Katie Taibl, RN, wrote the updated version of this article on 4/5/23. Andrea, a guest contributor, wrote the previous version of this article. Illustrations were created by Leo.
Finding a trans-competent therapist can be a game changer when it comes to mental and physical health. A staggering percentage of trans folks have to educate their health providers on transgender issues and health practices. This guide will help you find a trans-affirming therapist and navigate how to get the most out of therapy and support your mental health.
Therapy can help you explore your gender identity
Trans-affirming therapy helps transgender folks explore their gender identity in a safe and accepting environment. Being understood by your mental health professionals can lessen gender dysphoria and help you thrive in the way that fits your needs.
Benefits of transgender-affirming therapists include:
- Assists in navigating the complexities of expressing your unique gender identity in a way that feels most authentic to you
- Possesses deep knowledge of transgender health and mental well-being
- Exhibits expertise in providing trauma-informed care
- Creates a welcoming and inclusive environment where you can feel truly seen and heard
LGBTQ people are more at risk for anxiety and depression from minority stress. A trans-competent therapist can help you explore your gender identity and process trauma. Trauma-informed therapists nurture an accepting environment where you can talk openly and be understood. Therapists help teach coping skills for stress, anxiety, and depression. Best of all, trans-competent therapists can guide you from surviving to thriving.
Risks of a non-trans-affirming therapist
Many trans folks struggle to find a therapist who is both educated on trans identity and familiar with the needs of the trans community. Often, your choice may be between any therapist that takes your insurance. At worst, you risk exposure to transphobia. At best, you may have to educate a non-trans-competent mental health provider on the nuances of transgender care or identity.
How do you find a trans or trans-affirming therapist?
Finding a gender-affirming therapist who is educated in transgender mental health is challenging. Many trans folks struggle to find a therapist who is educated on trans identity and the nuanced needs of the trans community. The good news is there are increasing options, especially online, to find trans-affirming therapists who can meet your needs.
Search online for trans-affirming therapists
So how to find a trans-competent therapist or a clinician who is trans themselves?
Start by curating an online search. Specifically, research therapists, counselors, and mental health providers who work with trans people or identify as trans themselves. Start by googling "LGBTQ or trans therapist near me" or “LGBTQ or trans therapist in [your state].”
Search within your state
Make sure your location setting is on for your Google search for a trans-affirming therapist. Often, states will have specific mental health resources tailored to LGBTQ people. It's important to search within your state because therapists can only work with people in states they hold a license in.
Check Psychology Today
Seek therapists on the Psychology Today website. Plug in your criteria: insurance (if applicable) and zip code. Then select "Transgender" under the "Issues" tab. You can also search by therapists' gender, including "non-binary" therapists.
If you can't find someone near you, consider widening your search location to nearby cities or towns. Telehealth for mental health care for virtual visits is another option.
FOLX offers online therapy for mental health. Additionally, FOLX providers and care teams can help members find LGBTQ-affirming mental health resources, including group therapy and therapists near them. FOLX also offers peer support groups where you can connect with folks going through a similar journey.
LGBTQ mental health search engines
Look through LGBTQ online directories for LGBTQ and trans-affirming providers. For example, GLMA, the Gay and Lesbian Medical Association, has an LGBTQ+ Health Directory. You can search for therapists, psychiatrists, and sex therapists within a specific zip code. Providers list the therapies they specialize in, including gender-affirming and LGBTQ-affirming care.
For queer, kink, and poly-affirming providers, look into Manhattan Alternative in New York. Providers are listed by their credentials and LGBTQ focus. You can search by insurance, provider's LGBTQ orientation, and more.
For queer people of color, having a queer therapist of color might feel important. Studies show BIPOC LGBTQ folks experience more significant psychosocial stress. Find trans-affirming therapists of color via the National Queer and Trans Therapists of Color Network (NQTTCN) and Therapy for Queer People of Color online.
Word of mouth in the transgender community
Connect with a local trans resource group in your community, like PFLAG or the local LGBTQ center. They will likely have connections to gender-affirming therapists and resources to help you navigate transgender issues and TGNC mental health care.
If you know other LGBT people who are in therapy, ask for their recommendations. You can post in local queer Facebook groups or "queer exchanges" to check for trans-competent providers in your area.
Ask for referrals
Ask for referrals if a provider isn't taking new patients. Try a waitlist if a therapist seems like a good fit. See if that provider can provide trans-competent referrals for mental health providers. They know the local system better than anyone.
How do you know if a therapist is trans-affirming?
