Transitioning and Gender Therapy: How to Stay Safe and Get the Care You Deserve

By Alyus Vasquez
Originally published August 14, 2019 – Updated May 31, 2025 for clarity and accessibility

Why Licensing Matters in Transgender Therapy

If you’re seeking therapy as part of your gender transition, you deserve to feel safe, affirmed, and respected. Unfortunately, not every provider advertising themselves as a “gender therapist” is properly licensed—or ethical.

The truth is, there are clinical standards for working with transgender clients. Anyone who tells you otherwise is either misinformed or misleading you. Licensed mental health professionals—especially those with LCSW, LMHC, or similar credentials—are required to follow state regulations, clinical best practices, and professional ethical codes.

Before you open up to a therapist, verify their credentials. You can use the ASWB License Verification tool to look up social workers by name and ensure they are licensed in your state.

Watch Out for Red Flags

Many people practice under titles like “Life Coach,” “Coach,” or even “Gender Therapist” without having a license to provide clinical therapy. Some may even work across state lines, which is illegal unless they are licensed in both locations.

Here are a few serious red flags to watch for:

🚫 They are not licensed or cannot provide proof of licensure.
🚫 They offer EMDR therapy but aren’t certified to do so.
🚫 They tell you there are no clinical protocols for working with trans clients.
🚫 They ask for payment in the form of labor, favors, or anything other than money.
🚫 They suggest barter arrangements like working for them instead of paying.

These are all serious violations of professional ethics. If someone is asking for compensation that isn't monetary—or is making you feel unsafe—they are exploiting you.

Look for Therapists Who Follow WPATH Standards

The World Professional Association for Transgender Health (WPATH) has published comprehensive standards of care for transgender and gender-diverse individuals. These standards provide clinical guidance on everything from hormone therapy support to mental health care and social transition.

Any qualified gender therapist should be familiar with the WPATH guidelines. If they aren't—or dismiss them—that’s a red flag.

📘 Access the WPATH Standards of Care Version 8

What Is the Social Work Code of Ethics?

Licensed Clinical Social Workers (LCSWs) are held to the National Association of Social Workers (NASW) Code of Ethics, a guiding document first adopted in 1960. It exists to protect clients—especially those from vulnerable or marginalized communities.

The Code’s Six Core Values:

Service
Social justice
Dignity and worth of the individual
Importance of human relationships
Integrity
Competence

These values aren’t just abstract ideas. They form the foundation for how a licensed social worker is expected to practice. If your therapist is an LCSW, they’ve sworn to uphold these principles.

Highlights from the Code of Ethics

Here are a few key standards therapists must follow:

✅ Personal Conduct

Maintain high standards of professionalism
Engage in lifelong learning
Guide care with evidence-based practice

✅ Responsibility to Clients

Make client needs a priority
Respect self-determination
Keep information confidential
Charge fair and transparent fees

✅ Responsibility to Colleagues & Employers

Treat peers with respect
Follow employer protocols
Advocate for ethical practices

✅ Responsibility to the Profession

Advance social work values
Educate themselves in cultural competency
Work toward greater access to services

What to Do If You've Been Harmed

If you or someone you know has been harmed by a therapist—or someone posing as one—there are steps you can take:

📍 In California:

File a complaint with the California Board of Behavioral Sciences.

📍 In Washington State:

File a complaint with the Washington State Department of Health.
- You can also contact them via email at HSQAComplaintIntake@doh.wa.gov or call (360) 236-4700.
- For more detailed information on the complaint process, visit the Health Professions Complaint Process page.

📍 Nationwide:

Reach out to the Transgender Law Center for legal support or to talk to someone who understands.

You are not alone. You deserve care that is safe, ethical, and affirming.

Finding a Trans-Competent Therapist

It can be tough to find a therapist who understands trans issues—but they are out there.

One helpful tool is PsychologyToday.com. You can search by zip code and filter by specialties—including therapists who are trans, nonbinary, or affirming of LGBTQIA+ identities.

Tips for Vetting a Therapist:

Ask if they’re familiar with WPATH standards
Confirm their licensure and specialty
Ask if they’ve worked with trans clients before
Trust your gut—your comfort matters

Final Thoughts

There are many caring, qualified professionals who want to support you. But due to gaps in access and protections, trans people are often at higher risk of being taken advantage of. Don't settle. Don’t second-guess yourself. You deserve a therapist who respects you, understands you, and is legally and ethically accountable to do their job right.

I created RainbowAlphabetCollective.org to help folks like us find safe, affirming care. It's a grassroots resource hub focused on connecting transgender individuals in Washington State (and beyond) with support for legal name and gender marker changes, medical and mental health referrals, and transition guidance.

We’re currently giving the site a full makeover to make it easier to use, more accessible, and packed with updated resources. My hope is that it becomes a place where no one feels alone in this journey. Check back soon for new features, updated provider lists, and community tools to help you navigate transition on your terms.

You deserve care that sees you, believes you, and honors your identity. We’re here to help you find it.

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