Many people have the luxury of experiencing life through the lens of their true selves without a second thought. Gender-affirming care helps all individuals do so.

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At Inner Balance Counseling, our LGBTQIA+ therapists treat every client respectfully by acknowledging and accepting them and their identity. Those seeking gender affirmation evaluations are in particularly unique situations. We understand they need therapy and care unique to those situations and the individual. 

What Does Gender-Affirming Care Really Mean?

Gender-affirming care comes down to respecting all gender identities and sexual orientations. LGBTQIA+ individuals often don’t have easy access to resources about their orientation or gender.

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In many cases, they don’t have someone in their immediate circle identifying the way they do. Many people raised in heteronormative environments are full of feelings and thoughts that they struggle to navigate. And, all too often, they are surrounded by ignorance and hostility.

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Gender-affirming care helps these individuals navigate those thoughts and feelings about identity and orientation. Through therapy and education, we affirm, support, and validate the individual’s identity and self-perception.

Talk Therapy

Psychotherapy, or talk therapy, benefits everyone, regardless of who you are or what you’ve been through. A therapist will talk with you about goals, sort through emotions, thoughts, and experiences, and give you the tools to live life how you want.

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Gender affirmation therapy does all these things through a unique lens of the LGBTQIA+ experience. Therapy can help resolve traumas seen at a higher rate for these individuals, often religious or sexual abuse. 

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Many seeking affirmation therapy experience shame, guilt, or fear due to past experiences or upbringings. This focused care can help resolve these fears and help these individuals explore their identities in a safe and encouraging environment. 

Medical Care

Gender identity doesn’t stop at how a person feels, but often includes how they present themselves. This presentation might start with (or, for some, only extend to) different clothing or hairstyles. Another example: a person assigned female at birth who doesn’t identify as female may wear a chest binder to lessen the appearance of breast tissue. 

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For many transgender individuals, gender-affirming care will lead to a medical transition. This transition may include hormone therapy and medical procedures aligning a person with their preferred gender, such as a hysterectomy or facial hair removal. These interventions vary significantly in invasiveness, and there are no rules for what an individual is allowed or “should” do.

Who Is Gender-Affirming Care For?

Gender-affirming care aims to help individuals who identify with a different gender than that assigned at birth. When these two things conflict, it can cause a person to feel distressed. This situation is known as gender dysphoria.

Gender Dysphoria

Psychologists define dysphoria as a sense of unease, dissatisfaction, or unhappiness. Therefore gender dysphoria is that feeling of dissatisfaction with your gender. 

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Gender dysphoria often manifests as unhappiness with yourself and negative feelings and issues that go along with that. Someone with gender dysphoria may feel:

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• Low self-esteem
• Depression
• Anxiety
• Isolation

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A doctor or psychiatrist can diagnose someone with gender dysphoria if they present at least two symptoms for at least six months. These symptoms include:

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• A marked incongruence between one’s experienced/expressed gender and primary/secondary sex characteristics
• A strong desire to rid one’s primary/secondary sex characteristics because of a marked incongruence with the experienced/expressed gender 
• A strong desire for the primary/secondary sex characteristics of another gender
• A strong desire to be of another gender
• A strong desire for others to treat you as another gender
• A firm conviction that one has the typical feelings/reactions of another gender 

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Many people with gender dysphoria find other genders more appealing. They begin to role-play or experiment with more outward representations of their preferred gender, such as clothing, makeup, and even names.

Gender and Sex are a Spectrum

It’s important to remember both gender and biological sex exist on a spectrum. Gender is a subjective construct, and there are no limits to where a gender identity can land on the spectrum (or even how long you’re there). 

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We used to think of sex as chromosomes determining your genitals. We’re learning that it is far more complicated than that. Yes, the X and Y chromosomes we learned about in high school biology play a part, but so do hormones and different genes. Different sex characteristics show up later in life, and the grouping and arrangement of X and Y chromosomes have many possibilities. 

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Essentially, gender dysphoria doesn’t have to mean a person wants to be the “other” gender. A person needs to explore an incredible amount and levels of nuances through gender-affirming therapy.

Stages of Transitioning

While gender affirmation therapy is an option for anyone wanting to explore their orientation and identity expression, it’s essential for someone looking to transition.

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Transitions usually happen in different stages, and gender-affirming care defines the counseling and medical treatment a person receives. 

