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Finding a Therapist for Transgender Therapy

Louise D.

If you are experiencing gender dysphoria or you do not identify with your natal gender presentation, it can be incredibly beneficial to seek out mental health care is as a supportive function. Gender therapists can help you to address dysphoria related to your gender identity.

But dysphoria should not be the only reason you seek out a gender therapist. Gender therapy can be beneficial to many people for a number of reasons. Any questions or concerns that you could possibly have about your gender identity can be addressed through gender therapy. It is not only reserved for individuals who identify with a non-cisgender identity.

While discussing gender therapists and their services, we should confirm, once more, that gender identity issues are not a sign of mental illness.

Transgender people will usually seek out the services of gender therapists while they are seeking gender-affirming interventions. It is often easier to gain access to medical interventions if medical providers see that gender therapists are already involved in transition processes. It assures them that gender questions are being addressed professionally in a secure environment and that there is someone in addition to themselves who can provide adequate support to their patients.

There are various options available for people seeking gender therapy. The most common option is a referral from your primary healthcare provider to a transgender therapist. It is not uncommon for healthcare providers to work in multidisciplinary teams, which means that many have good professional relationships with healthcare providers in adjacent professions.

If there is an LGBTQ+ health center in your area, then they possibly offer counseling services from a gender-affirming therapist on-site, or they would have a list of mental health professionals in the area that do gender therapy.

There are numerous online directories available that will include lists of mental health professionals that can offer mental health care and professional consultation on personal issues or gender issues to the LGBTQ+ community. For example, the World Professional Association of Transgender Health (WPATH) will have such a directory on their website, and you are likely to find one on the American Psychiatric or Psychological Associations or even on the National Institute of Health websites as well.

Yet another option is online therapy. Especially following the COVID 19 pandemic, there has been a sharp rise in online therapy platforms. These platforms have extended the availability of gender therapy even to more rural areas that usually would not have had a gender specialist within driving distance. They are also sometimes more affordable than face-to-face counseling, especially if you do not have mental health insurance coverage.

Transgender Therapy

What is Gender Therapy?

Gender therapy is not a blanket concept that is applied the same way to everyone. Each person is an individual, and personal experience can differ. So gender therapy is quite involved and offers in-depth support services.

We also need to remember that although gender-affirming treatments can be a source of comfort to transgender people, it can also be a very stressful journey. Many changes happen in the body that can, at times, be difficult to adjust to, even if they are what you wanted in the first place.

So whether you are starting puberty blockers at a young age, or hormone therapy later in life, it is a good idea to attend some gender therapy just to make sure that you have someone to talk to, someone that you can trust, and someone who has experience with puberty blockers or other treatments.

Many people who experience gender dysphoria or other gender identity issues also experience additional mental health concerns, including increased prevalence of substance abuse. In such a case, gender therapy would be accompanied by psychotherapy.

It is vital that you find the right therapist for you. Someone who you are comfortable with. Someone you will want to discuss your gender transition with and someone who can help to educate you and your family members about gender transition and gender affirmation surgery, etc.

A gender therapist can help you to understand the various gender-affirming interventions that are available. Most people only have limited knowledge on gender issues and sexual orientation, and it can be challenging to find accurate and up-to-date information online. A gender therapist will also be able to refer you to support groups where you can talk to your peers and share experiences with other transgender clients who are familiar with gender therapy.

Lastly, gender therapists often have access to the latest peer-reviewed studies conducted by reputable medical associations, so they tend to stay up to date with the latest development in treatment measures and other research outcomes that can have a positive impact on transgender health.

Gender Therapy and Other Mental Health Issues

When looking for a gender therapist, you might need to answer questions like: is gender therapy covered by my insurance? If not, should I try to go to another mental health professional? If hormone injections are too expensive, can I use hormone pills instead?

The answer to most such questions is usually affirmative. A general therapist likely has limited knowledge about gender issues, but they are typically eager and willing to expand their knowledge base. In addition, they can educate themselves or speak to colleagues who have more experience in order to ensure that they are on the right track with your treatment.

If your insurance does not cover transgender health treatments, ask your medical providers whether they offer reduced rates or sliding scale rates, many do. There might also be an option to receive treatment from an intern or student who is under close supervision.

They tend to offer significantly reduced rates and are pretty knowledgeable despite being young and inexperienced. Sometimes when you agree to make use of the services of interns or students (who are under supervision), you are required to sign an additional client’s consent form, but it might be worth it to enjoy good service at a low cost.

Furthermore, you should be able to substitute injections with pills, but if you do, it is essential to discuss this with a doctor as some oral drugs carry an increased risk of liver damage. During consultations with your doctor, they will discuss your treatment options in detail and try to help you find an option that works best for you.

Sometimes you might start on one treatment but find that it is not working as you expected or that you are experiencing side effects that you do not like, so your doctor will help you switch to a different treatment option. However, if you do end up struggling with the treatment that you started on, do not feel defeated. You might need to change your treatment at least once before you find an option that works best for you.

