Toby Barron Therapy

Toby Barron Therapy

The Role of a Gender-Affirming Therapist During the Medical Transition Process

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Out of all US adults, 1.6 percent identify as transgender or non-binary. A transgender person is someone who identifies as a gender different from the one they were assigned at birth. 

Transgender folks often experience gender dysphoria – serious stress and negative emotions pertaining to the incongruence between their sense of self and their body or gender assigned at birth. Medical transition is a common piece of relieving dysphoria alongside personalized expression of gender identity (through clothing, hairstyle, behavior, etc.).

Going through a transition means embarking on a long journey that will lead to massive changes. Needless to say, many trans and non-binary people question the concept and wonder if it’s the right choice for them. The transition roadmap features multiple steps and having the support of a gender-affirming therapist along the way can bolster confidence and feelings of readiness in the process.

What Is a Medical Transition?

Medical transitioning, as the name suggests, involves medical treatments aimed at helping a person achieve a gender presentation they feel comfortable with.

Often, a medical transition follows a social transition. The first step often consists of:

  • Informing friends, family, coworkers, etc. of their pronouns
  • Choosing more congruent wardrobe and hairstyle
  • Packing, tucking, binding, etc.
  • Coming out to family members and loved ones
  • Changing one’s personal documents

Some parts of medical transition can occur without a person accessing a psychologist or other gender-affirming therapy professional. But for legal and insurance company-related reasons, certain treatments require a letter from a gender-affirming therapist or psychiatrist. As per recommendations by the World Professional Association for Transgender Health (WPATH), the health care provider will document a gender dysphoria diagnosis and they’ll also assess to see if clients’ social and safety needs are met in order to best access care.

gender affirmative for trans people

If a person pursues medical transition, it can involve one or more of the following procedures:

  • Hormone therapy (with testosterone, estrogen, or a combination of sex hormones depending on the intended result)
  • Facial feminization procedures
  • Top surgery (for breast removal and chest masculinization)
  • Augmentation mammoplasty (for breast growth)
  • Voice modification
  • Genital surgery like vaginoplasty, phalloplasty, and orchiectomy
  • Other surgical procedures (tracheal cartilage shave, hysterectomy, vaginectomy, stopping body hair or facial hair growth, etc.)

As you can see, gender-affirming medical care often (but not always) involves gender-affirming surgery and has many facets. Many trans and gender nonconforming people don’t desire or don’t pursue genital surgery. It’s important to be cautious of the notion of a “ successful transition”.  People’s needs around transition often vary wildly and can be nonlinear or not appear cohesive to others, but that doesn’t mean it isn’t authentic and valid. Upon exploring social transition, it may become clear that a person feels dissatisfaction with their bodily gender presentation, in which case a person can choose to medically transition and get surgical interventions or hormones to change their physical characteristics.

A gender-affirming therapist can play a critical role in helping a client identify their needs and to access ways to get their needs met. 

Who May Want to Consider Gender-Affirming Interventions

Gender-affirming interventions come in all shapes and sizes. Some people address their dysphoria exclusively through social transition, and this may be enough for them to feel content and authentic. In other instances, a more physical transformation will be required, which may include medical interventions.

So, who should consider this journey? For many people, the awareness is present at an early age. For others, a slow realization builds throughout adulthood.  And some people may even have a big “click” or “ah-hah moment” all at once in adulthood, which makes a lot of their past experiences suddenly make sense.  

Folks experiencing bodily gender dysphoria (or pursuing gender euphoria) may benefit from a consultation with a gender-affirming therapist. While some people have a very clear idea about their gender early on, others may need more time or support to bring their gender identity further into focus.

Even if a person is aware of their trans identity, they may still struggle with it mostly due to external social pressures or norms. If you’re one of these individuals, you may be grappling with how to best proceed. That’s normal – many trans and gender non-binary people question their reality and the journey they’ll potentially embark on in the future. 

trans person practicing their gender affirmative

Having questions about transitioning and your identity is normal. It’s normal to need a safe space to process your thoughts and feelings about social transition or medical procedures. Transitioning isn’t necessarily a linear journey. It’s ok to try different things or take a step back. Beginning the process by understanding the different ways to affirm your gender is usually an excellent choice that can build a solid foundation for the future.

How a Gender-Affirming Therapist Can Help You

Therapy can make a significant impact on your well-being and mental health, especially if you’re exploring fundamental aspects of your identity. Guidance and education on finding self-acceptance can be empowering and yield a better understanding of your options.

Working with a gender-affirming therapist is always a good idea as your mental health care professional can help you in more than one way.


People often feel they are not entitled to a broad range of emotions about gender identity or transition. A therapist who specializes in gender-affirming techniques will give you much-needed validation. Through these sessions, you should feel heard, understood, and seen. You will get a chance to work through your feelings, thereby noticing what is right for you.

Family Support

Coming out to family members and navigating important relationships can also seem like a challenge for many trans folks. A qualified therapist may be able to work with your loved ones to give them a better understanding of your struggles and a chance to adjust to the new situation.

Assistance with Mental Health Concerns

Dysphoria is debilitating for many trans and non-binary folks. Going through a transition can be linked to mental health issues like stress and anxiety. A trained gender-affirming therapist would be a great resource for working through those challenges.

trans person sitting on some stairs in the street

Having a Medical Advocate

Your gender-affirming therapist may also become your advocate if you choose medical transition. You can discuss the benefits, risks, and expectations for each procedure. A therapist can also give you referrals to help you contact experienced gender-affirming healthcare service providers. This way, you will be making informed choices and you’ll understand the procedures best suited to your needs.

Additional Types of Assistance

Your gender-affirming therapist can help you out in numerous additional ways, such as:

  • Addressing transphobia and discrimination
  • Accessing resources for dealing with the legal aspects of transitioning
  • Helping you figure out which parts of transition are going to help you feel more authentic and less dysphoric  (Exploring both social and medical transition as a means of treating gender dysphoria)
  • Educating coworkers or classmates (one’s social circle)
  • Processing and addressing internalized transphobia
  • Getting additional resources, e.g., support groups and communities

While finding a gender therapist with the right training and experience can be difficult, it’s very helpful to the process. They can help you develop coping skills and help you address the various stressors that may accompany gender exploration.

Remember! It’s normal to question and explore. Talking to a gender-affirming therapist can help people find their most authentic selves!