Are there various categories of therapists who are professionally qualified to deal with transgender issues? Are they licensed accordingly? The term therapist is so generic, and each state appears to have a different licensing system. It seems to me that there is a real spectrum of folks in this profession, perhaps with different theoretical opinions and approaches. How do you find someone who is not only compassionate but also knows how to distinguish where we patients really fit on the spectrum and what is the correct approach to treatment?
Thanks.

As far as I know, no. Any counselor of any ilk can call themselves a gender therapist. My insurance provider once sent me to a woman who didn't even know the word "cisgender".

There is an organization called WPATH, World Professional Association for Transgender Health. Some therapists belong to that organization, though I'm told that there is no requirement for admission other than paying the fee, so even if your therapist is a WPATH member, doesn't really mean much.

The dirty secret of therapy (of any kind) is that you really just need to go to a session and see if you and them click. You can see if they have some basic knowledge of gender. Be sure to read the thread on red flags in the therapy section.

Word of mouth helps too if you know other trans people in your area.

That's a great question.

I normally like this kind of rigorous approach to things, but I don't think it works very well in this case. The problem is that far to many people with the appropriate qualifications are actually useless, so its not a terribly useful filter.

I actually looked on the the forums here to find one that others recommended, and only managed to find people I wanted to stay far away from. I did manage to find a great transgender specializing endocrinologist though, and he gave me the name of really good therapist/psych. I did check the psych was suitably qualified for SRS letters just in case I ever need it, but that was a secondary concern and not why I went. I never thought to check the endo's qualifications given everything I've ready about him here, which is a bit careless I suppose.

This approach has worked out really well for me.

I am concerned that when I meet my therapist this week, I will have no way of determining her qualifications even after the session. I suspect she will be kind and affirming, and that's OK. But will she ask the right questions? I certainly expect "When did you first feel this way", but what are the other important areas to discuss?

Molly-

If you can get recommendations from other trans people in your area thats probably your best best bet - thats the way I did it and the therapist that was recommended to me turned out to be very, very good. Dud therapists will quickly get a negative reputation in the local trans community.

I was looking for someone that first and foremost that was a member of WPATH and my therapist was. Then I wanted someone that had extensive experience working with trans people, had a PHD, and could prescribe medication and she had that. Once I was satisfied that my therapist had the credentials I was looking for I scheduled my first session and met her. After an hour of chatting with her I knew that she was qualified to help me.

WPATH adherence is important because you'll know that your treatment will adhere to the standards of care published by WPATH - the chances of the therapist using gate-keeping shenanigans are greatly reduced.

Therapy is a very individual experience - what you'll need/want will be different than what other people will need/want. Once you have checked out a therapist as far as education, experience, reputation, and WPATH membership all that is left is the first session to see if you click with them or not.

Beware the general therapist that has little to no experience working with transgender people - some of them will tell you that they do gender therapy, but likely you will spend your time educating them and will not get much help.

Gender therapy is in my opinion not the same as other kinds of therapy - the therapist needs the special knowledge of our situations.

I looked for:

Raw qualifications. Masters in social work at a minimum from an accredited university.
Writing, which may be as simple as a website, blog or social media posts.
Association with WPATH and similar organizations.

I made the mistake and got a recommendation from the trans community to go get a therapist from a group of therapists. They just assigned me a random one who I did not have time to vet. She was awful. She did not know how to deal with my wife. She was like, "I don't know what to tell ya." Well, gee, isn't that what I'm paying you for???

I switched to another when I looked around, vetted her and made sure I was satisfied with her. I swapped a few emails with her before I went to the first session.

She did not disappoint. Not at all.

I also had a few preferences:

I wanted a female therapist. I would never go to a male one. Not that male therapists aren't good, it's just that I am uncomfortable telling a guy that I want to transition to present as a woman, because I feel that cisgender guys don't really "get" this. Unless he's trans himself.

I wanted someone who was comfortable dealing with racial minorities and ethnically diverse people. Thankfully this was never an issue.

I didn't want someone who sounds fake and whose empathy is fake. I wanted someone who genuinely cared.

I don't like hardcore gatekeepers. My body is my decision. Thankfully there are places in NYC to get hormones via informed consent.

I wanted someone who was comfortable with my politics. I am an independent and I really don't tow the left or right line. Anything political irrelevant to my transition I don't want to discuss.

I didn't want someone who goes strictly by the book. I don't follow the typical narrative in many respects.

I must say that the one I have now is an absolute keeper and I think I will be seeing her for a while, maybe for a couple of years. I see her twice a month but I am unsure if I will keep that schedule in the long term.

My first step was doing a lot of checking for resources online to learn about therapists in my area.  If you know of any support groups in your area, you may want to see if they have any input, pro or con. 

Making sure the person had the proper credentials was #1, with #1A being that they had experience with transgender patients.  Some will say they do, but support can be lacking. 

Shop around.  I narrowed a sizable list down to 3.  The first therapist I visited acted like I was part of a study, and she said she wanted input from me for 5 sessions before starting to address the transgender issues.  God almighty, I was barely able to hold it together before I saw her...I needed help NOW.  I went to second name on my list and it clicked right from the start.  Immediate help, immediate input...I sensed it was the right match for what I needed and never check the third option.  **The correct patient/doctor connection is of critical importance.**

Not everyone who indicates they deal with trans issues has real experience with trans patients.  Some may have come into contact with a few trans patients while dealing with other issues.  For me, I wanted someone who reeeeaaaally knew there stuff if I was going to survive this.

Make sure the person is trans-affirming.  If the person tries to make you "not be transgender"...RUN!  I cannot describe the nightmare of reparative  therapy, which is a failure and can be more dangerous than not seeking help IMHO.

And finally, if you believe that you will purse transition at some point, make sure the person can prescribe or rights referrals for the letters you need: hormones, feminization surgeries and SRS.

Good luck yo you, Molly.  I am wishing you all the best!  :-)

Does she know what you're going to see her for? I'd consider sending her an email and letting her know that you'd like to talk about being transgender. If she feels she isn't qualified or willing to help you, it gives her a chance to let you know immediately and save you a trip. If she's inexperienced, it gives her time to reach out to a colleague or do some reading before your session. She may already have experience and will tell you to come in.

No matter which way it goes, I highly recommend informing her about the reason you're visiting a few days in advance either by phone or email. It may feel awkward and uncomfortable, but it may be more so if you go in and put her on the spot.

Thank you all for such GREAT advice. I wanted a therapist that could assist me to determine the best course of treatment. But there is so much more to consider and reconcile with family, friends and business associates.