Gender Identity & Transgender Health
Gender is one of the most personal things a person can know about themselves, and one of the most public things the world tries to tell them. For many trans, nonbinary, gender nonconforming, two spirit, gender questioning, and gender expansive people, therapy has not always been a place of refuge. Instead of being met with curiosity, respect, and affirmation, many have found themselves in spaces where their gender was scrutinized, pathologized, or treated as something to explain rather than simply a part of who they are.
At MLC, we offer affirming therapy. This means we do not ask you to justify, defend, or explain your gender to us. We are not here to assess whether you are trans enough. We are here to walk alongside you in whatever your relationship to gender looks like right now, including if it is changing, including if it is complicated, including if you are not sure.
What affirming care actually means
Affirming care is not the same as being welcoming or open to all clients while practicing in a framework that was never built with trans people in mind. Affirming care is a specific stance. It means the clinician operates from the premise that you are the authority on your own gender and life. It means the clinician’s role is to support what you are moving toward rather than to assess whether the movement is legitimate.
It also means ongoing learning, ongoing accountability, and ongoing willingness to follow rather than lead.
What folks bring to this work
The reasons trans, nonbinary, and gender-expansive folks come to therapy are as varied as the reasons anyone comes to therapy. Some of the gender-specific material that often shows up includes:
- Early stages of self-recognition. Putting language to something that has been present for a long time.
- Considering or pursuing social, medical, legal, or spiritual transition, and processing what each step asks
- Navigating coming out, or choosing not to come out, with specific people in specific contexts
- Grief. For the version of yourself that did not get to grow up freely. For relationships that have changed. For time spent surviving rather than living.
- Joy and euphoria. For many trans folks, alignment with one’s gender is one of the most freeing experiences of life which deserves space.
- The exhaustion of operating in a hostile political climate, including hypervigilance, grief for community members harmed, and the specific fatigue of having one’s existence treated as a debate
- Family-of-origin work, including the relationships that have held, the relationships that have not, and the slow negotiation of who you can be in family contexts
- Sexual and relational concerns, including reconnecting with the body after years of disconnection, navigating intimacy through transition, and exploring desire and pleasure
- Letters for gender affirming medical care, approached with care, respect, and a commitment to reducing unnecessary barriers to accessing the care you are seeking.
- Dysphoria, including dysphoria that does not fit the common scripts and dysphoria that comes and goes
What this work can look like at MLC
In affirming care at MLC:
- We do not gatekeep. We are not here to assess whether you are really trans, trans enough, or appropriately trans-identified to deserve care. You are the authority on your gender. Our role is to support you.
- We work with folks at every part of this journey, including questioning, exploring, transitioning, post-transition, never transitioning medically, and transitioning in ways that do not fit the standard scripts. There is no single right way to be trans.
- We provide letters for gender-affirming medical care when that is part of what you need. We write them with care and respect.
- We hold the intersections seriously. Being trans as a Black or brown person, in a religious family, in a working-class context, as a person with disability, in a body that holds histories of trauma, as an undocumented person, these are not parallel experiences. Each is its own particular weather, and we pay attention to yours.
- We hold the political moment. Trans folks are living through a sustained political assault on the right to exist openly. The fear, grief, exhaustion, rage, and protectiveness that come with that are not pathology. They are appropriate responses, and we make space for all of it.
- We hold joy. Gender euphoria, chosen family, pleasure, the particular delight of being yourself in the world. These are not side notes. They are part of what makes the rest of the work possible.
The therapists at MLC do this work with care because we know how much harm has been done in clinical spaces. Some of our clinicians are trans themselves. All of our clinicians have done, and continue to do, the learning that affirming care requires. We are here to walk alongside you, in whatever your relationship to gender looks like right now.
