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

transgender guide for therapistsPsych Central contributor Edie Weinstein interviewed Nicole and Lori Bray, a couple she met last year when Nicole was in the process of transitioning from male to female. Their story touched her heart particularly, since they defied the statistical odds and are exceedingly devoted to each other through this arduous process. Part Two of the interview follows:

At this point, the attention of the interview turned to Lori, since she took the journey along with Nicole and has been steadfast in her support.

EW: How can partners/spouses/families be supportive?  Since this process is ongoing, how can the partner/spouse/family get support as well?

LB: How to Be Supportive

  • Understand that the Transgender individual has always been their identified gender even if they did not appear to be or did not always show signs. In other words, a biological male who identifies as a Transwoman has always been a daughter to a mother even if he appeared physically to be a son and showed mannerisms of a son. It’s the person’s gender identity that makes the difference.
  • Learn about the Transgender person’s story and what it means to them to be Transgender. What are some of their memories of when they did not seem to fit into their assigned gender? How did they seem to fit better into their identified gender? Learn about their story through their lens.
  • Use their preferred name and pronouns. If you make a mistake, fix it without making a big deal about it. Understand that you will make mistakes and that is okay. As long as you make the effort, the individual is usually appreciative.
  • Ask questions to understand more about the individual’s story. When news stories come up in the media, engage in conversation with the Transgender individual about these to demonstrate your support and that you are paying attention.
  • Check in with the Transgender individual to see how they’re coping with their journey. Gender dysphoria tends to ebb and flow. Your partner/spouse/family member will have some difficult days due to gender dysphoria. Talk about these openly and check in with them.

How to Get Support

  • Within your community, attend support groups for partners/ spouses/ families of Transgender individuals. Share your story, thoughts, and feelings with group members.
  • Within your community, attend support groups with the Transgender individual that are open to partners, spouses, and families. These groups allow you to meet other Transgender individuals and their families. This creates a greater sense of community and reduces isolation.
  • Join online groups for partners/spouses/families of Transgender individuals. This gives you the opportunity to chat with people around the world in similar situations.
  • Join Transgender Forums. Most have a section for partners/spouses/families. Furthermore, the other sections of the forums are very educational.
  • Seek out individual counseling with a therapist who understands gender identity issues.
  • Consider writing in a journal to document your thoughts and feelings.
  • Communicate with the Transgender individual about your thoughts and feelings as these may change over time.
  • Make sure that your focus does not become entirely about Transgender issues—allow time for other activities and discussions.

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
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