Social Transition

Social transition refers to the immediate things that you can control to express your gender identity to the world. It is often your clothing, but more importantly, it includes using your preferred pronouns and name.

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The social transition begins when someone “comes out” or reveals their gender identity and/or sexual orientation to others. It’s ok to come out at your own pace and only talk about it to a select few initially.

Medical Transition

Your medical transition refers to any physical changes. Typically, doctors will begin hormone therapy before any surgical procedures. These surgical procedures include top and bottom surgery, aligning your biological sex better with your preferred gender identity.

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At Inner Balance Counseling, we’ll perform gender-affirming evaluations that are required before physicians will perform any gender-confirmation surgeries. 

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Through a questionnaire and a clinical overview, we can help you towards your goal by documenting the following:

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1. Persistent, well-documented gender dysphoria
2. Capacity to make a fully informed decision and to consent to treatment
3. Be of the age of majority in the country of surgery (and follow SOC rules for children and adolescents*)
4. Significant medical or mental health concerns, if present, must be reasonably well controlled at the time of surgery

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It's important to note that a medical transition isn't required to live as your preferred gender. Many transgender people will never undergo top or bottom surgery, and some only do one. However, if you intend on medically transitioning, it's vital to speak to a professional that will provide a gender-affirming evaluation.

Legal Transition

The legal transition can be arduous, but it’s vital for many transgender and gender non-conforming individuals. For some, it’s as “simple” as a name change, but you have the option to change your sex on legal documents in many places, as well.

Gender Affirming Care Saves Lives

Addressing things like crippling depression and trauma can profoundly affect the lives of people suffering from them. Mental health and behavioral disorders can put life on hold and contribute to suicidal ideations, but counseling interventions can prevent this.

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Gender dysphoria leads to depression, and the LGBTQIA+ community is disproportionately affected by depression, suicidal ideation, and trauma. 

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From children to adults, studies have shown time and time again that gender-affirming care reduces gender dysphoria, depression, anxiety, and suicide rates in transgender individuals.

Gender Identity and Mental Health

One meta-analysis regarding mental health in the LGBTQIA+ community found that 65% of lesbian, gay, queer, and questioning youths self-harmed, and 45% of transgender and gender non-conforming youths did, too.

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Not only do mental health and substance use disorders affect this community at higher rates, but the symptoms also seem to be more severe. 

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You save lives by allowing people to be who they want to be. Transgender children who receive gender-affirming care display the same rates of mental health disorders as their cisgender peers.

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So far, no evidence suggests that gender-affirming care does anything other than improve lives. 

Supporting Someone Going Through Gender-Affirming Care

Expressing a gender you weren’t assigned at birth takes courage. Undergoing gender affirmation therapy and care is not a journey taken impulsively. If someone you know has decided to transition socially or medically, support them. Here are a few things you can do to be the best ally.

Educate Yourself

Take it upon yourself to do some research. What do the terms mean that your loved one and their medical professionals use? What does the treatment they opted for entail, and what difficulties might they face? Are there roadblocks, like legislation, that might keep them from reaching their goal?  

Talk to Them

Education doesn’t stop at the internet—your loved one will also have personal preferences and an insight into their journey that they want you to know about. What are their pronouns? How do they want others to refer to their gender identity? 

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If they undergo a medical transition, as you should with any friend having a procedure, ask them if they need help recovering. Offer to walk the dog, get dinner, or be a good companion while they relax. 

Be an Ally

Unfortunately, everyone in the LGBTQIA+ community will experience hostile ignorance and harassment. Please stand up for them. Use their preferred pronouns and name, and correct people who don’t use those pronouns and names. Shut down rude jokes and comments. Get involved, and support their community.    

The Inner Balance Approach to Gender Affirmation

We know the unique challenges within the LGBTQIA+ community. You more than likely have had to jump some hurdles and overcome challenges that most people you know can’t imagine.

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It’s time to reach your goal and express yourself unapologetically. Inner Balance Counseling has a staff of therapists explicitly trained to cater their care to LGBTQIA+ individuals and those seeking further gender-affirming care. We offer group counseling for those in every stage of transition, so you feel safe, encouraged, and included by other people who share your experiences.

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We’ll also perform gender-affirming evaluations for our patients who need them for gender-confirmation surgery.

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We want to help you be the best version of yourself. Don’t wait. Reach out today to schedule a consultation for gender affirmation therapy.