“There’s Something to Remind You that Everything Is Okay”: Australian Trans Young People and the Presence of Animals in Interactions With Healthcare Professionals

Abstract

While animals have long been a focus in therapeutic spaces for young people via approaches such as animal-assisted therapies, there is a sense in which such approaches overlook the broader contribution that animals play by being present in young people’s lives. In this article, we explore how the presence of animals (both physical and psychological) in interactions with healthcare professionals may hold specific meaning for trans young people living in Australia. Participants were recruited through Parents of Gender Diverse Children. Interviews were conducted in November 2021 with 17 trans young people and one of each of their parents living in Australia. All interviews were audio recorded, transcribed, and analyzed using thematic analysis. Two main themes were developed: (1) how healthcare professionals respond to conversations about animals and (2) the beneficial role of the presence of animals. The article concludes by discussing the importance of thinking about the presence of animals beyond existing frameworks and recognizing the value placed on the presence of animals by trans young people.

Introduction

It is often noted that animal-assisted therapy for children began with the unplanned presence of an animal in a therapeutic space. Levinson (1969), typically considered the founder of animal-assisted therapy for children, shared that Jingles, a dog whom he lived with, who was typically not allowed in the therapy space, greeted a distressed child who arrived early for an appointment, licking the child and eliciting a positive response from the child who then cuddled Jingles. Much has been written and researched since that time about the positive effects of animal-assisted therapies for children (see Charry-Sánchez et al., 2018; Feng et al., 2021; Hoagwood et al., 2017 for summaries). Research has found that it is the presence of animals and the relationships they engender that help humans feel grounded (Fine, 2017; Mallon, 1992). Yet, even accounts of such relationships can be reductive, denying animal agency. For example, Zilcha-Mano et al. (2011) summarize existing research and suggest that animals serve as ice breakers; that they help to establish rapport and reduce resistance; while at the same time stating that the “mere” presence alone of animals is not “sufficient to be helpful” (p. 545).

In this paper, we challenge the idea that the “mere presence” of animals is not enough to be helpful. To suggest that the presence of an animal in a therapeutic space is “mere” is to reduce animals to insignificance. Would we make the same reading of human therapists who sit in silence with their clients—would we describe their presence as “mere”? The word “mere” suggests something more must be added: that for animals to be considered helpful, they must do more than “be with” humans. To explore this line of questioning, we draw on a qualitative study in which we interviewed Australian trans young people and their parents about their relationships with the animals they lived with, including in terms of the presence (both physical and psychological) of animals when the young people undertook sessions with healthcare professionals.

Focusing on trans people specifically, Riggs and colleagues (2021) have theorized that animal companions may offer a unique form of recognition for trans people. Contrary to the popular liberal assimilationist narrative of trans people that “the gender changes but the person remains the same,” Riggs and colleagues explore how animals may often recognize that what changes for trans people is more than just a label. Rather, and particularly for trans people who commence hormone therapies, there are physiological, behavioral, and interpersonal changes that animals cue into, and engage with. Animal companions are valued by many trans people in a version of Franklin’s (1999) account of animal companionship as offering a form of ontological security, such that ontological shifts experienced by trans people are witnessed and recognized by animal companions in ways not necessarily recognized by other humans. Further, and as outlined in a collection edited by Vakoch (2020), the concept of “trans ecologies” frames trans people’s lives in a broader environmental and social context, such that analogies are made possible between the harms wrought against trans people by toxic social contexts and the harms wrought against the environment by human society. Trans ecologies, as a concept, also creates a much-needed space to examine how trans people’s lives sit in a relationship to animal lives, both in terms of harms experienced, but also in terms of a broader resistance to the binary of culture and nature.

