Transgender Issues: A Guide for Therapists Working with Clients in Transition

In order to go through a name change, you must attend a court hearing. Fortunately, this process was pretty uneventful, but you do have to meet before a judge with other people in the courtroom listening to why you are having your name changed.

Within my state, you also have to publish in the local paper the reason for your name change, along with your old name. Following the name change, I had to notify the Social Security Administration, Secretary of State’s Office, and every other company or organization that contained my old name that there was a court order in place for the new name. This took quite a bit of time to accomplish.

My Facial Feminization Surgery qualified me for a Gender Marker Change on my birth certificate. The Medical Affidavit needed to be completed by my surgeon, notarized, and submitted to the State. Then, I waited for my new birth certificate to come in the mail with “female” listed on it. Coincidentally, it was quite a treat to have this arrive on my birthday! The new birth certificate allowed me to have the gender marker changed on my driver’s license.

To me, the Gender Confirmation Surgery was the most needed surgery. From the beginning, my gender dysphoria was pretty severe and I was anticipating this surgery for years. At this time, I decided to have a Breast Augmentation done as well. Gender Confirmation Surgery requires a letter from two different therapists. I traveled out of state to obtain this surgery.

Even with the Voice Therapy, I just could not get myself to a place where I was content with the sound of my voice. It bothered me that my voice dropped whenever I was tired or comfortable with certain groups of people.

Furthermore, my voice was always a reminder of the old me due to the amount of effort I had to use in order to keep my pitch raised. For these reasons and several more, I knew I was a good candidate for Vocal Cord Surgery (Voice Feminization Surgery). I traveled out of state for this surgery.

As you can see, I traveled out of state often in order to complete various aspects of transition. Unfortunately, transition-related services are far and few between and few are provided within the state where I reside. Therefore, I traveled quite a bit in order to receive the steps necessary for my personal transition.

EW: What would you want therapists to understand and how would you recommend they respond to a client?

  • Create a warm, inviting respectful environment. Interact with the Transgender client as you would any other client.
  • Determine if the individual has a preferred name and pronoun and use these accordingly. When legal name changes occur, make certain that these occur on paperwork and office materials as soon as possible.
  • Learn about the person’s unique story and journey. Avoid making assumptions about how things may or may not turn out. Statistics are merely guidelines and should not be used as the determining factor to direct treatment. Avoid judgment.
  • Listen to your client. Understand that the client likely knows their gender identity. If they tell you they are Transgender, they most likely are. Avoid looking for problems or identities that do not exist.
  • For many years, Transgender was an “invisible” condition” because nobody talked about it and Transgender individuals transitioned in secret. Today, more and more individuals feel comfortable coming out, are seeking out therapy, and people are discussing Transgender issues. As a result, therapists are much more likely to have a Transgender individual enter their counseling office, so it is necessary to have some background knowledge on what being Transgender is and isn’t all about so that therapists feel qualified to begin treatment or to refer to an appropriate gender therapist while allowing the client to feel respected and to get set up with services.
  • If you are going to work with Transgender clients, do your homework and get educated on Transgender issues, WPATH, surgeons, how to find community resources, etc. Do not expect your client to educate you on all aspects of Transgender-related care.

Part Two will focus on Lori’s perspective.


Transgender Issues: A Guide for Therapists Working with Clients in Transition

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. 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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