A trans or non-binary client can arrive with concerns their therapist’s training left them completely unequipped for. This isn’t because the client is unusual, but because so much of psychotherapy’s own literature on gender is still catching up with itself. That’s also why this page is organized into three clusters rather than one flat list.
The first covers general and affirmative clinical practice. These books that assume you’re building baseline competence and give you a framework to work from. The second is psychoanalytic, and it’s worth saying plainly: these four books don’t agree with each other. The third cluster covers specialized topics such as trauma, sexual violence, sexuality specifically, family therapy, and non-binary identity.
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General and Affirmative Clinical Practice
Affirmative Counseling and Psychological Practice With Trans and Nonbinary Clients
Edited by Anneliese A. Singh and Rafe McCullough (2nd ed.), American Psychological Association, 2025
Singh and dickey co-chaired the APA task force that wrote the actual Guidelines for Psychological Practice With Transgender and Gender Nonconforming People. This book is the practitioner-facing expansion of that work.
The first edition was published the same year the guidelines were adopted. It opens with the fact that fewer than 30% of psychologists reported feeling competent with TGNC clients’ needs, and builds chapters around closing that gap. Topics covered include working with clients across race, faith, and developmental stage, plus advocacy strategies for clinicians and educators.
This second edition is described by its publisher as thoroughly revised rather than lightly updated. New chapters take on rapid-onset gender dysphoria claims directly, cover working with TNB clients in sport and physical activity, and address trauma and suicidality. These additions show how how the political and clinical landscape has shifted since 2016.
Recommended as the essential starting point for this page. Everything else here either builds on it or comes at the subject from a narrower angle.
A Clinician’s Guide to Gender-Affirming Care: Working with Transgender and Gender Nonconforming Clients
Sand C. Chang, Anneliese A. Singh, and lore m. dickey, Context Press / New Harbinger, 2018
This is the practical, exercise-based companion to the book above. It’s built around exercises rather than research chapters, taking the reader from historical foundations to hands-on skills. It opens by asking the reader to examine their own gender training and biases before it gets to clinical technique. It then works through the history of trans health care in the US as context for why so much current practice still gets it wrong.
This isn’t a book you read so much as work through. Each chapter is structured around exercises rather than arguments, which makes it a better fit for a training group or supervision setting than solo reading.
Adult Transgender Care: An Interdisciplinary Approach for Training Mental Health Professionals
Edited by Michael R. Kauth and Jillian C. Shipherd, Routledge, 2018
The book reads less like clinical advice and more like an operating manual for a care team. That’s because Kauth and Shipherd direct the VA’s national LGBT Program, where transgender care depends on psychiatry, psychology, and social work working in sync rather than any one clinician’s individual approach.
The book features chapters on evaluation and treatment for complex clinical presentations. It also includes one specifically on implementing a transgender care policy across a national healthcare system. That chapter walks through the insurance, documentation, and interdisciplinary handoff problems that come with standardizing care at that scale. That’s useful even for a solo private-practice clinician, since those same obstacles shape what a client has already been through with the healthcare system before they ever reach the therapy room
Best suited to clinicians working inside larger health systems or training programs.
Transgender and Gender Diverse Persons: A Handbook for Service Providers, Educators, and Families
Edited by Alfred F. Carlozzi and Kurt T. Choate, Routledge, 2018
This one is explicit about not being written only for clinicians – it’s aimed at educators and family members as much as mental health professionals. Not every chapter is directly relevant to a mental health setting, but the book is still worth having for therapists who want to understand the other ways a trans or gender diverse client is being supported outside the therapy room.
The family, transitions, and youth chapters are genuinely relevant. It has sections on counseling parents and siblings, understanding social and medical transition, and Diane Ehrensaft’s chapter on gender-affirming work with children. Alongside that, it covers school climate, legal rights, and spiritual care – ground nothing else on this page covers.
Best suited to therapists who are also working with a client’s family or school. Tthe appendices of vetted resources and further reading are worth keeping on hand to pass along to clients or their families.
Best suited to therapists who are also working with a client’s family or school. The appendices of vetted resources and further reading are worth keeping on hand to pass along to clients or their families.
