creative, and exploratory expression through music. No judgment, no expectations, no fear.


Kei Slaughter MFA, PLPC, MT-BC  

Owner/Music Psychotherapist, S O U L F O L K Sounds LLC 

Associate Professor, Music Therapy, Berklee College of Music 

Doctoral Student, Expressive Therapies, Lesley University

Besse, Cassidy (2021). Gender Aware Music Therapy: An Interpretative Phenomenological Analysis. Music Therapy Perspectives, 39(2), 152–161.

More Research on Gender in Music Therapy:

Abeles, H. (2009). Are music instrument gender associations changing? Journal of Research in Music Education, 57(2), 127–139. doi:10.1177/0022429409335878 

Bain, C. L., Grzanka, P. R., & Crowe, B. J. (2016). Toward a queer music therapy: The implications of queer theory for radically inclusive music therapy. The Arts in Psychotherapy, 50, 22–33. doi:10.1016/j.aip.2016.03.004

Delzell, J. K., & Leppla, D. A. (1992). Gender association of musical instruments and preferences of fourth-grade students for selected instruments. Journal of Research in Music Education, 40(2), 93–103. doi:10.2307/3345559

Scrine, E., & McFerran, K.  (2018). The role of a music therapist exploring gender and power with young people: Articulating an emerging anti-oppressive practice. The Arts of Psychotherapy, 59, 54–64. doi:10.1016/j.aip.2017.12.008

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