As we explore in this paper, trans young people navigate experiences of distress that are wrought at multiple levels. Distress may occur as a result of the internalization of social norms about trans people’s bodies and lives. It may occur as a result of external forces that seek to (often violently) enforce such norms. As a result, many trans young people are likely to seek therapeutic support for responding to this distress, as well as seeking access to medical aspects of gender affirmation. Importantly, our focus in this paper is not on animal-assisted therapies for trans young people (i.e., formally trained and recognized assistance animals). Rather, our focus is on the role that animals play in the lives of trans young people who interact with clinicians in a diversity of healthcare settings: animals as a topic of conversation between client and practitioner, animals who live with trans young people being present during telehealth sessions, and for a small number of participants, an animal companion of a healthcare professional being present in a session. In all three situations, these animals are never simply a “mere presence.” Rather, their presence can be the basis of strong, meaningful, and unique bonds that trans young people experience, as family members or friends who help to facilitate connections with healthcare professionals, and more broadly to be motivated to undertake therapeutic work within the clinical space.

Materials and Methods

Researcher Reflexivity

We come together as a team of academics with differing genders, sexualities, gender histories, engagements with animal rights, experiences of living with animals, and experiences of academia. While we work together as a team, we are very mindful of our differing experiences and standpoints, even within our broad parameters of feminist, intersectional, and critical human–animal politics. What brings us together is our commitment to animal rights and our views about the importance of focusing on animal and LGBTQ human lives.

Participants

Ethics approval for the study reported in this article was granted by the Flinders University Social and Behavioural Research Ethics Committee. The study was undertaken in partnership with Parents of Gender Diverse Children, an Australian organization that supports trans young people and their families. The organization circulated a flyer advertising the study via their social media. This was shared widely by other organizations and individuals, making it difficult to determine response rates out of the target population who potentially viewed the advertising materials. Inclusion criteria were (1) being a trans young person aged 10–17 years, (2) living in Australia, (3) living with at least one animal, and (4) being willing to be interviewed with a parent (an ethics requirement to ensure the safety of young people). Upon contacting the research team, interested people were sent an information sheet, a full one for parents and an abridged version for young people. Interested people were then asked to complete a brief demographic form and parental consent form, and to organize an interview time with the second author. During the interview, young people were asked to assent to participation. Both parents and young people consented to their transcribed interview material being used in subsequent publications. Participants were given a $50 voucher as recognition of their time and contribution to the study, reflecting broadly agreed upon practice in Australia, especially for members of marginalized group who often face a considerable demand for time from researchers.

In total, 17 parent–child pairs participated in the study. Of the parents interviewed, 15 were women and 2 were men. The average age of parent participants was 47 years (range 38–54 years). Young people participants reported a diversity of genders: non-binary (5), male (6), female (5), and gender fluid (1). The average age of the young people interviewed was 14 (range 10–17 years). Participants lived in one of six Australian states or territories: Victoria (5), New South Wales (3), Queensland (4), South Australia (3), Australian Capital Territory (1), and Western Australia (1). Most participants described their cultural background as Australian, though a small number described having European backgrounds. Parents reported that their children were seeing a diversity of healthcare professionals related to being trans, including endocrinologists, counselors, psychologists, general practitioners, fertility specialists, surgeons, social workers, and speech pathologists. Between them, participants lived with 23 dogs, 14 cats, many fish, as well as reptiles and birds. Parents described the relationship between their children and animals as either siblings, primary caregivers, friends, companions, co-carers, walkers, mothers, or aunties.

Materials

Participants were interviewed by the second author via Zoom in November 2021. All interviews were undertaken when the participants were in their own homes. Interviews began with a short introductory overview provided by the second author, where the research team was introduced, along with the focus of the study. Young people were then asked to provide assent to participation and were asked to provide their pronouns. Participants were then asked about the animals they live with, with many introducing their animal companions on Zoom. The focus of the present article is on the interview questions: “Have you ever talked about your animals with your healthcare professionals?” with prompt questions being “what did you talk about?” “how did the healthcare professional respond?” and “was it helpful to talk about your animals?” Participants were also asked “Do you think it might be useful to you to include animals in healthcare session?” with prompt questions being “why might it be especially useful to you as a trans young person?” and “how could healthcare professionals be inclusive of your animals?”

All interviews were audio recorded. Interviews lasted on average for 33 min (range 18–48 min). Audio recordings were transcribed by a professional service, and pseudonyms were allocated by the research team. Participants had the option to review their transcripts. Only a small number elected to do so, and of those who did, only one made minor changes to some of the identifying information included.