Affirming therapists typically will have information listed about their involvement with the LGBQ and TGNC (transgender and gender non-conforming) community, including training and certifications. They may have pronouns listed or WPATH (World Professional Association of Transgender Health) emblems on their site. Still, truly knowing if a therapist is competent in transgender health can be challenging.
Your best bet is to schedule a consultation call to see if they are a good fit. Usually, these are free of charge. This is an effective screening tool to see if you're connecting with a trans-competent provider and someone who can truly meet your needs and align with your mental health goals.
Prepare a set of questions to assess for trans competency ahead of time.
Questions can include:
- What is your experience working with the trans community and trans clients?
- What training have you completed to better understand working with trans people?
- Do you identify as trans? (Some therapists may not want to disclose, but many will!)
- Do you currently have other trans clients?
- What would you do if I shared something you needed to be educated on that part of my identity or experience?
- Are you in supervision? Does your supervisor understand trans identity?
If you feel good about their answers to your questions, schedule an initial intake session to better gauge if it's a good fit. Most therapists use the first three sessions to see if it is a good fit. You can do the same. There's no shame in therapist shopping.
If you don't feel heard or understood, or the vibe seems seriously off, it's okay to move on to someone else. The same goes if your therapist says something invalidating or doesn't seem competent in transgender identity. You're not obligated to work with this person. You don't owe the therapist an explanation; it's not your job to ensure they understand why it's not a good fit. Of course, if you feel comfortable, you can share feedback–though it's not necessary or an obligation to do so.
Making the most out of your therapy sessions
When you find a therapist that feels like a potential fit, make the most of your sessions. Remember to set goals for yourself about what you want out of therapy. If your initial visit goes well, consider sticking with that therapist for at least a few months and plan to check in with yourself.
- Review your goals for mental health treatment and see if you feel you're on track.
- Define what success for you looks like. Success can include feeling more positive, less anxious, feeling like you have the energy to go out more, or communicating better with your friends, family, significant others, and coworkers.
- Set realistic goals you feel you can achieve and take them one step at a time.
Consider cost and insurance
Gender-affirming and trans-affirming care can be covered under insurance. Health plans cannot automatically exclude you from trans-related care. The National Center for Transgender Equality has helpful info about coverage and your treatment rights. They also have resources for what to do if you experience discrimination in a healthcare setting.
Accessing trans-competent therapy with FOLX
We've heard from our community how challenging it can be to access mental health services, so we are proud to now offer therapy and mental health medication management in select states (with more being added all the time). FOLX offers therapists who are not only experts in LGBTQ health; they're either LGBTQIA themselves or have strong ties to the community.
Locating a trans-competent therapist has never been easier (even though it's still hard). FOLX mental health services support anxiety, depression, sleep, gender identity, LGBTQ issues, and medication management. All of this is offered via telehealth.
Trauma-informed, trans-affirming mental healthcare starts with a trans-knowledgeable provider. An environment that is safe and affirming lays the groundwork for personal healing. When you don't have to educate your therapist about trans issues, you can work towards better mental health.
Therapy can be an incredibly transformative and healing space for trans people, but it has to be with someone who "gets it." A good fit could be with someone who is trans, LGBQ, or is doing the work outside of your time together to show up for their trans clients. You deserve a therapist who will always validate your gender and doesn't make you work as a teacher during your healing time.
If you are currently struggling and need crisis mental health resources now, please reach out to one of the following resources:
- Trans Lifeline (877-565-8860)
- The Trevor Project (866-488-7386, for LGBTQ+ youth ages 13-24)
- The Gay, Lesbian, Bisexual, and Transgender National Hotline (888-843-4564)
Find mental health care that fits your life with FOLX's mental health offerings. Sign up for a FOLX membership to get LGBTQ-affirming mental health care, including peer support groups and access to FOLX's Community Platform.
FOLX Health is the first digital healthcare company designed by and for the LGBTQIA+ community. Our services include virtual primary care, gender-affirming hormone therapy including estrogen and testosterone (HRT), mental health care, sexual and reproductive health care, preventive care, and fertility consultations. FOLX memberships give you access to LGBTQIA+ expert clinicians, peer support, thousands of LGBTQIA+ resources, and more. Whether you’re lesbian, gay, bisexual, transgender, queer, gender non-conforming, or nonbinary, you can find LGBTQIA+-specialized health care that helps you meet your wellness goals. FOLX Health is health care that's queer all year. Get all the benefits of becoming a FOLX member and sign up today!