Amidst the usual holiday / end of year flurry, trans people and families have been concerned about upcoming changes to transgender rights (e.g., bans on military service, healthcare bans,, or other policies). They’ve been preparing legal documents, pouring hours into information seeking, and considering drastic life changes, such as whether to uproot and relocate the family.

They’re fairly consumed with questions like, “Will I lose access to my hormones?”

“Will my child’s school change its policies?” 

“Should we move?” 

“Change jobs?” 

“Do I have all the information I need for making decisions for myself or my family?”

As a provider, you might be wondering, “What can I do to help my transgender clients and their families who are worried, burned out, and grieving at this time?” “How do I deal with my own worries in continuing to do this work?”

Here are some tips for addressing the needs of your trans clients (and possibly yourself)…

Validate your client’s sense of fear, marginalization and/or hopelessness. 

For your client, it might feel as if the world is against them, or their family. It’s extremely important to not minimize their feelings of “paranoia” or defensiveness. The world feels unsafe, and uncaring of their feelings (if not their whole existence). They’re likely experiencing a marked increase in microaggression and disparagement, as people they’ve regularly interacted with may feel encouraged by the current media climate to say or act differently.

Your client also might not have had the space to express feelings of grief and disappointment, outside of friends and family. Interacting with coworkers or peers might feel like trying to cross a minefield. They might have overheard comments that have made them feel unsafe, triggered, and uneasy, and simultaneously felt disempowered / discouraged from responding. 

Mirror and confirm that what they’re feeling is understandable, and confirm the appropriateness of feeling angry and sad at the same time. Affirm that responding in those triggering situations could be unsafe, or put them into unwinnable situations, and explore actions they can take.  Notice their reactions; do they shut down, or become passive aggressive? What do they do once away from the person and situation–what are their coping mechanisms? Do they have the skills to navigate a situation they can’t change and can’t leave?

You may need to help them understand healthy boundaries, and (if they need) give them permission to decline invitations or extra responsibilities during this time. Help them remember that setting clear boundaries protects their emotional energy, and will yield more time for recuperating from unavoidable stress. 

Also, try to help them recognize whether their coping habits are helpful or harmful.

Introduce your client to new coping skills. 

Here are a few tools that can help your clients, your supervisees and even yourself in times of stress.

The Power of Mindfulness (practicing presence)

A few of our favorite, most recommended mindfulness techniques…

The 5-4-3-2-1 Grounding Exercise (learn more):

Identify 5 things you see,

4 things you can touch,

3 things you hear,

2 things you smell, and

1 thing you taste to anchor yourself in the present moment.

Along with that, you might recommend deep breathing techniques like Box Breathing (inhaling for 4 counts, holding for 4, exhaling for 4, holding

for 4), and 4-7-8 Breathing for reducing anxiety and insomnia.

For clients who are feeling explosive or incapacitated by their feelings, you might help your client explore coping techniques for managing feelings of distress over unchangeable situations. 

Dialectical Behavioral Therapy helps people who struggle with emotional dysregulation learn positive coping skills for managing emotionally intense, and unchangeable situations.  While DBT may not be your go to model, many of the skills are very helpful for our current situation. DBT in part involves learning mindfulness practices, or (the opposite side of the coin) learning to engage in helpful distractions. 

DBT skills can help you and your client manage the intense feelings they’re experiencing each day leading up to the inauguration, as well as learn to healthfully manage whatever comes after. These skills might seem basic but are very important, such as meditation, going for a nature walk, or connecting with a friend.

Build resilience by changing the meaning of the situation, or reframe the experience.

Without being dismissive and if it feels right you may help your client reframe their difficult experiences. Bring attention to the fact that being trans speaks of their innate ability to transform, evolve, and survive. Invite your client to consider this chapter of their lives as a stage of conscious evolution, where they are able to proactively respond to the fear, anxiety, and grief.

One effective exercise for helping clients reframe their experience is therapeutic storytelling. Therapeutic storytelling is a common practice of writing and analyzing one’s narrative (if not a chapter within that overall narrative), starting with seeking the “therapeutic metaphors” in the literal story, then creating the “new” story.

Although intended for children, this pdf has guidelines for therapeutic storytelling to help clients focus on the reframe process. You might adapt this into homework, or spend the session helping your client actively write and rewrite the story underlying this passage, so they can recognize the themes within current events are reshaping their “role” within their story.

Another activity for reframing their experience might be the “ikigai” worksheet, available through the PositivePsychology website. “Ikigai” is a Japanese concept, and refers to the process of finding one’s unique life purpose.  The process of finding this purpose is intended to help guide one’s current and future behavior, so that their choices are aligned with the mission of fulfilling their unique purpose. 

You can learn more about “ikigai” on this webpage, as well as explore other related activities and prompts for helping your client use the worksheet as a tool.

If interested, you can refer to some of the tools in this article, “23 Resilience Building Activities & Exercises for Adults”, and adapt some of the tools intended for measuring or testing individual resilience for your client.

Finding a community to validate their experiences. 

This is the most important thing for all of us right now and is incredibly potent for trans clients at this time. They might be afraid and grieving now, but remind your trans client that the trans community is known for its collective resilience. This is an opportunity for strengthening solidarity and communal bonds within their existing support networks. We need each other.

Encourage clients to reach out to people who are feeling the same fears and concerns, who are also deeply internalizing the political rhetoric and social commentary, and who would be able to make satisfying remarks about the news, and ultimately offer support and recognition.

If your client has a trans family member, and feels they’re unable to connect with many people who quite understand what they’re experiencing (perhaps due to living in a region where gender diversity is particularly stigmatized), it might be helpful referring them to an online community that can offer them the connection they crave.

A few resources for helping  LGBTQIA+ people, families, and professionals find and connect with one another…

CenterLink: The Community of LGBTQ Centers

CenterLink provides a directory of LGBTQIA+ community centers worldwide. These centers often host support groups, social events, and workshops designed to foster a sense of community and belonging.

Website: lgbtqcenters.org/

PFLAG (Parents, Families, and Friends of Lesbians and Gays)

PFLAG is one of the largest support networks for LGBTQIA+individuals and their families. They offer local chapters across the U.S. where people can connect in person, as well as virtual meetings and resources for community building.

Website: pflag.org/

The TransFamily Alliance Education & Membership Community

The TFA Education & Membership Community offers a virtual education center filled with science-backed resources, alongside a safe, resourced, and vetted community for connecting with other parents and caregivers of gender-expansive youth.
NOTE: TFA Membership is now open for new enrollments January 1-31st, 2025.

Website: .transfamilyalliance.com/community/

Make sure that you’re doing the same practices that you’re suggesting to your clients. 

As a counselor and therapist, you are probably empathizing with your client, and treading the deep emotions your clients bring to you. You also may be worrying about the potential attacks on you and your practice for your work. Remember to allow yourself time and space to process these feelings. Grant yourself the time and space for using some of your own favorite therapeutic tools and activities, as well as for exploring new ones.

GHTI Advanced Coaching & Mentorship Program

In our Coaching and Mentorship Program, we dive deeply into an understanding of both your trans clients’ and their families’ journeys alongside your own clinical gender journeys to help you provide competent care with confidence and cultural humility while avoiding the ethical pitfalls along the way.

Website: genderhealthtraining.com/coaching-and-mentorship/

Links & Resources

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