Analytic Approach

Following Braun and Clarke (2023), the analysis reported in this paper adopts a “Big Q” approach, referring to our interest in meaning-making practices among our participants in collaboration with us as researchers (and the second author as interviewer in particular), rather than simply seeing interviews as a means to an end to collect a certain type of data (what Braun and Clark refer to as “small q” approaches to qualitative research). In terms of our rationale for using Braun and Clarke’s (2006) approach to reflexive thematic analysis, again we echo Braun and Clarke (2023) in suggesting that the theoretical flexibility inherent to their approach was well suited to our interest in writing this paper. Specifically, our interest was to adopt a critical realist approach: one in which we could take as given our participants’ views, whilst also examining the broader social structures within which their narratives are located, including us as authors.

For the purposes of the present article, responses to the interview questions outlined above were extracted for analysis. Having extracted interview responses, the first author coded the data according to the approach to thematic analysis outlined by Braun and Clarke (2006). The first step in this process involves familiarization with the data set through repeated readings. The first author read all of the transcripts three times, looking for repeated topics or codes. Having developed codes based on repeated readings of the transcripts, the first author then shared these codes with the other authors, who confirmed the codes as representative of the data set in terms of core topics. The first author then developed themes based on the codes.

For this article, two main themes were developed through a process of repeated readings of the initial coded data, and developing codes into coherent thematic groupings. The two main themes each encompass three sub-themes. Having developed these themes and sub-themes, the first author again shared them with the other authors, who confirmed the thematic structure. The first author then identified and collated representative quotations for each theme. As such, the quotations included in the results are indicative but not exhaustive of each theme. Given the relatively small population size and the potential for identification, in the results below, we do not differentiate participants by age or gender or the type of healthcare professional they are speaking about. Where relevant, we mention where animals are living with participants and include parent responses where appropriate.

Results

Healthcare Professional Engagement With Animals as a Topic

Within this first main theme, three sub-themes were developed. These were (1) talking about animals is limited to information gathering, (2) substantive engagement with animals by healthcare professionals, and (3) healthcare professionals sharing about their animals.

Talking About Animals Is Limited to Information Gathering

Several participants indicated that some healthcare professionals had asked them about their animal companions, but this is where their curiosity about clients’ animals ended. Typically, part of routine intake interviews focused on getting to know the young person and their family situation and included questions about animals. For example, Emilia and her parent shared that Emilia had been asked about her animals:

Interviewer: Have you ever spoken about your animals with any of your healthcare professionals?

Parent: Yeah, your [healthcare professional] asked you about your animals.

Emilia: Yeah, they did too.

Interviewer: Could you tell me a bit about that?

Emilia: So, basically, they just asked what my animals were and their names, and that was basically it, wasn’t it? Yeah, she was just getting the family. I felt like we basically narrowed them down to names and what they are, basically, yeah.

While it is notable that animals were asked about as part of the family, the information sought was “basically” about names, rather than further detail being sought about relationships with animals and their role in the young person’s life. Similarly, in the following extract, the parent noted that animals were asked about, but that it was “just making conversation”:

Interviewer: Have you ever spoken to any health care professional about your animals in any way?

Parent: [Healthcare professional] asked about pets, and when you saw [other healthcare professionals] they also asked about pets. I think they were just making conversation.

Interviewer: So, can you remember anything about how that conversation went?

Parent: I think they were just asking about family dynamics and stuff and who’s in the house and asked about pets.

Again, while it is notable that animals were asked about in the context of “family dynamics” (i.e., that animals were potentially being viewed as family members), the conversation did not extend beyond basic information gathering. Cameron, below, noted specifically that it would be beneficial if healthcare professionals did more than just ask about animals in the context of information gathering:

Interviewer: I’m wondering, is there something that your healthcare professionals could do to make you feel more safe and comfortable to speak with them?

Cameron: I suppose when you do that whole introduction session, asking more questions about the roles that your pets play in your life. Because, for me, it’s been, “Do you have any pets?” “Yes, I do, these are them,” and they’d be like, “OK, sick, moving on.” It’s not like an in-depth kind of thing, like, “How long have you had them for? What connection do you feel for them?” It’s kind of like, “Oh, you have pets, cool. Now, let’s move onto the nitty-gritty of your gender dysphoria.” It’s not a whole discussion about the role that they play.

