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Therapy Experiences of Transgender and Gender Diverse Adolescents and Their Caregivers

ABSTRACT Transgender and gender diverse (TGD) adolescents and their caregivers have highlighted the dearth of providers trained in gender-affirming practices as a critical treatment barrier, yet little is known about their specific experiences in mental health therapy. The present study sought to elucidate these experiences. Qualitative description was employed to analyze data from 105 clinical interviews completed with TGD adolescents (n = 49; ages 11–20) and/or their caregivers (n = 65; ages 36–84) seeking medical gender transition services at a pediatric gender program in the U.S. Participants highlighted satisfactory experiences with therapists they perceived as gender-affirming and who actively involved caregivers in therapy. Several participants reported unhelpful experiences with therapists viewed as non-affirming. In a few cases, caregivers were alienated from therapy when therapists told them to affirm their adolescent’s gender in highly directive ways. Findings underscore the need to train therapists in gender-affirming practices and highlight the importance of thoughtfully engaging caregivers in therapy.