An Intersectional Approach to Therapy with Transgender Adolescents and Their Families

In recent years, transgender individuals have experienced both greater visibility and increased discrimination, such as direct discriminatory practices and removal of Obama-era protections for transgender students. Minority stress theory suggests that discrimination toward gender identity is related to poor mental health outcomes. This hypothesis is supported by the literature regarding transgender adults and adolescents; notably, familial rejection is highlighted as having a strong association with negative outcomes. The field of psychology has continued to explore best practices in approaches to family therapy with transgender individuals. Gender-affirming techniques have gained momentum, largely due to a recognized need for therapy techniques that aim to cultivate familial support for this vulnerable population. As transgender individuals and their families hold many social identities, including race, ethnicity, socioeconomic status, and gender, affirming family therapy involving transgender individuals must explore ways in which gender identity intersects with and is understood in context of family members’ other identities. In particular, we must explore how identities may serve to bolster or impede therapeutic processes targeting acceptance. The current article aims to raise awareness of a need for an intersectional approach with gender-affirming family therapy techniques. We detail ways intersectionality can inform therapy practice and provide case examples from our work with a diverse group of transgender adolescents and their families.