As Cameron notes, it is indeed a useful approach to ask about animals when seeking to learn about a young person’s life, but this should extend beyond simple demographics. Rather than seeing animals as background information and topics like gender dysphoria as substantive topics, Cameron suggests that both topics should be treated as substantive so as to gain a deeper insight into the young person’s inner world.

Substantive Engagement With Animals by Healthcare Professionals

In contrast to participants included in the previous sub-theme, other participants noted that their healthcare professionals treated animals with a substantive focus, such as in the following extract:

Interviewer: You said you spoke with your healthcare professional about them. How did they respond to discussing your animal?

Mason: They were like, ‘Oh my God. She is so cute’, and just asking if she was helping and how the relationship was between us, and they said that it was just great that I could have someone there.

Interviewer: Did you feel like it was helpful for you to actually be able to have a conversation about your animal companion and that sort of relationship?

Mason: Yeah, I definitely think it was and it made me think about it more and just that gratitude again, think about that more as well.

As Mason notes, not only did the healthcare professional respond positively to mention of an animal, but they went beyond this response to ask more about the relationship and to speak positively about the benefits of the relationship for Mason. For Mason, this helped him to feel gratitude, not just for the healthcare professional’s response but also for his relationship with his animal. Other participants too, such as Ari, noted that healthcare professionals appeared to love animals shared by participants:

Interviewer: Have you ever spoken about him or your other animals with any kind of healthcare professionals?

Ari: I talked with [healthcare professional] about him sometimes about how he’s doing, what kind of mischief he’s been up to.

Interviewer: How does your healthcare professional respond to that?

Ari: Very good, very positively. She loves him. He’s very fluffy and cute.

While Ari did not elaborate in detail about the response from the healthcare professional, the emotive response provided appeared to constitute a meaningful interaction for Ari, over and beyond simple information gathering. For Shay too, the response by a healthcare professional recognized the important contribution that animals can make in the lives of trans young people:

Interviewer: Can you remember anything about your healthcare professional’s response to you talking about your animals?

Shay: Well, she said she thought it was a good idea for stress, and helping me at home and that kind of thing. Yeah, when she was talking about how to help my stress, she said that was a good idea to spend time with my dog and that would help.

Here, animals are viewed as important sources of support by a healthcare professional, recognizing the significance of the animal–human bond. While in a certain sense, this is reductive (i.e., animals as a source of stress relief somewhat absent of discussion about the relationship), for Shay, it would appear that recognition of the role of their animal was important.

Healthcare Professionals Sharing About Their Animals

In addition to feeling that healthcare professionals were receptive to conversations about animals over and above information gathering, our participants were especially taken by healthcare professionals who reciprocated by sharing information about their own animals. For example, Greyson noted that his healthcare professional “shares stuff” about her animal:

Interviewer: What does a conversation with your healthcare professional look like? Like, so you might say, “I did this with my animal today,” how do they respond to that?

Greyson: She’s like, “Oh, that’s so cute,” and then we talk about the cats. And she shares stuff about her animal as well, she’s got a dog.

Some parents, such as in the following extract, noted that healthcare professionals who talked about their animals helped to reduce a sense of clinical distance:

Parent: Seeing [healthcare professional’s animal] was so important. We would never have seen that side of her otherwise. We don’t know, because she kept really clear clinical boundaries, we don’t know anything about her or her family, or where she lives or any of that. So, it was nice that she picked up her little dog, and introduced us to her dog and I think it important.

While it is understandable that healthcare professionals would seek to maintain “clinical boundaries,” the professional veil drops a little when talk turns to animals, allowing young people and their parents to see a different side to professionals. When animals play a significant role in the lives of trans young people, moments like these can help to strengthen the alliance between professionals, clients, and their parents, allowing young people (and their parents) to see the importance of animals for healthcare professionals too. For Zeffie (below), talking about animals with healthcare professionals was important, regardless of the broader topic of the interaction. When healthcare professionals responded in kind, it was highly valued:

Zeffie: I think [two of my healthcare professionals] are probably the ones that I bring the animals up, probably too much. Even if it’s a really casual interaction, and I’m there for five minutes, and she’s like, “Hey, what have you been up to this week?” I’m like, “Well, here’s all the things that my dog did,” and it’s in chronological order.

