3 Mistakes to Avoid When Working with Transgender and Non-binary Clients

By Kristie Overstreet on October 21, 2019

Have you ever worked with a client and felt unsure if you are providing the best support? Whether you are a new or seasoned therapist in the mental health field, we all can benefit from ensuring we are giving the best care. When you work with transgender and non-binary clients, it’s essential to provide the clinical care they deserve.

Many transgender and non-binary people face hardships, which can include discrimination, fear of violence, suicide, as well as lack of family support. Clinicians need to be aware of how their assumptions and perspective affect their clinical presence.

As clinicians, we aren’t perfect, but we must continue to work on our clinical skills. There are many mistakes that clinicians can make in working with transgender and non-binary clients; here are three to avoid during your next session.

1) Assuming you know what is best for your client

Regardless of the amount of training or experience we have, we can’t place ourselves as the authority in our client’s life. Even though this is a fundamental clinical skill, some clinicians forget this when working with transgender and non-binary clients.

This often happens when a transgender client discusses their social or medical transition journey. For example, the client shares that they want to start hormone replacement therapy before coming out to their partner. If a clinical tells their client that they should come out to their partner before they start their medical transition, then they are placing judgment on their client’s decisions.

Just because we are clinicians doesn’t mean we have the right to tell the client what we think is best for them or offer judgment. Our clients are responsible for their decisions and actions, so we can’t tell them what we think is best for them. Don’t make the mistake of telling your transgender and non-binary clients what you think they should do with their life.

2) Asking your client to educate you on gender identity

You probably have worked with a transgender or non-binary client that has told you that they had to spend most of their last counseling experience educating their therapist. This pressure for the client to have to teach during their therapy session ends with you.

It’s not the client’s responsibility to teach the clinician what they need to know about gender identity. Our clients attend therapy for many different reasons, but none of these are to pay for counseling services, then spend the session explaining themselves.

There is a difference in asking your client about their experience if it’s what they want to discuss versus asking your client to explain the differences in gender and sexual identity. Whether it’s the clinician’s expressing surprise about the basics of gender identity to non-binary differences, the client is there for therapy, not to educate. Knowing the difference in sexuality and gender identity prior to working with clients is just the start.

3) Struggling to understand why your client is non-binary versus transgender

One area that some clinicians struggle with is the difference between non-binary and transgender people. This mistake can negatively affect clients. For example, your non-binary client shares with you a part of themselves, and you tell them that it sounds like they are more male than non-binary. Then you tell them that they may be more transgender than non-binary.

As a clinician, it isn’t our place to tell a person who they are or aren’t. Often the client is on a journey to figure out who they are. This is where a culturally competent clinician helps support the client through their journey.

A trained clinician will help the client be their best self without casting judgment or telling them who they should be. There are differences along the gender spectrum, and it’s our job as a clinician to support our clients through their exploration.

If you want to learn how to be a better clinician to transgender and non-binary clients, attend trainings and workshops to improve your clinical skills. Be sure to understand the basics of gender and sexual identity. Be prepared to provide culturally competent care to all clients regardless of where they are on the gender spectrum.


Dr. Kristie Overstreet is a clinical sexologist, certified sex therapist, licensed professional clinical counselor, author, speaker, and consultant. She holds a Ph.D. in Clinical Sexology, Master of Arts in Professional Counseling, and a Bachelor of Science in Biology. She is a licensed counselor in California, Florida, Georgia, and Louisiana. She is also a Certified Sex Therapist and Certified Addiction Professional. She has over 12 years of clinical experience specializing in sex therapy, transgender healthcare, relationships, and helping counselors build their private practice. She is president of Therapy Department, a private practice that provides counseling, training, speaking, and consulting services across the United States.  For more information about Dr. Kristie's work visit www.KristieOverstreet.com.


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October 22, 2019


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