What Is Gender Therapy, and How Do I Find a Good Therapist for My Kid?

The following is an excerpt from Darlene Tando’s book,

The Conscious Parent’s Guide to Gender Identity: A Mindful Approach to Embracing Your Child’s Authentic Self (F+W Media, Inc, 2016).

Finding the Right Gender Therapist

If your child/teen comes out to you as transgender, you may want to find a professional to walk with you on this journey. Finding a good “gender therapist,” as some people say, can be a daunting task. If someone claims to be a gender “expert,” don’t assume your hunt is over. Ask questions (see below for a sample list) and always go with your gut instincts. Ultimately, YOU are the expert on your child.

Sample Questions to Ask a Potential Gender Therapist

How long have you worked with children?
Have you been trained in how to talk to and interview children in a non-leading manner?
How involved are the parent(s) in the therapy with the child?
What is your opinion about how young a child can understand their gender identity?
What is your general opinion on letting a child express their own gender identity?
And, depending upon where your child is in their gender journey: What are your thoughts on social/medical transitioning for transgender youth?

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!

If the therapist seems to focus at all on changing your child or getting your child to conform to the gender identity associated with their designated gender at birth, please do not hesitate to terminate immediately. This is known as “reparative” or “conversion” therapy and is illegal in some states. There is plenty of evidence that shows this method of treatment is extremely damaging to the children who go through it.

Let the 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. As referenced above, 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 should be tailor-made to your family.

Your child will be the best source of information regarding 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 will be an excellent historian for how your child has expressed their gender from an early age, current significant behaviors, any signs of distress, etc. Of course, part of the gender therapist’s job will be working with you in regards to your feelings about your child’s gender expansiveness, and feelings about potential options for your child’s future.

Red Herrings

Many parents are witness to their child’s gender expansiveness AND a lot of other emotions and behaviors. Sometimes it can be hard to tell which emotions and behaviors are elicited by internal gender struggles. Those that seem unrelated to gender identity but may actually be symptoms of the distress caused by dysphoria or nonconformity can be considered “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 expression is affirmed or 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, signs of a gender identity that does not match their assigned gender at birth, 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 from following the red herrings. Conversely, if your child’s therapist seems determined to only focus on these other things, and not address the gender topic, this should also be a red flag for you. While you may feel some relief if the gender therapist recommends holding off on making any major decisions or wants 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!

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 identity. Children tend to try to take care of their parents and avoid causing their parents distress; therefore hearing statements made by parents (particularly those expressing resistance) can impact their ability to say what they want and need in regards to gender expression, identity, 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 gender identity, 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.

If you are struggling to find a gender therapist that is right for your family, reach out for help online. There are several groups that can help you find one in your area, such as Trans Youth Family Allies, PFLAG, and TransFamily Support Services.

Darlene Tando, LCSW, has a private practice in San Diego and has been working with transgender youth/adults since 2006. She writes a blog about the many facets of gender and gender transition. Darlene is a proponent of the Informed Consent model and believes the individual is the “expert” on one’s own gender identity. Her role is to make the journey easier. Darlene recently authored the book “The Conscious Parent’s Guide to Gender Identity: A Mindful Approach to Embracing Your Child’s Authentic Self”.

Excerpted from The Conscious Parent's Guide to Gender Identity: A Mindful Approach to Embracing Your Child's Authentic Self by Darlene Tando. Copyright© 2016 F+W Media, Inc. Used by permission of the publisher. All rights reserved.