Author ORCID Identifier:

https://orcid.org/0009-0006-1940-6643

Date of Graduation

7-2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Counselor Education (PhD)

Degree Level

Graduate

Department

Counseling, Leadership, and Research Methods

Advisor/Mentor

Higgins, Kristin

Committee Member

Christian, David

Second Committee Member

Popejoy, Erin

Third Committee Member

Shelton, Leslie Jo

Keywords

gender affirming therapy; gender diverse; interpretative phenomenological analysis; mental health; qualitative; transgender

Abstract

Transgender and gender diverse (TGD) people frequently seek out counseling services and experience greater mental health difficulties than the general population. Oppressive political and social structures are often cited as a main contributor to mental health disparities. As antitransgender laws and sentiments increase in the U.S., the likelihood of mental health professionals encountering TGD clients will also increase. This requires specific competencies in how to provide effective gender-affirming mental health services. Affirming MHPs are more accessible to TGD clients now than ever due to increases in provider training and improved attitudes. However, previous research revealed that MHPs who identify as affirming and/or LGBTQ+ may not have the tools necessary to provide effective therapy services to TGD clients. Additionally, research specifically examining TGD individuals’ experiences with affirming MHPs is limited. Using interpretative phenomenological analysis, this qualitative study investigates the lived experiences of TGD individuals who have received therapy from gender affirming MHPs. Six adult participants were recruited using purposive sampling within a southern state. The study utilized a two-interview protocol to deeply explore how participants made sense and meaning of their experiences with affirming providers. An in-depth step-by-step analysis process yielded seven themes and five subthemes that characterized participants’ experiences of the therapeutic relationship, changes in perspective, and greater authentic expression of self. Implications for MHPs and counselor educators, limitations, and recommendations for future research are discussed. Keywords: transgender, gender diverse, gender-affirming therapy, interpretative phenomenological analysis.

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