The Importance of Gender-Affirming Therapy for Transgender Individuals
We live in a world brimming with beautiful diversity. Just as going on a hike reveals a variety of flowers, trees, and wildlife that enrich the landscape, the diversity of human beings brings light into each environment. We celebrate the vibrant colors of autumn leaves, each one adding its own beauty to the season. Similarly, people are breathtaking in their diversity, and it's inspiring to see more and more individuals embracing the identities that bring them joy. The journey to authenticity is one of self-discovery, resilience, and, oftentimes, immense vulnerability. Gender-affirming mental health therapy is a critical component of this journey, providing a safe space for trans individuals to explore their identities, confront societal challenges, and cultivate self-acceptance.
Gender-affirming therapy is therapy with a focus on affirming a client’s gender identity, instead of trying to “repair” it and is the ethical approach to working with trans clients.1 This goes beyond general mental health support and offers specialized guidance that acknowledges the unique experiences and needs of transgender, non-binary, and gender-nonconforming individuals. For many, the process of understanding, accepting, and expressing one’s gender can be difficult and emotionally taxing. The stigmatization and discrimination that trans people face in society, at work, and within relationships can make this journey feel isolating. When compared to the general U.S. population, severe psychological distress and depression rates are estimated to be between six to nine times higher for trans people.2 Gender-affirming care improves the quality of life for transgender individuals and without access to this care, this community faces increased risk of adverse mental health outcomes.2 That’s why this supportive therapeutic environment is vital; it allows trans individuals to feel seen, heard, and validated – all of which can be life-changing.
Gender-affirming therapy includes addressing eight main themes: trauma, shame, depression, self-harm, violence, sexuality, medical treatment, and societal stigma.3 Each of these themes can have a profound impact on the mental health of trans individuals in society.
Trauma
Trauma is unfortunately a common experience for trans people due to rampant transphobia and marginalization in society. Trans individuals carry the weight of these experiences, which can range from family rejection to mistreatment in healthcare to workplace discrimination to even physical and sexual assault, and much more.4 Gender-affirming therapy offers a compassionate space where trans individuals can process these traumas without fear of judgment, which is crucial for healing.
Shame
Many trans individuals experience intense shame around who they are, which stems from transphobic messages from society and those around them.5 This shame is internalized and leads to self-criticizing thoughts that tell them that their gender identity is “wrong” or “unacceptable.” It is important in gender-affirming therapy to challenge this shame, fostering a loving space where clients can explore their identities without judgment. Gender-affirming therapists work with clients to help them recognize and release this shame, replacing it with pride and confidence.
Depression
The Minority Stress Model can be applied to explain how anti-trans stigma and discrimination heightens the risk for this community to develop negative mental health outcomes.6 Depression is one outcome that affects the trans community, due to the compounding societal rejection and barriers to safety that they face. Gender-affirming therapists understand that for many trans people, depressive symptoms are a response to persistent experiences of invalidation and erasure. Therapy helps trans clients explore the roots of their depression and provides tools to combat these feelings, while celebrating their identity rather than suppressing it.
Self-Harm
Many trans individuals experience isolation, shame, and feelings of helplessness, which can lead to engaging in self-harm. Gender-affirming therapy helps individuals understand and replace self-harming behaviors with healthier alternatives, while ensuring to honor the individual’s gender identity and trans experiences.
Violence
Unfortunately, violence is a reality for many trans folk, whether it be physical violence, verbal abuse, or domestic or sexual violence.7 Trans women of color particularly face increased rates of violence due to the mix of transphobia, racism, and misogyny.8 Gender-affirming therapists must be educated on how to help clients heal from trauma, as well as be able to offer trans folk safety resources and engage in safety planning.
Sexuality
Exploring and understanding sexuality and gender identity is the cornerstone of gender-affirming therapy. Gender-affirming therapists offer a safe, judgment-free space where trans individuals can explore questions related to their sexuality and gender identity, as well as process important topics like gender dysphoria. By doing this, therapists support clients to develop a holistic sense of self free from shame. This exploration allows clients to feel more comfortable in their bodies and relationships, fostering a sense of confidence and freedom.
Medical Treatment
Medical treatment and gender transition are deeply personal, yet important aspects of life for many trans folk. From hormone therapy to surgical options, the journey can be both exciting and scary for many. Gender-affirming therapy walks this journey with clients, helping them explore their desires and concerns about medical treatment without pressure. A skilled gender-affirming therapist will help trans clients make an informed decision that aligns best with their own values, needs, and long-term goals. By supporting clients in this way, gender-affirming therapists are able to empower trans individuals to confidently take control of their own journey.
Societal Stigma
Transphobia can affect the basic needs of trans folk, including everything from employment opportunities, housing, finances, to interpersonal relationships. Additionally, anti-trans legislation is being passed at alarming rates, stripping the rights of this community to exist in society.9 This constant discrimination can take a toll on the mental health of trans folk and contribute to shame, isolation, and feeling ostracized from others. Gender-affirming therapy acknowledges the very real impact of transphobia and helps trans individuals build resilience against it. Therapists empower their clients and offer tools for self-advocacy and self-care that reinforce their right to live openly as they are. This support is critical to help clients challenge internalized stigma and advocate for their place in society.
Finding Gender-Affirming Therapists
Here are some ways you can find a gender-affirming therapist:
PsychologyToday is great for finding therapists, and you can filter by professionals near you who serve specific communities. Follow this link to find a filtered PsychologyToday list of therapists in New Jersey who focus on serving sex and gender diverse clients.
The National Queer and Trans Therapists of Color Network and Therapy for Queer People of Color are two organizations dedicated to helping sex and gender diverse people of color find gender-affirming mental healthcare.
The LGBTQ+ Healthcare Directory can be used to find both gender-affirming therapy options, as well as LGBTQ+ focused healthcare near you.
Use Google to search for mental health providers who work with trans people or who identify as trans. Here are some helpful search phrases to get you started: “Trans therapist near me” or “Trans therapist in [your state]”
Connect with your local trans community or LGBTQ center to find trusted gender-affirming therapists through word-of-mouth. PFLAG is a national organization for LGBTQ+ support and advocacy with many chapters in different states. Reach out to your local chapter to find resources near you for gender-affirming therapy.
If you are in a mental health crisis and require trans-affirming mental health support, you can contact the Trans Lifeline at 877-565-8860.
If a mental health provider isn’t taking new clients, you can ask for a referral for another trusted gender-affirming therapist.
The need for gender-affirming therapy is critical, especially with how pervasive transphobia and anti-trans legislation is becoming. As advocates and human-centered caregivers, we must push for better access to these services. This looks like training more therapists in gender-affirming practices and creating policies at the practice that make these services accessible to trans individuals of lower socioeconomic status. For trans people, authenticity is a journey that requires courage, resilience, and community support. Gender-affirming therapy is a crucial, life-saving resource for this journey and is an investment in the mental well-being and future of trans people everywhere. Together, we can build a world with services and infrastructure that fosters and uplifts–rather than marginalizes–gender diversity.
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