Case Studies in Clinical Practice With Trans and Gender Non-Binary Clients
lore m. dickey, with a foreword by Marsha Botzer, Jessica Kingsley Publishers, 2021
dickey presents real case narratives spanning childhood, adolescence, and adulthood, each one anchored in a specific presenting issue rather than gender identity in the abstract. Examples include a client navigating school, another going through puberty, others facing job discrimination, bullying, suicide risk, or autism alongside their gender identity. Each case is followed by short commentary from a different named expert.
dickey co-chaired the same APA task force behind the guidelines underpinning the Singh books earlier on this page.
This one works best as a follow-up to the more conceptual books above. It doesn’t make the case for the framework, it shows what using it actually looks like across a client’s lifespan.
Psychoanalytic Perspectives
These four books don’t agree with each other. One in particular has drawn real criticism for its more cautious stance, which some readers see as closer to gender-critical than neutral.
Please Select Your Gender: From the Invention of Hysteria to the Democratizing of Transgenderism
Patricia Gherovici, Routledge, 2010
The book’s central argument is that psychoanalysis handles trans identity today the way it once handled hysteria – as something to diagnose and solve, not something to actually understand.
Gherovici traces that argument through a century of medical history, showing how hysteria and transgender identity have been read the same way by medicine again and again. Shen then uses that parallel to argue that psychoanalysis’ historical unease with trans patients says more about psychoanalysis than about trans people.
Best for a clinician who’s never worked with a trans client through a psychoanalytic lens and wants to understand why the field has struggled with this, before getting into how to actually work with someone.
Transsexuality and the Art of Transitioning: A Lacanian Approach
Oren Gozlan, Routledge, 2014
This is the most theoretically dense book on this page. It’s just over 100 pages, but makes no attempt to be a primer. Gozlan’s argument is that gender identity isn’t something that expresses an underlying sexuality, but is something split from the start. The book works through real examples: sculptures by Anish Kapoor and Louise Bourgeois, and memoirs written by trans authors. Gozlan uses these to show what transitioning actually feels like psychically, rather than making the case with clinical case studies the way most books on this page do.
Best suited to readers already comfortable with Lacanian terminology. This isn’t the place to start if psychoanalytic theory is new to you.
Transgender Psychoanalysis: A Lacanian Perspective on Sexual Difference
Patricia Gherovici, Routledge, 2017
This book makes a direct argument: some Lacanian analysts have long treated trans identity as a form of psychosis, and Gherovici sets out to prove them wrong. She’s picking up where her 2010 book left off, but this time she names the problem instead of working around it.
She argues the instability psychoanalysis finds in trans patients isn’t pathology; it’s the same instability psychoanalysis claims sits at the center of all sexual difference, trans or otherwise. Where the 2010 book stayed with one patient’s history, this one confronts psychoanalysts head-on with a single demand: stop reading trans identity as psychosis.
Start with Please Select Your Gender for the historical grounding, then come here for the harder claim: what Lacanian psychoanalysis is capable of saying about trans experience once pathology is off the table.
Transgender Identities: A Contemporary Introduction
Alessandra Lemma, Routledge, 2022
Unlike the other three books in this section, Lemma argues for caution rather than affirmation. She lays out what she frames as unresolved controversies in how to approach transgender identity in the consulting room. She then builds a psychoanalytic ethical framework specifically for clinicians working with clients requesting medical transition – one that treats the current emphasis on affirmative care as a question to weigh rather than a settled standard to apply. A chapter on adolescent development and gender identity applies that same caution to the age group where the affirmative-versus-exploratory debate is most heated clinically and politically.
Lemma’s institutional standing is substantial. She iss a Fellow of the British Psychoanalytical Society, was for years Head of Psychology and then Professor of Psychological Therapies at the Tavistock Clinic, and edited Routledge’s New Library of Psychoanalysis series until 2020.
But that standing hasn’t shielded the book from criticism. Some readers, including trans readers, have read it less as a neutral clinical overview and more as an exercise in selective caution. Best read as one side of a live debate, not a settled position.
Specialized Topics
Treating Trauma in Trans People: An Intersectional, Phase-Based Approach
Reese Minshew, Routledge, 2022
Minshew doesn’t adapt an existing trauma protocol for trans clients. She builds a new one from scratch, specifically for them, called the “Triphasic Model. Phase 0 is preparatory groundwork, Phase 1 is safety and stabilization, and Phase 2 is reprocessing the traumatic material. Phase 3 is the part that departs from standard trauma-phase models. It is about finding and building affirming community, not just individual integration.
The book treats gender and trauma as running through the same physiological, psychological, and interpersonal channels rather than as two separate things happening to overlap in one client. The closing chapters go beyond individual techniqu. They argue that one-on-one therapy alone can’t fully help a client whose trauma is caused, in part, by ongoing discrimination.
