Trans-affirmative therapy in London
Support for gender dysphoria and all that comes with being trans
Knowledgeable, understanding and compassionate therapy in Kings Cross, Oxford Circus or online. Get the help you deserve from an ally.
What is gender dysphoria?
Gender dysphoria is a state of severe distress caused by a person’s biological sex not matching their gender identity. For example, someone who was assigned as male at birth (usually because they have male genitalia) may experience themselves as female or non-binary (not exclusively male or female). The person may live with an ongoing feeling of incongruence that is exacerbated by particular triggers.
What triggers gender dysphoria?
Each trans person is unique and may have particular things that make their gender dysphoria worse, but common triggers include:
seeing yourself in a mirror and what you see not matching your image of yourself
being misgendered (someone addressing you according to your biological sex rather than your gender identity)
being discriminated against for being trans
having to use facilities (toilets, housing, uniforms, etc) in line with your biological sex rather than your gender identity
having to undress in front of others, such as in changing rooms
having others touch your body, for example doctors.
What age does gender dysphoria typically start?
Zaliznak et al (2021) found that most trans people first experience feelings of gender dysphoria between the ages of 3 and 7. Of course, at that age they are unlikely to understand what it means to be trans or to have the vocabulary to explain it. They may also pick up on anti-trans prejudice in their homes or communities. As a result, many trans people spend a lot of their childhood feeling confused, not understanding why they feel the way they do and being scared to talk to anyone about it.
The Trevor Project’s 2025 U.S. National Survey on the Mental Health of LGBTQ+ Young People found that 11% of transgender and nonbinary young people surveyed had attempted suicide in the previous year and suicide attempts were higher amongst where families did not respect the trans person’s gender identity.
Is it possible to grow out of gender dysphoria?
This is a tricky question and one that has been politicised. Research shows that not all children with gender dysphoria continue into adulthood as transgender (eg Steensma et al, 2017). However, what is less clear is whether those children who “desisted” did so because they no longer experienced gender dysphoria (or experienced it less severely) or because their families and wider communities were not supportive of their gender identity.
Do I really have gender dysphoria or am I just confused?
It can be really hard for people to know whether what they are experiencing is gender dysphoria. Nobody can crawl inside your head to check, and you might not trust your own assessment. You might wonder if you are minimising your feelings because you would rather be cisgender (not trans) or because you fear how your loved ones would react to you being trans. Or you might be confusing feeling like you’re “not a macho guy” or “not a girly girl” with having gender dysphoria. It’s worth remembering that you don’t have to conform to gender stereotypes to be cisgender.
Thoughts and feelings that indicate a higher likelihood of gender dysphoria include:
feeling uncomfortable stating your sex when you fill in forms
enjoying the idea of changing your appearance to look like a different gender
wanting to hide your secondary sex characteristics (breasts, facial hair, Adam’s apple, etc)
feeling like your sexual anatomy is wrong
daydreaming about what it would be like to be treated as a different gender.
I help clients to explore their gender identity and whether they might be repressing their true gender out of fear. If it’s helpful for them, we think together about how they might want to identify - male, female, non-binary, trans, cis, etc.
Is gender dysphoria a mental disorder?
Gender dysphoria is included in DSM-5 (the diagnostic manual for mental health). However, it is not considered a disorder and terms such as gender identity disorder are used less now to reduce stigma.
Is there a pill for gender dysphoria?
Gender dysphoria is not a disease or disorder that needs fixing with a pill; treatment focuses on helping the person to live as they choose to live. To reduce the intensity of dysphoria, that will usually mean living in line with their gender identity rather than their assigned sex.
In support of that aim, treatment includes:
hormone therapy to bring the person’s body more in line with their gender, for example by increasing facial hair or growing breasts
counselling or psychotherapy to help the person with the challenges of gender dysphoria, which may include navigating transitioning, coping with the distress of gender dysphoria and dealing with prejudice
speech therapy to help the person’s voice sound more in keeping with their gender
surgery to bring the person’s body more in line with their gender, for example breast reduction surgery or construction of a vagina.
Can you treat gender dysphoria with therapy?
Therapy is an key element in the treatment of gender dysphoria. It won’t make gender dysphoria go away completely, but it can lessen the distress. Working with a trans-affirmative therapist like me, depending on where you are in your journey, you might:
explore your gender identity
express the distress of living with gender dysphoria
discuss the frustrations and inequity of daily life as a trans or non-binary person
share the process of accessing treatment and how it (and probably the long wait times) affect you
acknowledge the hurt caused by prejudice and rejection.
You can of course also talk about all the other things that are going on in your life that may or may not interact with your gender identity. I don’t make the mistake of thinking that your whole life revolves around your gender identity and that you don’t also have to deal with the regular stuff of life - family issues, relationship breakups, bereavements, work stress, health issues, etc.
Talking about all of these things (the gender stuff, the other stuff, how the gender stuff interacts with the other stuff) with a compassionate therapist who understands gender dysphoria makes living with them less distressing and more manageable.
To find out more, read my blog post How I work with trans clients.
What is the best therapy for gender dysphoria?
As with most issues that people bring to therapy, the specific type of psychotherapy or counselling (CBT, person-centred, etc) doesn’t make much difference. What does make a difference is how comfortable you feel with the counsellor or therapist.
Understandably, many clients with gender dysphoria want to work with therapists who have experience in the area. That makes sense and is something I’d recommend. Sadly there are too many stories of trans people being misunderstood and misgendered by inexperienced counsellors or psychotherapists. Shockingly, I’ve also heard of therapists seeing gender dysphoria as an unconscious reaction to childhood experiences, sexual abuse, etc, and trying to ‘fix’ the client’s gender identity. That approach only brings more shame and frustration for the client.
What should I look for in a counsellor for gender dysphoria?
I recommend choosing someone who has:
a good understanding of gender dysphoria
experience of working with trans, non-binary and gender questioning clients
a gender-affirmative approach (accepting that your sense of your gender is true and not trying to change it)
a warm, approachable manner
registered membership of one of the main professional bodies for psychotherapists, such as BACP or UKCP.
Why choose me?
I have many years’ experience of working with clients experiencing gender dysphoria. Exploring your gender can be a difficult thing to talk about; clients tell me they find me easy to talk to and appreciate how supportive I am.
I am a registered member of BACP with therapy practices near Kings Cross and Oxford Circus, and I also offer online therapy. I offer free introductory chats and half price initial consultations, so you don’t have to spend a lot to get a feel for whether I’m a good fit for you.
Most clients who come for an initial consultation with me choose to continue with me, but if I’m not the right fit for you I will be happy to refer you to a colleague. I manage a large team of therapists so if I’m not the perfect fit for you there’s a good chance I know someone who is!
Next steps
If that sounds good to you, it’s easy to book an initial consultation or a free introductory phone call here…
If you want to find out more first, feel free to contact me and I’ll get back to you promptly.