Supporting Trans Young People Through Counselling and Therapy

Recently I was privileged to attend this event organised by Gendered Intelligence for therapists and others who work with trans young people and children. As we introduced ourselves it became very clear that I was the only person in attendance who lived or worked north of Coventry. Obviously this was not because of a lack of interest or expertise in other parts of the country, but perhaps the issues Rural Rainbow explores, that young people will move to the big city, did come into play.

The conference itself was inspirational. To be in a group of people who see knowledge sharing as not only positive, but a vital part of what they did meant that every moment was used to the best effect. The aim was partly to work out how best to put young people who needed or wanted counselling in touch with the right counsellor for them. As I discuss here you really should interview your counsellor. Therapists are not all the same, and in such an intimate relationship finding the right one for you is vital. I am of course aware that many people can only access counselling via charities or the NHS, and may feel they have no choice. However if there is a possibility of choice, pursuing it is so important.

For one of the sessions we were asked what trans meant. It seems an obvious question, and many umbrellas were drawn. Below is a quick picture I took of our brainstorming.

brainstorming what trans means

It soon became clear that for many (but by no means all) young people exploring ideas of gender and identity the old fixed binary certainties are not part of their landscape. It was pointed out just how recent terms like non binary are. I myself likened our current position to people who believed there was a Hadrian’s wall between cis and trans, one crossed with interventions and surgery, who were instead discovering there was an uncharted area, with many meandering streams and paths. We thought the world was black and white, and instead (if you will forgive me) discovered it is 500 shades of grey.

What does this mean for trans Young People?

During the course of the event what struck me most strongly was that in this we have to be the followers. If like me you grew up with just a few, very fixed, genders and gender identities, you are having to unlearn, and learn at the same time. As therapists this should be our perpetual state of mind anyway. We should be approaching each new client without preconceptions or prejudice, accepting their realities, learning from them about their world. Which is not to mean that we should expect them to educate us. As I have discussed previously that is very different and can itself mean people disengage from counselling.

What struck me most is that trans young people, like all young people, like all people, are looking for the basic three core conditions. However to those in a particularly vulnerable place in society it is even more important they are offered.

What Are the 3 Core Conditions?*

Unconditional Positive Regard.

I feel this is best summed up by what is perhaps my motto – Everyone is doing the best they can with the resources they have available to them. It is a radical stance when you realise everyone includes the young person who is self harming, the client who uses drugs, the mother who rejects her LGBTQ child, and the child who rages against that mother. In the context of trans young people it means accepting, with heart and mind, their own self concept. Believing they are the ones who know themselves best, and wholeheartedly supporting any and all decisions they make about their gender.


UPR has at its heart empathy towards others. In a client/therapist relationship this means we go beyond merely trying to understand a client, but also accept their emotions, their attitudes, their beliefs. Empathy is not however sympathy. It does no good to say “That is really upsetting” if we hear of transphobic bullying or transmisogyny. Empathy is about seeing how those things can cause pain, even if our experience of life is very different.

The best explanation of the difference between empathy and sympathy I have encountered came from one of my old tutors. You are walking along and you see someone has fallen down a hole. Sympathy is jumping into the hole to give them a hug. Empathy is throwing them a rope so they can get out of the hole.


Another word for congruence is authenticity, and I think in dealing with people who are searching for, or trying to express their own identity, to become authentic, it is a vital quality for therapists to demonstrate. Sometimes we may have to express our ignorance, to go away and research something, to admit we grew up in those days of strict demarcations and no grey areas.

Another aspect of congruence is admitting the boundaries of our own competence. When I conducted my research on the barriers trans people faced accessing counselling many respondents detailed previous negative experiences. People were willing to take on trans clients without examining their own prejudices and biases. This lack of congruence led to many negative therapeutic experiences.

This is not to say it is acceptable to be prejudiced against any group. However to not even have the congruent attitude that makes one aware of your prejudice does, it seems to me to be a huge issue.

In conclusion the event left me very positive about the future, and optimistic that there are many people across the country looking at how we offer trans young people the support they want and need. As Gendered Intelligence themselves say their aim is to improve the lives of trans young people, empowering individuals to advocate for themselves and make positive life choices. As a profession we can, if we are determined to be the best we can be, take a vital role in that.

  • I am aware any number of different core conditions have been identified, however what struck me at the event was just how important those fundamentals are.

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