How to Become a Gender Therapist


A gender therapist is a licensed mental health therapist that works with people who are either exploring their gender or who have already transitioned their gender to present in the way they are most comfortable in life.

A gender therapist is specialized to work with clients who are transgender, gender non-binary, genderqueer and gender fluid as well as other people who are transgender.

A gender therapist works with clients to explore their identity or affirm their true gender identity. When a person is considering transitioning, a gender therapist can help them with the process such as writing gender affirming letter to their doctors or processing self-esteem and discrimination or oppression that people are experiencing.

A gender therapist can process with the client their identity so they can feel fully ready to transition or come out to others in their affirmed gender.

There has been some discussion on whether mental health therapists or counselors should call themselves gender therapists because gender dysphoria and being a part of the transgender community is not thought to be a mental illness by most gender therapists, so therapists want their clients to know they are treating the whole person, not just their gender identity.


As a gender therapist, therapists may be asked to recommend clients to begin hormones to transition their gender or they might write gender confirmation surgery letters for clients. When therapists write these letters, they are assessing the mental stability of their clients to make an informed decision to start hormones or have surgery as well as their gender history and diagnosis.

Therapists are charged with exploring with the clients their gender identity and how they may want to disclose their gender identity if they choose to do to other people. A gender therapist will explore with their clients the ways their gender affects their self esteem or self-worth and feelings of co-occurring depression, mood disorders or anxiety they may have.

Often gender therapists also teach other therapists how to be gender affirming and educate their colleagues on best practices when working with transgender clients. While gender therapists generally work with teenagers and adults, they can also work with young children and elementary age children at times.

The responsibility of a gender therapist is to protect their client’s safety and mental wellness and offer positive affirming care for their gender transition and mental wellness as a whole, not just in regards to their gender identity. A gender therapist treats the whole person and focused on the person as whole with multiple intersections of identity.

What is the difference between an LGBTQ friendly therapist and affirming therapist and how can you become affirming and knowledgeable?

To learn about how to become a gender therapist, it’s important to note the differences between someone who is affirming, someone who is knowledgeable and someone who is well trained in gender therapy and The World Professional Standards of Care Version 7, for working with transgender clients.

A therapist that is affirming is someone that works with clients and believes in clients identities based on who they are and what the client tells them. An affirming gender therapist would use the client’s correct name and pronouns and not try to sway the client not to be who they are as a person. They may have taken a transgender 101 continuing education class, or their personal belief system is affirming to the transgender community.

A therapist that is knowledgeable and affirming is someone who may have had a continuing education course about gender identity that is beyond a basic transgender 101 course and knows more detailed information such as information about the medical transition process and a better understanding of diagnosing gender dysphoria.

A gender therapist that is well trained in working with transgender and non-binary clients has been to multiple advanced trainings and continuing education surrounding the transgender community and may have taken medical training as well.

They have received supervision or consultation about working with clients who are transgender and have taken and sought classes that more involved and advanced than a 101 training. They may teach other therapists how to work affirmingly with transgender clients and they may offer other therapists’ supervision or consultation to work with transgender clients.

The process of becoming a well-trained gender therapist is an on-going process that requires staying up to date with new surgery techniques and reading new research about working with transgender clients. Often times therapist attend yearly national gender conferences to obtain this training because there may not be local training available to them.

Education, License and Certification

In order to become a licensed therapist, you need at least a master’s degree education. If you are interested in pursuing graduate school to become a therapist, you don’t have to have an undergraduate degree in a helping profession.

You can change focus.

Graduate degrees are often obtained in social work, psychology or professional counseling and LMFT’s often have a certificate in Marriage and Family therapy.

Most therapists are either licensed clinical social workers, licensed professional counselors, licensed marriage and family therapists or psychologists. After a student receives their master’s degree, they generally take a test to become an associate licensed therapist, which is someone that is still practicing under the supervision of another fully licensed therapist.

Therapists are responsible for approximately three years of supervised directed work experience and receive over one hundred to one hundred and twenty-five contact hours of supervision with a fully licensed therapist in order to apply to their state boards to take their test for becoming fully licensed. A therapist must take and pass a test in their degree specialty to become fully licensed after their supervision and work experience.

After high school, it takes at least six years of education and three additional years of supervision to become fully licensed for a total of nine years of training to become a fully licensed therapist.

Advanced Training in Working with Transgender Clients

The World Professional Association of Transgender Health, or WPATH publishes the standards of care for mental health professionals and medical professionals who work with transgender clients and patients. They are currently using standards of care version 7, published in 2011 and have formed the committees to begin the process of writing and publishing version 8.

WPATH standards of care are written to guide professionals on the standards of working with clients such as how to write a letter for beginning hormones and when it is recommended to have gender confirmation surgeries. The standards of care include recommendations for surgeons, primary care physicians, endocrinologists, and mental health professionals as well as other professionals.

A gender therapist should have extensive knowledge of the WPATH standards of care most current version 7. WPATH is currently working on publishing the next version of The Standards of care Version 8.

WPATH currently offers a certification, the GEI certification in transgender health care that is excellent training and in-depth covering 50 hours of education, but they are still in the process of completing the final requirements for the program.

There are several conferences each year with a focus on gender identity including the long-running Philadelphia Trans Wellness (formerly Health) Conference. It is a three-day conference in the summer that offers a professional track that allows for continuing education credit hours and a general track that the transgender community can attend for free annually.

Gender Odyssey is also a three- or four-day conference each year, this year in San Diego, that offers continuing education for mental health therapists to learn more about giving affirming and knowledgeable gender therapy.

There are several other conferences throughout in the United States of America that are focused on the transgender community and there are others worldwide.

It is recommended that if someone is a gender therapist that they receive ongoing supervision or peer to peer consultation with other more seasoned gender therapists in order to increase their skills in working with the transgender community on a continuous basis. A peer supervisor or consultant should have great experience working with a number of transgender clients and have knowledge of the intersectionality that is possible with clients who are transgender.


According to, the average median salary for a licensed clinical social worker is 67,300 dollars in a metro area and 56.429 dollars in a rural area.

Psychologists can make upwards of 92,000 dollars.

Gender therapists can work in a variety of settings including private mental health practices or for a public employee. Gender therapist can also be compensated by offering continuing education to other therapists and provide public speaking engagements and write and publish books on the topic for additional streams of income.

Job Growth and Outlook

Gender therapists have a positive job outlook. As the community of transgender people rise, more people will have the need for gender therapy and gender therapists should see an increase in services requested. More hospitals and private mental health centers are hiring clinicians that are trained to work with transgender clients.

There are multiple opportunities for training and speaking engagements at conferences around the United States of America and worldwide through WPATH.

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Katie Leikam specializes in working with anxiety, relationship stress and helping people with their gender identity. She is also a speaker, educator, author and consultant for other therapists for their business goals.