Best suited to clinicians working with trans clients whose trauma is bound up with structural discrimination and marginalization, more than clients presenting with a single, isolated traumatic event.
Working with Trans Survivors of Sexual Violence: A Guide for Professionals
Sally Rymer and Valentina Cartei, Jessica Kingsley Publishers, 2019
This is less about therapeutic technique with an individual client and more about why the sexual violence support sector itself often fails trans survivors before therapy even starts. Many services still run strict gender-segregated intake, which can exclude trans clients outright.
The book works at every level of the problem. At the organizational level, it names why gender-segregated intake and services built for cisgender clients shut trans survivors out before therapy even starts. At the individual level, it covers what the trauma of sexual violence looks like specifically for trans survivors, and what a professional can actually say and do differently in that first session. It doesn’t stop at naming the problem: every section closes with concrete recommendations for what a service or a practitioner can change.
Recommended for clinicians working inside a sexual violence service specifically, or anyone with influence over intake policy. The individual-session guidance is here too, but the book’s real value is in the organizational-level case it makes.
Sex, Sexuality, and Trans Identities: Clinical Guidance for Psychotherapists and Counselors
Edited by Jan C. Niemira, Gary J. Jacobson, and Karalyn J. Violeta, Jessica Kingsley Publishers, 2019
Most books on this page cover trans identity broadly but go quiet on what happens to a client’s sexuality specifically, during and after transition. This collection fills exactly that gap. It covers shifts in sexual orientation following transition, negotiating sexuality with a partner mid-transition, and gender dysphoria alongside co-occurring autism spectrum presentations
Recommended for clinicians facing a specific sexuality question from a client that the broader affirmative-care books don’t cover.
Trans and Sexuality: An Existentially-Informed Enquiry with Implications for Counselling Psychology
Christina Richards, Routledge, 2018
This book is a research monograph, not a clinical manual, And it reads like one – with a literature review, methodology, and discussion section rather than chapters organized around technique.
Richards argues the field has a habit of sorting trans people into subgroups, then assuming that subgroup predicts their sexuality. She says that shortcut has quietly biased a genuinely under-researched area. She works from qualitative interviews conducted across gender identity clinics and community settings rather than the clinic alone.
This one’s for reading beforehand, not for reaching for mid-session. It helps you catch your own assumptionss you might otherwise bring into an assessment unnoticed. Pair this with the Niemira/Jacobson/Violeta book above if you want the practical guidance version of the same territory.
Attachment-Based Family Therapy for Sexual and Gender Minority Young Adults and Their Nonaccepting Parents
Gary M. Diamond and Rotem Boruchovitz-Zamir, American Psychological Association, 2023
This is a step-by-step clinical manual for working with a young adult and their still-rejecting parent together, in the same room, rather than treating the young adult alone. It stands out for a simple reason: it’s backed by an actual clinical trial. The protocol it describes (ABFT-SGM) was tested in a pilot study of 30 families and published in Family Process in 2022. Both young adults and mothers independently reporting increased parental acceptance over 26 weeks of treatment.
Diamond originally developed the base protocol for depressed and suicidal adolescents before adapting it first for LGB youth and then extending it to sexual and gender minority young adults specifically; Boruchovitz-Zamir served as a therapist on the original clinical trial.
Recommended for clinicians doing family work with a young adult client and a parent who hasn’t yet come around. This is the one book on this page built specifically for that two-person room, not for the young adult’s individual therapy alone.
Non-Binary Genders: Navigating Communities, Identities, and Healthcare
Ben Vincent, Bristol University Press / Policy Press, 2020
This book is a sociological study, not a clinical guide. The method is what makes it distinctive: non-binary participants in the UK kept diaries over time rather than sitting for a single interview. That approach catches something a one-off interview can’t: real shifts in identity over months, and a healthcare system that isn’t built to accommodate that.
Most of this book reads as sociology rather than therapeutic guidance. The one chapter that earns it a place here is “not feeling trans enough.” This is the anxiety non-binary clients often bring into a gender clinic assessment, worrying they don’t count as trans enough to be taken seriously. A clinician who doesn’t know this pattern could easily mistake that anxiety for the client being unsure about transitioning at all.
Recommended for that one chapter specifically. Most useful for clinicians conducting gender clinic assessments, than anyone doing ongoing therapeutic work.