Link to original post by Darlene Tando, LCSW

The Hunt

Finding a good gender therapist for your child can be a daunting task. If you are in the process of looking for a gender therapist, this means there is already a lot going on in your family! Gender dysphoria or gender nonconformity can at times cause distress for parents and the child who is experiencing it.

There doesn’t seem to be many of us out there (gender therapists who work with gender nonconforming youth), and I wish there were more. So once you’ve found one in your area (or relatively close to you), how do you know if the therapist is a “good” one? As with every profession and specialty, there are the good, the bad, and the ugly.

If someone claims to be a gender “expert”, don’t just assume your hunt is over. Ask questions (see below for a sample list) and go with your gut instincts.  Ultimately, YOU are the expert on your child.

After you have met with the therapist for 1-3 times, re-evaluate how the sessions are going for both you and your child. Is your child comfortable? Are you? If not, address your concerns with the therapist.  The therapist should be open to your feedback and be able to explain their reasoning behind the treatment methods. If things don’t change, begin your search again!

Let the Client (Child) Lead

As with any therapy, or reason for seeking therapy, the gender therapist should not enter into therapeutic work with you and your family with an agenda. If you get the sense on the phone that they have their mind on accomplishing something (such as getting your child to transition or not transition), consider that a red flag. Every child and family is different, with a different story and different needs. Some of the interventions and suggestions will be similar to those used with other families, but most will be tailor-made to your family.

Your child will be the best source of information re: their gender identity. Children of a very young age are aware of what gender they are, and/or what gender expression they are comfortable with. You, the parent(s), will be excellent historians for how your child has expressed their gender from an early age, current significant behaviors, etc. Of course, part of the gender therapist’s job will be working with the parents in regards to their feelings about their child’s gender nonconformity, and feelings about potential options for their child.

Red Herrings

Many parents see their child’s gender nonconformity AND a lot of other emotions and behaviors. Some of these emotions and behaviors will be related to their child’s gender identity; others may not. Those that seem unrelated to the gender identity but may actually be symptoms of the distress the gender nonconformity is causing are what I call “red herrings”. The gender therapist can help you sift through some of these factors to find out what needs to be addressed first. It is common for some emotions and behaviors to be resolved once the gender identity is validated. One good way to narrow down what is really going on for your child is to focus on what seems to be causing the most distress. For example, if your child is having social skills problems, academic problems, gender nonconformity/expressions of gender identity that does not match their body, anger outbursts, and anxiety, what seems to bring them the most mental distress? What do they talk about the most? What do they shed the most tears over? This is what needs to be addressed first.

Often times things such as the anger outbursts/academic problems are what bring the parents the most distress, and therefore this is what the parents want addressed first. This may be like putting a Band-Aid on something without treating the cause. In some cases, it will be the therapist’s job to gently prevent you, the parents/guardians, from following the red herrings. If your gender therapist seems determined to only focus on these other things, and not address the gender issues, this should also be a red flag for you. While you may feel some relief that the gender therapist is recommending holding off on making any major decisions or is wanting to address everything else other than the gender identity, pay attention to what your gut is telling you. You know your child. If the therapist’s recommendations seem to bring your child more distress, something has gone awry!

Hormone Suppression/Therapy

Your gender therapist may help you (and your child) explore whether or not your child is gender nonconforming or transgender. If the consensus is your child is the latter, your gender therapist can help you navigate the next steps in your child’s journey. Your gender therapist can be your ally in deciding if hormone blockers/therapy is the right decision for your child, and if so, when to start. Sometimes, making this move can help ease some of the other symptoms that may have arisen for your child. Many times the child may express being ready for hormone blockers or hormones before the parents feel ready. The gender therapist can help parents walk through many of the anxious and difficult feelings that may arise during this significant decision-making time.

Structure of Sessions

There is no exact science to how a gender therapist might structure their sessions with you, but in general there should be a good balance of meeting with you and meeting with your child. The therapist should meet alone with you as part of the assessment process and at other times as needed throughout treatment. This is because you need to have free reign to say what you want to say about your child’s gender expression and your feelings about it. Your child should not hear all of your thoughts, opinions, and feelings about their gender expression or possible transgender identity. Children tend to try to take care of their parents and avoid causing their parents distress; therefore hearing statements made my parents (particularly those expressing resistance) can impact their ability to say what they want and need in regards to gender expression, transitioning, etc. This can have serious ramifications on their mental health and futures.

Similarly, your child should have the opportunity to speak alone with the gender therapist and speak their mind without censoring things out of regard for their parents. The gender therapist will not tell you exactly what your child has said while in private, but should help your child communicate better with you when you are all together. For this reason, joint sessions are also called for when it comes to working with youth. It is important for family members to learn how to talk to one another about the gender identity issues, and to become more comfortable with the topic. Additionally, parents tend to be better historians and reporters of behaviors, which can be extremely beneficial to the treatment course.

Sample Questions to Ask a Potential Gender Therapist

  1. What is your opinion about how young a child can understand their gender identity?
  2. What is your general opinion on letting a child express their own gender identity?
  3. What are your thoughts on hormone blockers/therapy for youth?
  4. How long have you worked with children?
  5. Are you experienced in building rapport with children?
  6. Have you been trained in how to talk to and interview children in a non-leading manner?
  7. How involved are the parent(s) in the therapy with the child?

If you are struggling to find a gender therapist that is right for your family, reach out for help. TransYouth Family Allies is a great resource. If you join TYFA Talk, you can chat with other families and get information about what resources are out there. Wishing you all the best on YOUR journeys!

*Special thanks to Kim Pearson of TYFA who requested this piece to present at this year’s Gender Odyssey Family Conference.

**While this post was written specifically for parents finding a gender therapist for their child, many elements can be applied to the gender nonconforming or transgender adult. Go with your gut! Find a therapist who will support you in your journey and help you access resources. If it doesn’t feel right to you, keep looking.