Interviewer: And how does she respond?

Zeffie: Well, she loves dogs, she’s obsessed. She has like a framed picture of her dog on her desk, and her watch background is her dog and her phone background, she loves dogs.

A love for animals appeared to provide some of our participants with a window into the lives of their healthcare professionals. Zeffie noticed the multiple small examples that a healthcare professional gave as a fellow animal lover.

How the Inclusion of Animals Is Beneficial to Clinical Care

In this second main theme, we focus on what our participants perceived to be as the benefits of including animals in clinical care. Within this main theme, we developed three sub-themes: (1) animals make clinical sessions relaxed, (2) telehealth-specific benefits of animal presence, and (3) physicality of animals a comfort. We explore these three sub-themes in turn.

Animals Make Clinical Sessions Relaxed

For many of our participants, there was a sense that animals made sessions with healthcare professionals more relaxed. This was most evident when it came to talking to healthcare professionals about difficult or challenging topics. The presence of animals had a calming effect that helped participants to stay grounded. Mika, for example, was thankful that the healthcare professional’s animal inserted themself into the therapeutic space:

Mika: I think she [professional] had some sort of hound, and they just – I don’t know the pronouns of the dog, they just came and lay at my feet, and it was just because we were talking about really heavy stuff, like gender identity. So, it was quite a heavy topic, and this dog just came and lay at my feet after five minutes. Like it somehow knew that I was struggling in the conversation a bit, and it was just so helpful and kind. Yeah, I was so thankful.

In some ways similar to Jingles, this dog appeared to “somehow know” that Mika was dealing with heavy topics, and came and sat near him. For Mika, the dog’s presence was very much welcomed and helped him through a difficult conversation. Mason too noted that in difficult sessions, having an animal present would be helpful:

Interviewer: What would be good for you to have relief in terms of maybe having an animal as a support in those therapeutic scenarios?

Mason: Well, obviously there’s gender dysphoria and sometimes it just clicks in your brain and gets really bad for those sessions. It’s basically like a panic attack. So, I think having an animal out with you when it’s getting really hard and sometimes there’s little kids who don’t know when they come up to you and ask questions like, ‘Are you a boy or a girl’, and go on and on. I think in those times it would just be good to have something there to be like, ‘It’s all right’. There’s something to remind you that everything is okay.

Different to Mika, Mason here is conjecturing about how the presence of an animal might help during sessions where things get “really bad.” While we must acknowledge here the objectification of animals to a certain degree (i.e., an animal is “something”), we would emphasize our suggestion that this framing of animals speaks to the topic of presence. In other words, being a something rather than (or in addition to) a someone potentially speaks to the role that animal presence plays for trans young people, a topic we take up in more detail in the discussion below. For Emilia, the potential presence of an animal played a role in helping her feel safe to speak:

Interviewer: So, what do you think might be a benefit of having [animal] at an appointment with your healthcare professional?

Emilia: Well, then I can say what I have to say, and them hearing me, and not being as stressed as to people judging me. Because, I feel, I can just imagine that I’m talking to the animals.

Animals do not judge humans’ social identities. For Emilia, there was always the potential as a trans young person that other people, including healthcare professionals, will judge her. This concern about potential judgment can serve as a barrier to conversations in the clinical space. For Emilia, then, the presence of an animal would allow her to imagine she is talking to the animal, thus reducing her sense of being judged.

Telehealth-Specific Benefits of Animal Presence

Given that our interviews were conducted at a time when COVID-19 was a significant concern in most Australian states, with many healthcare professionals continuing to see clients remotely, it is not surprising that many of our participants spoke about animals in the context of remote sessions. This sub-theme is similar to the previous in that it focuses on the calming presence of animals. However, it is different in that it focuses specifically on how the presence of animals is useful in the context of telehealth. Galen, for example, noted that telehealth provided him with opportunities to purposively include animals in the session:

Interviewer: So, obviously, some people include animals, whether in the room or in tele-health, like Zoom sessions, they include animals in healthcare or therapy sessions. Is that something you’ve ever done?

