In this episode, Ioannis Ntanos (he/him) is joined by Avgi Saketopoulou (she/her), a clinical psychologist and psychoanalyst based in New York City who has been working with the trans community for over 20 years. Originally from Cyprus and Greece, Avgi immigrated to the US where she trained at NYU's Postdoctoral Program in Psychotherapy and Psychoanalysis, where she now teaches. She also serves on faculty at the William Alanson White Institute, the Stephen Mitchell Relational Center, and the National Institute for Psychotherapies.

Avgi is the co-author, with Ann Pellegrini, of Gender Without Identity (Unconscious in Translation Press / NYU Press, 2023). The book  won the 2024 Silver Medal for LGBTQ+ Non-Fiction from the Independent Publisher Book Awards. She is also the author of Sexuality Beyond Consent: Risk, Race, Traumatophilia (NYU Press, 2023), and her interview on relational psychoanalysis is part of the permanent collection at the Sigmund Freud Museum in Vienna.

Together, Ioannis and Avgi explore the limitations of the concept of gender identity - a framework that emerged from psychoanalysis but which, they argue, cannot do the work it promises and leaves out too many people's lived experiences. Gender Without Identity proposes instead that gender is something all people acquire, and that trauma can sometimes have a share in that acquisition - not as a way of pathologising transness, but of illuminating it. They discuss the "born in the wrong body" narrative and the oppressive expectation that trans people must prove the validity of their gender in order to be considered worthy of medical care - a standard never applied to cis people seeking gender-related treatments such as cosmetic surgery or menopause care.

They reflect on how anti-trans rhetoric is inseparable from the broader rise of fascism and how transness as a social issue galvanises many forms of violence that extend far beyond the individual.

The conversation also turns to the clinician's role: why surgeons should remain half a step behind their patients, following their lead rather than imposing frameworks; how erotic transference in the therapeutic relationship can surface a clinician's own unexamined assumptions about gender and sexuality; and why treating trans patients requires the clinician to genuinely change and evolve - not just apply a checklist.

Featured Guest: Avgi Saketopoulou (she/her) is a clinical psychologist and psychoanalyst practising in New York City, and faculty member at NYU's Postdoctoral Program in Psychotherapy and Psychoanalysis. She has worked with the trans community for over 20 years and is the co-author of the award-winning Gender Without Identity and author of Sexuality Beyond Consent: Risk, Race, Traumatophilia (NYU Press, 2023). Her work has received numerous prizes including the JAPA essay prize twice, the Ralph Roughton Award, the Symonds Prize, and the APA Division of Psychoanalysis Scholarship Award.

Connect & Learn More

Find Ioannis Ntanos:

LinkedIn: Ioannis Ntanos

Instagram: @ioannisntanos

Threads: @ioannisntanos

Resources: Learn more about top surgery at ioannisntanos.com

Find Gender Without Identity by Avgi Saketopoulou and Ann Pellegrini at your local bookshop or online retailer.

Find Sexuality Beyond Consent: Risk, Race, Traumatophilia by Avgi Saketopoulou at NYU Press.

About The Podcast The Top Surgery Podcast explores the intersection of healthcare, advocacy, and community through candid conversations with experts, patients, and allies. New episodes released every month.