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Therapy for Trans Folks: Getting High-Quality Care

Transgender people face unique stressors. Transphobic harassment, social rejection, and difficulty accessing services and opportunities are cause for a greater need for mental health services in the trans community. However, trans people seeking help may experience a reasonable apprehension toward therapy. Psychotherapists of the past have treated diverse gender identities as manifestations of illness or dysfunction, and as a result, transgender individuals were often subjected to backward and traumatic treatments. Trans clients may also have had negative personal experiences with mental health providers. Therapists who invalidate trans identity, focus too little or too much on a client’s gender identity, or are just not very knowledgeable about trans issues can discourage trans people from seeking further mental healthcare. However, you are entitled to adequate mental health services, and while it might not be as easy as it should be, you can find a conscientious, knowledgeable, and competent therapist who is willing to self-educate about issues that affect the trans community.

Finding Good Therapy

Sometimes, you can glean a lot from how a therapist advertises. Things to look for when visiting a therapist’s website are specific mentions of LGBTQ issues and/or trans inclusionary language. For instance, therapists who describe themselves as trans-affirming are signaling that they will recognize and support their clients’ gender identities. While actions ultimately speak louder than words, advertising their trans-affirming stance is a good indicator that a therapist will put effort towards providing a secure and supportive therapeutic environment for transgender clients. Often, you can find lists of local trans-affirming therapists at places like LGBTQ community centers, Planned Parenthood, and endocrinology offices.

In some instances, the best move will be to ask your prospective therapist directly about their ability to work with trans clients. This can be an intimidating task, especially if you’ve previously experienced transphobic reactions from health professionals. With that in mind, it may be easier to send an email than to ask over the phone. In which case, I suggest taking some time to draft a short list of questions about things you feel are important for you to know before beginning treatment. Potential questions include, “Do you have experience treating trans clients,” “Are you knowledgeable about trans issues,” and “Are you familiar with the WPATH Standards of Care?”

WPATH Standards of Care

The World Professional Association for Transgender Health (WPATH) Standards of Care (SOC) for the Health of Transexual, Transgender, and Gender Nonconforming People is a set of healthcare protocols that have been adopted by healthcare providers around the world. Mental health providers abiding by these standards approach diverse gender expressions as healthy and valid. They treat their clients in a manner that addresses concerns both related to and separate from gender identity. Additionally, the WPATH SOC guide clinicians in interacting with other relevant systems in trans clients’ lives. This may include mediating family conflicts, educating the public about trans issues, or helping clients access community resources. The standards of care also provide guidance to clinicians in helping clients navigate other areas of the healthcare system. For example, therapists can help interested clients become fully informed about options for gender-affirming medical interventions. They can also play a part in psychological preparation and referral to—as well as coordination of care with—medical professionals.

Clinicians abiding by the WPATH SOC are required to maintain competency and awareness in and around trans issues, diversity in gender expression, and options for clients. These protocols are also meant to affirm clients’ agency. For example, if a client is experiencing uncertainty about their gender identity, the WPATH SOC instruct therapists to support them in their exploration of and potential changes to their gender. If you’d like to learn more about the WPATH Standards of Care, you can find the most recent version here, and if you wish to do so, it is fair and appropriate to ask a therapist you are thinking about seeing if they’d be willing to abide by the WPATH SOC when treating you.

Unfortunately, trans people continue to face obstacles in accessing quality healthcare. While there is work yet to be done, the mental health field has made significant improvements. Whereas trans people were once pathologized and subjected to unethical treatments, there is now a general acknowledgement of the wrongdoings of the past—and a recognition that gender diversity is healthy, natural, and often an important part of a person’s larger personal journey. Naturally, therapists will differ in their knowledge of trans issues and experience treating trans clients, but it is a therapist’s responsibility to self-educate and grow their competencies, and it is your right to receive good mental healthcare.

Thomas Shooman is a mental health counselor who follows the WPATH Standards of Care and practices at Resolution Psychotherapy in Poughkeepsie, New York. Thomas’ clients include individuals dealing with anxiety, grief, and obsessive thinking. He enjoys helping people navigate uncomfortable circumstances and find solutions that are in line with their personal style. Thomas is a member of the Association for Contextual Behavioral Science and the International OCD Foundation, and he is currently accepting new clients. For more information or to schedule a session with Thomas, please visit or e-mail

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