For many years, therapists have often been perceived by trans people as gatekeepers to transition. Doctors would not write a hormone prescription without a referral letter from a mental health specialist; surgeons would not perform transition-related surgeries without a similar referral letter. Viewed in this light, many trans people did not consider that therapy might be beneficial beyond providing referral letters. This entry addresses what affirmative therapy might look like, beyond providing letters leading to treatment with hormones and surgery.

There are few populations as diverse as trans people. (Trans people cannot even agree on terminology, as some will not use the umbrella term trans.) The only thing this population has in common is calling into question birth gender assignment. What does affirmative therapy look like, ...