Many therapists wish to provide an inclusive service but feel fearful about whether they are competent to work with transgender clients.
They may be asking themselves questions such as:
- Do I know enough to work with this client group?
- What if I get it wrong?
- Is there something I’m missing?
Most therapists will acknowledge that working with transgender clients means working outside their lived experience and brings up issues of language, identity and culture. That can feel like a lot to get right so it makes sense that therapists may hold back for fear of causing harm.
In this episode of the Good Enough Counsellors podcast, I’m joined by Josiah Twiselton, founder of Offbeat Therapy, to learn about what being trans inclusive really means in terms of therapy.
You can listen to the conversation in more depth here:
If you would like to subscribe to the podcast, click here.
Being “Trans Friendly” isn’t the Same as Competence
One of the takeaways from the conversation is that the lack of hostility towards transgender people isn’t the same as being an ally.
From the client’s perspective, there’s a difference between the therapist:
- ticking a box to say they work with trans people,
- displaying a rainbow sticker on a website
- sharing a supportive post
And actually helping the client to feel safe.
What Does Competence Look Like?
It isn’t necessarily about knowing everything, having the perfect language or never making a mistake.
It tends to look like the following.
Awareness of Your Assumptions
Taking time to reflect on the messages we’ve all grown up with around gender so that you’re aware of what you’re bringing into the room.
Openness to Learning
Working with transgender clients means you won’t be the expert on their lives but you do need to be open to listening and being corrected where necessary. There will often be things you don’t know yet.
It can also mean using supervision to explore areas you’re unsure about, or recognising when something is beyond your current level of experience and helping the client find the right support.
Not Making It All About Gender
While some transgender clients will want to explore gender issues, for many others therapy is somewhere to talk about other aspects of their lives. Examples include relationships, health or anxiety. There’s also the need to acknowledge that transgender people also experience trans joy alongside issues such as minority stress.
Understanding the Impact of Politics and the Social Context
Many transgender people access therapy because of the impact of current social and political discourse on their lives. Their gender is not the problem, other people’s attitudes towards their gender are. Understanding the wider political climate can really influence how you respond to their concerns.
The Role of Lived Experience and Community Understanding
It can be worth asking yourself how involved you are with the transgender community. This may be more than having a friend who is trans. Meeting people and listening to them can make their concerns more real than reading books or following people online.
Signs You May Not Be Ready to Work with Trans Clients
It’s OK to acknowledge your doubts and these may show up as:
- Feeling anxious about saying the wrong thing
- Wanting to prove you’re an ally
- Relying on labels rather than understanding
- Not being able to recognise the gaps in your learning
None of these are wrong, they may just indicate that you’d like to do more before committing to work with a transgender client.
This could include:
- Seeking out more training and learning opportunities
- Identifying and reflecting on your assumptions
- Listening to voices from the transgender community
And importantly, giving yourself the time to develop more knowledge and understanding.
So – Are You Ready?
Perhaps the answer isn’t as simple as “yes” or “no”.
Perhaps it is more about how you’re approaching the work, whether you’re willing to be open to more learning and to reflect as you do so.
You don’t need to have all the answers but you do need to be thoughtful about the questions you’re asking.
As a starting point, you may like to take a look at Josiah’s training for therapists, which you can access HERE.
And if you’d like ongoing support with your marketing and private practice – including how to communicate your values and approach – you’re welcome to join me inside Therapy Growth Group.
Frequently Asked Questions About Working with Trans Clients
How do I know if I’m ready to work with trans clients?
You’re ready to work with trans clients when you can approach the work with openness, reflection and a willingness to learn. You don’t need to know everything, but you do need to be honest about your level of experience and committed to ongoing learning.
Do therapists need training to work with trans clients?
Therapists don’t always need specialist training, but it can be very helpful. Training supports your understanding of common experiences, language and wider social context. Alongside this, self-reflection and listening to lived experiences are equally important.
What if I’m worried about saying the wrong thing to a trans client?
It’s normal to worry about saying the wrong thing. What matters most is being open, respectful and willing to listen. If you make a mistake, acknowledging it and adjusting your approach helps build trust more than trying to be perfect.
Is being “trans friendly” enough in therapy?
Being trans friendly is a good starting point, but it isn’t the same as competence. Clients often need more than acceptance. They need therapists who understand context, reflect on their own assumptions and respond thoughtfully in the therapy room.
Should I say I work with trans clients on my therapy profile?
You should only say you work with trans clients if you have reflected on your competence. It’s helpful to include your experience, training or approach so clients can understand how you work, rather than simply ticking a box.
Do I need to understand everything about trans identities?
You don’t need to understand everything about trans identities to work with trans clients. What matters is curiosity, respect and awareness that each person’s experience is different. Being open to learning is more important than being an expert.
What if I don’t feel ready to work with trans clients yet?
If you don’t feel ready, it’s okay to take more time. You might focus on learning, reflecting on your assumptions and gaining more understanding before offering this work. Readiness is a process, not a fixed point.
What should therapists learn before working with trans clients?
Therapists should understand their own beliefs about gender, the impact of minority stress, and the wider social context affecting trans people. Learning from lived experience and being able to reflect on gaps in knowledge is also important.
Is therapy always about gender for trans clients?
Therapy is not always about gender for trans clients. Many people seek therapy for relationships, anxiety or life challenges. Gender may be part of their experience, but it isn’t always the main focus.
How can therapists create a safe space for trans clients?
Therapists can create a safe space by being open, respectful and honest about their experience. Listening carefully, avoiding assumptions and allowing the client to guide what feels important can help clients feel understood and supported.