There are a lot of things that can be extremely frustrating for transgender individuals who are considering, seeking or beginning a transition. Finding a therapist is one of them.
Before I go further, I want to say I am pro-therapy. To me, therapy is different than the mental health assessment that is described in the WPATH Standards of Care (SOC). Therapy is a commitment made by an individual that will allow them to explore their internal and external world and sit in the discomfort instead of run away from it. For a person who is transitioning, therapy is also a way to stay present.
Even if someone feels confident about their transition and better about their life, a lot could instantly change. From my own experience, the highs are really high and the lows are really low. The lows are brought on by people treating you differently, family, relationship, and employment conflicts, and mood changes either due to hormones or after surgeries. For all of these reasons, building a relationship with a therapist before the transition is a way to build a foundation that will be built upon as you move forward in life.
Some people may need or benefit from seeing a therapist weekly, others bi-monthly and others just here and there when they need a check-in. So for those of you just beginning or in a place where you are looking for someone new, here are my tips:
1) First visit WPATH’s website and see if they have any providers listed in your area.
Providers listed on WPATH’s site are members, meaning they pay a fee, so keep in mind some may be excellent therapists, others may have the financial means to advertise where they like.
If you can’t find a provider in your area on WPATH’s site, then go to Psychology Today. On this site, run a search for therapist who marked that they work with transgender clients. Be aware . . . a lot of therapists will mark the “transgender client” box even if they haven’t had clients that are exploring gender identity/expression. They may mark it because they have worked with gay and lesbian clients, they have a transgender friend, or they saw someone talk about their transition once.
There are a lot of transgender websites that also lists therapists in different regions, but information on those sites may be outdated or the person may be outdated (meaning they were once on top of this issue, but hasn’t kept up with the times).
2) When you find someone you are interested in calling, ask for a free phone consultation in order to ask them questions.
A) Have you worked with transgender clients before?
If yes, ask how many and for how long.
If no, you can choose to go on to someone new on the list, or if they are your only resource you can ask if they’d be willing to work with someone that is exploring their identity.
B) Have you worked with an array of clients, trans men, trans women, nonbinary, genderqueer, etc?
If they say, “gender what?” you know they don’t know very much about the community. This question will give you a gauge of how involved and knowledgeable they are about gender identity and expression.
C) Do you write letters for people seeking hormones and surgeries?
This is another gauge of their experience. If they say, “Yes,” they know what you are talking about. If they say, “Uh…I haven’t yet, but I can look into it,” it shows that they are still willing, but you will need to do some educating, (there are examples of letters on WPATH’s website). If they say maybe or no, consider if it would be a waste of your time to continue seeing them, or if you are willing to take the chance with them.
D) Do you use certain standards of care for someone transitioning?
There are other standards besides WPATH’s…WPATH’s is just more universally used. This will give you a sense of their knowledge.
E) Which standards do you follow and what is your philosophy around them?
The WPATH Standards of Care went through a revision in 2011, so they are old, but the revision eliminated a lot of the obstacles transgender individuals experienced when working with providers, so asking this question will allow you to assess if the therapist has stayed on top of the changes, their philosophy around working with transgender clients, and their comfort with gender queer or nonbinary forms of expression.
These questions will be a good starting place for you.
3) The next step is to schedule your first session and see what your gut is saying about the person.
You will most likely be nervous. Talking to someone about things personal to you is never easy, but you’ll become more at ease as your relationship grows. If you keep getting nervous, then I feel it is a sign the therapist is doing what they need to do, which is helping you bring out the hard stuff and actually look at it, explore it, analyze it and approach it.
Therapy isn’t easy for you or the person providing it. It’s a process that in the end I hope brings you larger clarity to your life.