Psychotherapy for Transgender Individuals

LGBT Affirmative Counseling Petaluma, CA

Counseling Transgender, Gender Variant, & Gender Queer Clients

One of the issues my associate intern therapists and I love working with is gender identity. As we see it, working with clients who identify as trans, gender variant/queer/non-conforming/non-binary/expansive is a privilege we take very seriously. The process of coming to live fully in one’s experience of self is a personal journey we think of in terms of Jung’s notion of individuation. Jung theorized that over the course of the lifespan, we become who we are by integrated the hidden, lost, or outcast parts of ourselves. These hidden parts are often those shunned in the larger cultural context, yet they often contain tremendous vitality when we bring them into conscious awareness.

Many of the trans/gender variant individuals with whom I have worked utilize therapy to engage in this process of individuation. They move from a state of awareness about their gender experience, through a course of exploration in order to make sense of that experience, to a final, yet ongoing state of integration. Practically, this often involves some sort of social and/or medical transition, though not always. But internally, it is a process of arriving home to oneself in a new way that aligns internal and external facets of who one is.

Lev (2004) offers a model that can be helpful to some:

  1. Awareness: Awareness of a sense of difference in terms of gender, sometimes accompanied with distress over that awareness.  
  2. Seeking Information/Reaching Out: The individual seeks out information and support to make sense of this new awareness and to provide a context for it.  
  3. Disclosure to Significant Others: Not a requirement, but Lev highlights the importance of talking with loved ones, when it is safe to do so, about one’s gender identity.  
  4. Exploration – Identity and Self-Labeling: Exploration of various transgender identities to see which makes most sense for oneself (e.g., transgender, gender variant, gender expansive, gender non-conforming, genderqueer, gender non-binary, etc. etc.).  
  5. Exploration – Transition Issues/Possible Medical Treatment: Exploration of social and medical transition issues, which may include presenting in public in one’s identity and/or starting medical care (e.g., hormone therapy).  
  6. Integration – Acceptance and Post-Transition Issues: Internal sense gendered sense of self and outward identity are integrated and synthesized. This is a lifelong process for some, and a source of continued meaning and development for others.

Although stage models tend to present an over-simplified version of very complex processes and, therefore, should be taken with a grain of salt, for individuals who are new to questioning their gender experience, they can sometimes be helpful.

If you are somewhere in this process and would like to discuss with someone, please contact us for more information about our psychotherapy services.

Sil Machado, Ph.D. is a licensed psychologist offering psychotherapy, counseling, and neurofeedback in Santa Rosa, CA. His unique approach incorportates years of training and experience working with transgender individuals and couples, and other members of the LGBT community. He works extensively with LGBT adults with depression, anxiety, brain injury, and AD/HD. He is a therapist offering psychotherapy and neurofeedback in Santa Rosa, Petaluma, Rohnert Park, Healdsburg, and Sebastopol.