About Therapy First

Therapy First exists because we see a great need arising from the current oversimplification and politicalization of gender dysphoria in the field of mental health.

We believe that

Individuals who are exploring gender identity or struggling with their biological sex should have access to therapists who will provide thoughtful, developmentally appropriate care and tend to legitimate mental health concerns, without pushing an ideological or political agenda.

We are pleased that the emerging cultural conversation opens the door for individuals to discuss and explore their sense of identity in ways that might have been discouraged or disallowed in the past. We believe that identity exploration is normal and necessary, especially for young people. At the same time, we see that certain restrictive norms have emerged which limit free and healthy exploration, making it harder for both clients and therapists to work meaningfully together on questions of gender identity.

It has become extremely difficult for clients to find mental health professionals who will facilitate identity exploration while also helping them confront important psychological issues that may be contributing to their distress, including their concerns about gender. Instead, by using a one-size-fits all approach many therapists misunderstand identity “affirmation” and inadvertently push ideological or political agendas onto their gender-questioning and dysphoric clients. Sadly, this can happen on “both sides” of the gender issue:

Some therapists operate on underlying assumptions that gender dysphoria or gender non-conformity is always a sign that a client is trans, and that  a client’s current understanding of their gender identity will remain permanently fixed. Such assumptions may lead the therapists to neglect the work of psychological exploration, and instead, act as a facilitator for acquiring hormonal and surgical interventions (which come with a heavy medical burden and potentially negative consequences).


Other therapists operate on the underlying assumption that identifying as trans is categorically wrong. Such therapists may challenge a client’s stated gender identity using political arguments or ideological frameworks, imposing their own agenda of getting the client to renounce or change their gender identity.


Between these two extremes lies an approach that treats identity development as a complex, gradual process that can be influenced by a variety of factors and mental health issues.

It has become difficult for therapists who take a depth or exploratory orientation towards gender identity to find spaces which encourage open dialogue about these issues. The fear of being labelled “transphobic” has, in many circles, shut down conversation and prevented genuine exchange, learning, and training.

Our goal, therefore, is to develop a network of mental health professionals who practice ethical and developmentally appropriate therapy with clients who are experiencing distress regarding gender or biological sex. We provide a place for such therapists to network, dialogue, and learn from one another. And we provide resources, information, and therapy referrals for clients and their families.

Therapy First is a registered 501c3 nonprofit. Contributions to Therapy First are tax-deductible to the extent permitted by law. Therapy First’s tax identification number is 87-3936604.