Galen: When I used to do [extra curricular activity], at the end of every session I’d give my teacher close ups with [animal]. When it comes to when he pops up in conversation, like over a tele-health, I’ll generally manage to skew the frame and show that he’s sitting in the background.

Here, there is agency occurring in two ways. First, Galen is able to “skew the frame” in the telehealth session to include his animal in the session. And second, the animal “sitting in the background” reflects their interest in being physically near Galen. This kind of connection can be very comforting for humans and animals. For participants such as Emily, being able to turn away from the screen to look at an animal was a welcomed relief:

Interviewer: What sort of affect does your animal being present on telehealth have?

Emily: It gives me something else to think about.

Interviewer: So, it feels like a distraction?

Emily: Yes. A good distraction. Sitting in front of the screen can be a bit much, so I can look away at [animal].

Zeffie provided more depth on the topic of animals as a “distraction” in the context of telehealth:

Interviewer: Because of lockdowns or other reasons of inaccessibility, a lot of people have had tele-health appointments. So, have you ever had tele-health appointments with your animals around?

Zeffie: Yeah, I’ve had a few tele-health, quite a few of them. And without fail pretty much every time I have the dogs in the room. Even if they weren’t, generally, in camera or I wasn’t even sitting there patting them or anything, but just having them in the room. I’m not great with eye contact, so, if there was ever a point in conversation that I found to be really – not emotionally distressing, but I found to be a bit hard to talk about and I didn’t want to make eye contact, I could just look at the dog. And if they were off camera, but I could just look at them, and found it easier to continue talking, and be like, ‘That’s cool, I can feel a bit more free to talk about that now’, because it’s sort of a distraction of just, ‘The dog’s there, the dog’s my support person’.

Telehealth, for many people, evokes different demands about eye contact as compared to in-person healthcare sessions. For participants such as Zeffie, then, animals provide a means to orient away from the rather singular focus of the screen, and to instead take a moment out, and to feel supported by the presence of an animal. While Zeffie, similar to Emily, frames animals as a “distraction,” this is more than simple objectification. Rather, it speaks to the presence of animals as an emotional anchor, eliciting a sense of “freedom” from the constraints of telehealth.

Physicality of Animals a Comfort

Finally, in terms of the beneficial aspects of animals being present during sessions with healthcare professionals, some participants spoke about animals’ physical presence being important—close enough to touch. Jay, for example, spoke about patting an animal as being helpful during stressful sessions:

Interviewer: What’s a good way for a healthcare professional to work with you and an animal?

Jay: Well, if they let me have the animal right next to me and I’m patting the animal while I’m doing whatever they’re doing during their session, because appointments are stressful.

Parent: We had to do an evaluation over multiple sessions. And we took our dog each time. She did let you do a big cuddle before you went in each time and then she’d just sit down and that helped, and you went in, and you did it.

Here, Jay’s parent shares that having an animal in attendance during evaluation sessions helped to mitigate some of the significant stress that Jay felt about these evaluations. Specifically, it was the physicality of a “big cuddle” that helped prepare Jay for the evaluations. Shay also spoke about physical touch with an animal as comforting:

Interviewer: So, imagining that maybe get to take [animal] into the doctor’s office, or maybe to a stressful appointment or something like that, how do you think that that might be useful?

Shay: It might help me feel a bit more comfortable when I’m talking, or I can pat my dog while I’m in the session and that might help a bit.

On initiation from the second author, Shay conjectured why the presence of an animal might be helpful, suggesting that patting an animal would “help a bit.” Similarly for Kasey, having an animal present allowed for the possibility of holding an animal when sessions were too intrusive:

Interviewer: Do those healthcare settings stress you out sometimes?

Kasey: The [clinical setting] definitely does. I don’t like it. It’s loud and there’s lots of people everywhere and it smells weird. It’s a bit nerve-wracking to have to talk about my personal issues. It’s ‘I don’t really want to talk about that’, but then having the cat or emotional support with me, it’s easier. Just have that thing there to hold and be warm and pat and have that grounding.

Kasey’s cat offers “emotional support” by being willing to be held—something cats usually only do when they are very attached to humans. In its physicality, this support is grounding. Also important to the story is that the cat is present to be held: that they are in the room.