It is uncommon for transgender individuals to have to stop treatment entirely. Usually, this is only because of persistent severe side effects from numerous different treatments or the diagnosis of comorbid medical conditions that contraindicate hormone treatments. This is unlikely, but it can potentially happen. It is crucial to be honest with your doctor and therapist.

What is Gender Identity Disorder (GID)?

GID is an outdated, and no longer in use diagnostic framework for gender identity issues. It was included in the Diagnostic and Statistical Manual (DSM) IV but was removed in the newer DSM 5. Gender dysphoria is still included in the DSM 5, but gender-affirming treatments necessitate diagnosis for coverage by insurance companies and to ensure ethics in treatment practices.

Hypothetically, if no diagnostic framework for gender dysphoria is available, healthcare professionals would not be obligated to treat it at all or would be left to their own devices on how to treat it. This is potentially catastrophic for the transgender community. Having a diagnostic framework helps to standardize treatment practices and ensures that health care workers behave ethically as far as possible.

Furthermore, including gender dysphoria as a diagnosable mental health concern underlines the seriousness of it and highlights the need for treatment. What also counts in favor of transgender health with this diagnostic criterion for gender dysphoria is that the indicated treatment is gender-affirming therapies, either in the form of social transition, hormone replacement therapy, surgical treatments, or a combination of these.

Can Anyone Be a Gender Therapist?

General therapists will receive training in gender identity and gender dysphoria issues as well as training in helping the LGBTQ+ community; however, their training is not specific to such issues, and it might be better to seek out a specialist gender therapist instead if it is at all possible.

If you really cannot find someone who specializes in gender therapy, then your next best option is to seek out a general therapist who is eager and willing to learn about gender identity and support you as well as they possibly can.

Therapists, like doctors, are used to working in multidisciplinary teams and often are in contact with other professionals within their area who might have more experience and can offer them guidance. If you choose to go with a general therapist who does not have a lot of experience but is willing and eager to learn, then you might be paving the way for other transgender individuals in your area.

A sign of a good gender therapist is someone who seeks to keep continuing education within their field, engages in professional training and supervision for their services, and makes sure to stay up to date with new treatments. Generally speaking, a gender therapist is someone who has specialized training in gender dysphoria and gender identity issues.

If you are unsure whether your gender therapist is really a gender specialist, remember the following.
  • It is okay to ask your therapist about their training.
  • It is okay to ask them if they have worked with gender identity issues before, but they will not be able to give you specific information about their clients that could compromise their confidentiality.
  • They can only give you general information that is not specific to a case or other client.
  • If you think you will require a letter for gender-affirming interventions in the future, it is best to ask early on whether your therapist provides such letters.
  • It might be good to ask them about their therapeutic approach to better understand whether you will ‘click’ with the therapist and their therapeutic approach.

Ultimately, one of the most important elements of finding a gender therapist is to find a gender therapist that you are comfortable with. There will be cases where you just do not click with a therapist, no matter how well trained they might be. In that case, it is fine to rather go to someone else.

Transgender Therapy

Do All Transgender People Have Gender Dysphoria?

Gender dysphoria requires marked distress that interferes with social, professional, or educational life. If there is no significant distress, then there is likely no dysphoria. So it is possible for transgender people to not have dysphoria about their gender identity.

Dysphoria can take two forms (although often, a mixture of the two will affect an individual together). It can either be connected to the body or to societal expectations of a gender role.

The real question is, can someone be trans without having gender dysphoria?

The answer seems to be that it is perfectly possible. Because ‘transgender’ is not a diagnosis, but in fact an umbrella term, as explained by the American Psychiatric Association, it can indeed include people who do not identify strongly with their sex assigned at birth but do not experience anxiety about their bodies gender roles, or pronouns.

Being transgender generally means that you identify with a different gender than your body expresses. You would have gender questions at some point, and they might be difficult for you to answer on your own. This might be a good time to find a gender therapist and some support groups in order to get some social support.

The only time that this can become potentially problematic is if an individual seeks out medical treatment for gender affirmation that a lack of dysphoria might become a roadblock. This is because ethical guidelines for medical interventions stipulate the need for a clear history of gender dysphoria.

Transgender Therapy

Therapy for Gender Nonconforming Clients

It is becoming clear that a gender binary approach is no longer appropriate in today’s society. Even when it comes to gender-affirming care, gender nonconforming people should not be denied treatment simply because they can’t ‘pick one’.

Oftentimes, gender expression can be a little bit confusing for a person who does not identify strongly with any kind of gender. This uncertainty alone can cause severe mental health distress. Moreso, if a person lives in an area where there isn’t much gender diversity and people do not have a lot of awareness about transgender issues.

Gender therapists can be immensely helpful for this demographic, and if you are in a remote area where you might not have access to transgender health care in the area, then you could try online therapy as a first port of call. A mental health professional is likely to be able to offer advice on gender expression and gender diversity.

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