Finding a Trans-Affirming Therapist

Guest Author: Acey Mercer, LMSW

As a trans-identified therapist, I have had the unique experience of navigating transition for both myself and others on their own journey. There is no cookie-cutter way to transition, though having support can make the experience easier. The path to one’s authentic self can be filled with trials and tribulations, therefore having a compassionate mental health professional present for support and guidance can be life-affirming. For many people, it takes time to become clear about exactly what their authentic identity is. Confusion around one’s gender can be especially painful. Good therapy offers folks the opportunity to explore their gender identity safely, while also having access to referrals for additional transition-related services.

All that said, I know firsthand how frustrating and overwhelming it can be to find the right providers, particularly those that are not just trans-affirming, but knowledgeable about trans health care, trans bodies, and able to provide referrals for good medical care. Unfortunately, few mental health providers have training on how to best support transgender clients. The search for competent and empathic providers can be daunting, no doubt. Nevertheless, trans-affirming and informed practitioners absolutely exist and are out there! Below I’ve offered some tips on how to find a good therapist and characteristics to look for:


Poll your peers.

If you have contact with other trans-identified folks, ask them! Perhaps they know of some really great providers. The best referrals will come from the experiences of other trans people. Word of mouth is a powerful resource.

Connect with community.

Is there an LGBTQ center or well-known organization in your area or nearby? Chances are they may have a list of agencies that are trans-affirming.

Check out WPATH.

The World Professional Association for Transgender Health has a provider search page - just type in your information to see what’s available near you. WPATH is an internationally recognized body of medical and mental health professionals that has published extensively on the experiences of transgender individuals and guidelines for treatment and support. People who are WPATH members, are specialists in working with trans and non-binary people.

Click “Find a Therapist” then type in your city or zip code. On the left it lists “Issues” - click “Transgender.” Therapists who advertise on Psych Today list all the populations they are work with (trans, children, couples, etc.). Someone who lists trans is likely supportive, but may or may not have had advanced training. You may want to ask them some questions on the phone about their experience and skill-level.



Before beginning a therapeutic relationship, interview the therapist and inquire as to their degrees, qualifications, and belief systems regarding gender as well as more general psychotherapeutic issues. Remember that you are the consumer. If you are not satisfied with the therapists' expertise, or style, find another more compatible therapist. Therapy can be a healing and empowering experience, so do your homework to find the right person to work with.

Licensed Professional.

The therapist can hold a number of different degrees including a Master’s in Social Work, Counseling Psychology, or Marriage and Family Therapy. However, they should be trained in a wide range of practice skills including individual and family therapy, psychodynamic and developmental processes, mental health issues, addictions, and trauma recovery. Ideally, the person should be eclectic in their treatment approaches, and treat each client as a unique person, without fitting them into a predetermined treatment modality.


The therapist should be aware of issues of sexual and gender identity, and the impact of political and social forces in the construction of identity. A clinical and medical knowledge is not enough; an understanding of the intersectionality of identities is essential.

Training background.

Ideally, the therapist should have some training in gender issues. This means that they have studied transgender identities through courses or research, and are affiliated with transgender organizations. This can be a difficult obstacle, since there is limited training available. Many people with advanced degrees have little knowledge in this area, and some people who are very knowledgeable are "self-taught." If the therapist admits to a lack of concrete knowledge, they must be willing to read and study, as well as be under the supervision of someone trained in gender issues.


You must feel comfortable with the therapist. This is something only you will know, and may have little to do with the therapists' skill. This is about "connection," and in order to trust and make use of your time, nothing is more important that an authentic relationship.

Making the decision to seek counseling is not an easy one. It can be especially challenging for transgender individuals given the lack of informed providers. Too often trans folks are avoiding or delaying medical and mental health care for fear of being misunderstood.

Source: 2015 Transgender Discrimination Survey

Because of this reality it becomes imperative that we make these proactive advance efforts to assess practitioners in order to identify those that are competent and trans-affirming.

As someone who has navigated the transition process and now provides therapeutic services at Choices Counseling & Consulting, I want to offer you hope that there are professionals out there that care, are educated, empathetic, and eager to provide you the support you’re needing.

There are educational opportunities available to increase cultural competency within clinical and medical settings. If you know of providers needing professional development when it comes to serving trans individuals, I invite you to refer them to the Training Institute for Gender, Relationships, Identity, and Sexuality (TIGRIS).

TIGRIS provides consultation, educational trainings, as well as policy development and implementation as it relates to best serving transgender and nonbinary populations. TIGRIS has provided professional development for various educational institutions and programs, and regularly conduct trainings for mental health and medical providers in various venues, including hospitals, clinics, college counseling centers, nonprofit and for-profit agencies. TIGRIS also facilitates monthly online clinical supervision for practitioners.

Acey A. Mercer, LMSW is a graduate of the University at Albany School of Social Welfare, where he obtained his Master’s in Social Work. Prior to graduate school Acey studied at Radbound Universiteit in the Netherlands where his academic focus was in Gender and Sexuality Studies. These foci ignited Acey’s passion to further explore and examine human behavior, relationships and the dynamics of class, race, ability, gender and sexuality. These motivating factors drew Acey to pursue social work and ultimately to become a licensed psychotherapist and educator. Acey is currently Practice Manager at Choices Counseling & Consulting in Albany, NY where he oversees clinical referrals and is responsible for the overall daily operations. He is also a Clinician at Choices and counsels clients exploring gender identity and expression. He works with adults, youth, and their families as they navigate questions and challenges related to the social, legal and medical aspects of gender transition. Acey’s clinical lens gives a strong compliment to the professional education services he delivers as Senior Consultant of the Training Institute for Gender, Relationships, Identity, and Sexuality (TIGRIS). Acey specializes in providing clinical training and policy development as it relates to best serving transgender and nonbinary populations in medical, mental health and educational institution.

Contact Acey:

Acey Mercer, LMSW

Choices Counseling & Consulting

Training Institute for Gender, Relationships, Identity & Sexuality (TIGRIS)

10 Colvin Avenue, Suite 102

Albany, NY 12206

Phone: (518) 438-2222

Fax: (518) 438-7777