Discussion

In the introduction to this article, we queried the framing of the “mere presence” of animals as insufficient to qualify as contributing to positive therapeutic outcomes for young people. In the results above, our participants oriented in many ways to the presence of animals that speaks to benefits, absent of purposively directed therapeutic animal-related goals. With that in mind, below we first summarize what we see as the key aspects of animal presence that our participants suggested were important, before then exploring how we might think about animal presence differently.

First, looking at the first main theme, our participants wanted their healthcare professionals to do more than acknowledge the existence of their animals. They wanted to have interactions where animals were actively asked about, valued as family members, and recognized as a significant source of support. This was more likely to happen when healthcare professionals shared their own love of animals. Both physically and psychologically, animal presence takes specific forms. It includes engaging with animals as a substantive topic, rather than simply as an initial point for information gathering. It includes a shared love for animals, including that reflected in the healthcare professional’s physical possessions (such as dog photos on desks). And it includes a proactive welcoming of conversations about animals. Here, we might think about the mindful presence of animals: a presence in which healthcare professionals actively orient to animals.

Second, the presence of animals is not simply the presence of an object, despite some of our participants using the conventional language of an animal as “something.” Rather, the presence of an animal in the context of interactions with healthcare professionals marks the presence of an agentic subject, one who might sit in the background, or come and sit by someone, or give them a cuddle, or walk past the computer screen. This is a presence, then, that is non-directive as much as it is directive: it is a presence that can be purposively called on by young people or healthcare professionals (i.e., as a “distraction,” a comfort, or a touchstone), or it can be a presence directed by the agency of the animal (i.e., animals inserting themselves into interactions). Again, this is more than the existence of an object, and the animals’ presence is not necessarily pedestrian, even when they are still and silent. Rather, it is the existence of animals whose presence often makes a meaningful contribution to the clinical space.

Our findings suggest that positioning the presence of animals as “mere” does a great disservice to both animals and to their human companions. For trans young people in particular, who have been our focus in this article, the presence of animals in the context of interactions with healthcare professionals highlights the importance of the bonds that trans young people experience with animals. Perhaps more specifically, animals make a positive impact simply by their presence because they are not human. Certainly, they engage with us humans, come to know our ways, and their own ways are often shaped by our own. But more than that, animals always also have their own ways of being, ways of being that bring meaning to trans young people. They may serve as reminders of the caring relationships trans young people have. They may provide a sense of safety in otherwise challenging clinical settings. And they may help to connect trans young people to their own passions and desires. All of this is to say that the presence of animals brings with it a reminder that there is more: more to life than dysphoria, more to life than the immediate moment of the clinical encounter, and more to life than human interactions that may not always be satisfying. The presence of animals is thus never “mere.” Instead, it is a reminder that there is always more to the world than what humans might make of it.

Drawing on a sample of young people diverse in ages and genders, this article provides a solid base for future research. This would include more interviews with young people about what the presence of animals means, thinking closely about both physical and psychological benefits. More broadly, it would include interviews with young people that ask them how their relationships with animals potentially help them to think differently about the world. Additionally, future research could usefully involve interviews with healthcare professionals, to ascertain their views on the inclusion of animals when working with trans young people, and the potential role of animal-assisted therapy in working with trans young people. Ethnographic work could look at how animals engage and are engaged with in the clinical encounter, including in the context of animal-assisted therapy. It is also important to note that not all humans—trans young people and their parents included—relate with animals. While our participants spoke about positive relationships with animals, some trans young people relationships may experience distant or fraught relationships with animals. Further research may usefully evaluate parental views about the role of bonds with animals in the lives of trans young people, but also explore what it looks like for trans young people when relationships with animals are fraught. Another important lesson from this research is that animals must not be reduced to objects. Reducing animals to objects in the lives of trans young people does a great disservice to animals themselves, and may be counter to the best interests of such young people, given the significance of their relationships with animals. Bonds with animals may help trans young people to situate themselves in a realm of possibilities not anchored or limited by human expectations, norms, and limitations. Celebrating the presence of animals—for both trans young people and their animals—is thus both the very least we can do and potentially constitutes a significant intervention into the lifeworlds of trans young people.