Transgender Issues: A Guide for Therapists Working With Clients in Transition Part 2

EW: What has helped you move through this experience as a couple?

LB: Nicole and I already had pretty strong communication in our marriage even before she came out. Once the transition process began, we made a commitment to one another to continue having open communication about our thoughts and feelings as each of us went through transition. Both of us understood that as Nicole went through a transition from male-to-female, loved ones were transitioning with her.

Outlining a timeline together that matched both of our levels of readiness helped us immensely. Again, this took open communication, lots of compromise, and a willingness to be open to each other’s ideas. Nicole was ready to transition immediately whereas I was ready to put on the brakes. The timeline helped both of us to recognize we were on the same page.

We became a two-person educational team by sharing news articles and research with one another whenever we came across it. This helped both of us to understand Transgender issues more in-depth which helped me to build my specialization within my practice and helped both of us to teach others about the needs of Transgender individuals.

Nicole and I decided to document our journey in different ways. Nicole is an independent filmmaker and is in the process of developing a documentary about her transition. I am writing a book about transition from the spouse’s perspective. Both of us discuss our project ideas frequently which allows for collaborative brainstorming and increased closeness.

Nicole and I also put great emphasis celebrating accomplished “Firsts” and milestones. For example, we will forever keep the first dress Nicole tried on. An accomplished milestone will be celebrated via a second birthday commemorating the day her Gender Confirmation Surgery took place.

Each of these concepts brought Nicole and I closer together as a couple. The concepts were born and developed by one of us discussing the idea with the other, brainstorming about it with open minds, and carrying it out as long as it fit for both of us. As you can see, open communication is the key to moving forward and developing closeness. If you can tie in humor into your open communication, the transition process will be filled with lots of good-natured laughs! This creates quality of life!

NB: The financial cost to transition from one gender to another can be unbelievably high. Lori and I kept track of nearly everything that we spent money on including surgeries, flights, hotel costs, car rentals, medications, replacing male wardrobe with a female wardrobe, and so forth and estimate the cost to be around $150,000. As a result, a full transition from one gender to another can be cost prohibitive for some. Unfortunately, at this time, insurance covers very little and, in most cases, no aspects of transition-related costs.

Therapists need to be prepared for this very issue to come up during counseling sessions. One part of the Transgender client’s dysphoria may be related to not having enough money to afford certain aspects of transition. At the same time, therapists need to be aware that not every Transgender client desires transition.

Therapists will need to develop an individualized plan that meets the needs of their clients, work with them to achieve their goals based on this plan, and develop coping skills to manage their dysphoria along the way.

Pride heart image available from Shutterstock

Transgender Issues: A Guide for Therapists Working With Clients in Transition Part 2

Edie Weinstein Moser, MSW, LSW

Edie Weinstein, MSW, LSW is a journalist and interviewer, licensed social worker, interfaith minister, radio host and best-selling author. A free-lance journalist, her writing has been printed in publications and on sites such as The Huffington Post, Elephant Journal, Beliefnet, Identity, Inner Child Magazine, New Visions, Holistic Living, Conversations, Bellesprit, The Whirling Blog, The Doylestown Intelligencer, The Philadelphia Inquirer, YogaLiving, Wisdom, Mystic Pop, In Your Prime, the “What The Bleep Do We Know?” website and The Bucks County Writer. She has been interviewed by the Philadelphia Inquirer, Fox 29 news, CBS 3 news, WWDB 96.5 and National Public Radio as well as numerous blog talk stations. Check out her website at:


APA Reference
Weinstein Moser, E. (2016). Transgender Issues: A Guide for Therapists Working With Clients in Transition Part 2. Psych Central. Retrieved on August 10, 2020, from


Scientifically Reviewed
Last updated: 12 Apr 2016
Last reviewed: By John M. Grohol, Psy.D. on 12 Apr 2016
Published on All rights reserved.