What Trans Adults Need to Know Before Starting Therapy

You need a therapist to navigate your gender journey—whether you're exploring your identity, preparing for medical transition, or processing years of suppression. You Google "gender therapist near me," find someone who claims to be LGBTQ-affirming, book an appointment, and show up hoping for support. Then you realize: this person has no idea what they're doing with trans clients, or worse, they're actively harmful through outdated gatekeeping approaches.

After 20 years and over 7,200 comprehensive gender assessments, I've heard countless stories from trans people about terrible therapy experiences—and I know what separates good trans-affirming therapy from harmful approaches.

In this video, I walk you through everything I wish every trans adult knew before starting therapy: how to evaluate potential therapists before booking (green flags like explicit trans specialization vs red flags like outdated terminology), what to expect from initial consultations (I share exactly how I do mine—including examples of when I've told potential clients I can't help them and referred them elsewhere), six essential questions to ask during consultations with examples of good vs problematic answers, red flags in therapy approaches to watch for (gatekeeping, stereotype-based assessment, pathologizing gender exploration), realistic expectations for what therapy can and can't do, when and how to fire a therapist who isn't serving you, and where to actually find trans-competent therapists. I also explain why you should be wary of therapists who promise they can help everyone with everything—good therapists know their limits and prioritize getting you the right help over getting your business.

Watch this video to go into your therapist search informed and empowered—knowing what to look for, what questions to ask, what red flags to avoid, and what you deserve from the therapeutic relationship. I offer free 15-minute consultations because I believe in making sure I can actually deliver value before taking you on as a client.