Sexuality & Gender Identity Therapy Columbia SC | A Personal Framework
- Mark Stewart
- May 3, 2025
- 5 min read
Updated: Feb 23
The Disclosures That, For me, Opened My Perspective
In another of those life instances where things somehow proceed like "crawl, run, stumble," I found myself sitting, silent and still, as a childhood friend worked through the anxious challenges of making a BIG disclosure. I was not yet a counselor, and untrained in listening and heightening emotional experiencing. They spoke for a bit about things clearly meant to lead up to their main point, and I began to gather what this was about. Then, suddenly, they arrived at the moment and shared "I feel I am 5% the other gender." I didn't know what to say, but clearly whatever I did convey in that moment assured my friend that I got what they meant. I could see the relief bubble and flow as their energy relaxed, and they went on to share how their gender conceptualization had been a deeply protected (and hidden) secret since they were a preteen. Now they were seen. The sense of relief was palpable.
Some years later, over dinner with another friend who shared some salacious details of her dating life, I must have misconstrued her meaning because she quickly corrected me, saying "I'm situationally bisexual, though totally hetero-romantic." Oh, my bad.
I noticed that midlife was offering more of these interpersonal disclosures, and I began to wonder. As I started to learn more, I began to see more instances where people tried to explain the unknowableness of thoughts centered around self-conception of sexuality and gender. Unknowable as while for some people they both know themselves and are willing (and able) to name their internal realities, for most people, however, this is simply not the case. It is hard for people to defy social, cultural and religious messaging, first of all, and even more importantly, the unknown is largely unknowable. That is, we may feel we sense an internal distinction within ourselves, yet without any way to evaluate our feelings they remain murky, if not repressed or self-talked away. If we don't know, we don't know, that's usually the gist of it.
From REM Sleep Imagination to Theoretical Framework
Then, early one morning an idea came together in my imagination. I jumped up and sat at the kitchen table sketching this out before it was lost to the day's activity. I came up with this:

Fast forward some years. Rediscovering this model while cleaning out my emails, I was struck that I was now nearing the completion of my advanced degree in Marriage and Family Therapy - a second career after a long prior one of analysis, structuring and negotiation. I began to review the professional journals and publications, reading widely and as deep as I could find material - and soon discovered that the popular press (and especially the internet) contained more useful considerations of these twinned conceptualizations of sexuality and gender.
And yet, I also saw in these popular presentations a tendency to politicize more than personalize. I was more interested in the idea of providing a framework for people to consider their own internal thoughts and feelings, whether or not they choose to make these public. Reflecting back to my childhood friend, I saw the need to be truly seen can, and does, often co-exist with other personal choices around how we choose to present ourselves to others. Life is complicated, in some ways for everyone.
The Flip-Book Conceptualization Becomes a Welcoming Metaphor
So, I decided to flesh out this idea of a simple model based around the basic shapes of the letters M and W, which are traced out as one marks out responses to each of the five sexuality and gender considerations in the model (where someone could select and number or fraction between 1 and 5 for each of the five items).
As I considered how various people might respond, I also saw that the model can accommodate other lived experiences such as being transgender and asexuality, to any degree. The thing that brought the model to life for me was the realization that tracking responses across many people could be imagined as a flip-book of each individuals' responses. With each flip of the page, the letters would be different shapes and colors as they flipped and altered shape as the data points moved to reflect that individual's internal self-conception. Most importantly, despite each being unique, they are all readable and knowable. We are all unique as individuals, and yet we can be knowable by others. Even when stretched and attenuated, these letter forms are understandable to others.
After graduation, I presented this conceptualization of wobbly letter forms at the 2022 South Carolina Association of Marriage and Family Therapy annual conference. The board for this is a bit dense, as these things tend to become. More importantly, the ideas contained in this model's creation inform my practice of therapy on a regular basis. I hope it gives you something to consider, too, whether or not you have given much conscious thought to these concepts.
What moves me most about this model is what happens when you imagine many people's responses layered together — a flip-book of individual self-conceptions, each page unique, each letter form shaped differently by the particular constellation of that person's inner life. Some M's will be tall and symmetrical. Others stretched wide, or compressed, or leaning. Some W's will be barely recognizable as the letter they started from. And yet every single one remains readable. Knowable. Itself.
That is the point. The model was never designed to categorize or contain. It was designed to welcome — to offer a framework spacious enough that wherever a person locates themselves within it, they find not an edge or a boundary, but simply a place that is theirs. No response that the model cannot hold.
In therapy, this matters. Some people who carry questions about their sexuality or gender have spent years, decades even, in the exhausting work of self-concealment, unsure whether what they sense in themselves is nameable, shareable, or even real. Others, of course, are not so burdened. What I have found as an LGBTQ affirming therapist is that having a simple, visual framework can do something quietly powerful: it can make the previously unspoken feel, for the first time, speakable. Not because the model provides answers, but because it reflects back the legitimacy of the question.
You do not need to know where you land. You do not need a label, a declaration, or a fully formed sense of self to bring these questions into a therapeutic space. You need only the willingness to begin to look — and the assurance that whatever you find there is worthy of being seen.



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