Creating Safe Spaces for Gender Identity Exploration: Therapist’s Guide to Supporting Your Clients

Introduction

I still remember the first time I gathered enough courage to tell my therapist that I had been quietly questioning my gender for decades. The room felt like it was closing in on me, my body covered in nervous sweat, and my voice shaking. It felt like I was standing on the edge of a cliff, not knowing how my therapist would respond or whether I’d even be able to say the words aloud. My heart was pounding, and in that moment, I wasn’t sure if I was ready to speak my truth.

But I did. I found the words, stumbled through them, and then braced myself for the response. And I’ll never forget the relief that washed over me when my therapist met me with warmth, curiosity, and understanding. She didn’t ask for explanations or push me to define my identity. She simply held space for me to explore, to sit with the uncertainty, and to feel safe enough to keep questioning. That was the first time I realized I could explore my gender in a way that felt right for me—without having to know all the answers right away.

Since then, I’ve grounded myself in an identity that’s always felt true on the inside—feminine-leaning, sometimes fluid, but always free. I now live in my gender identity with a sense of clarity and confidence that, at one point, I didn’t think I would ever find. And I know I couldn’t have gotten here without the support of gender-affirming therapists, healthcare professionals, and the friends I’ve made along the way. For me—and for the clients I now sit with each week—gender-affirming therapy has been nothing short of a lifeline. It has instilled in me a kind of hope that keeps me moving forward, even in a world where being true to oneself can feel like an act of resistance.

This is why I’m writing this blog post. I want you, as a well-meaning therapist, to have the tools and confidence to offer the same kind of support to your clients who are questioning their gender. I know the fear of saying the wrong thing, of not knowing enough, or of unintentionally causing harm. But gender-affirming therapy is about creating a space where clients feel seen and safe. And with time, you’ll develop the confidence to lean into these meaningful conversations with your dear clients, too.

For adults and older teens, questioning gender identity can be both an exciting and daunting process. As therapists and mental health professionals, it’s our responsibility to provide an affirming space for exploration, reflection, and growth. But for many practitioners, the fear of making a mistake or saying the wrong thing can make the process feel intimidating.

In this blog post, I’ll share insights on how to support individuals questioning their gender identity, drawing from both personal experience and professional expertise. Whether you’re a therapist seeking guidance or someone on your own gender journey, the following reflections and strategies are designed to create a supportive and inclusive space for gender identity exploration.

Understanding Gender Identity Exploration

Gender identity exploration is a deeply personal journey, one that often involves questioning one’s internal sense of gender and reflecting on how—or if—it aligns with the gender assigned at birth. For many, this process brings both excitement and confusion, especially in adults and older teens who may feel the weight of societal expectations or personal histories bearing down on them. But it’s important to remember that gender identity is not always about finding a label—it’s about discovering what feels true to oneself.

Some individuals come to therapy knowing they might identify as trans* or nonbinary but need time and space to explore what that means for them. Others may find themselves grappling with societal norms and pressures as they navigate the intersections of race, gender, class, culture, religion, or sexual orientation. These intersecting identities play a crucial role in the process of gender identity exploration, especially for those who belong to marginalized groups. For example, the experiences of Two Spirit individuals in Indigenous cultures are shaped not only by their personal sense of gender but also by the ongoing impacts of colonialism and the cultural importance of their identity within their communities (Singh & Dickey, 2017).

As therapists, affirming that questioning one’s gender is a healthy and necessary part of self-discovery is essential. This process may take time, and every individual’s journey is incredibly unique. Drawing on Carl Rogers’ Person-Centred Therapy, we are reminded that clients are the experts in their own experience, and our role is to provide a supportive and nonjudgmental environment (Rogers, 1951). It’s not about leading them to a specific conclusion or pressuring them to “figure it out,” but rather about creating space for reflection, exploration, and acceptance.

According to Singh and Dickey (2017) in Affirmative Counseling and Psychological Practice With Transgender and Gender Nonconforming Clients, therapists need to move away from deficit-based thinking that pathologizes gender exploration and instead adopt an affirmative framework that celebrates the diverse experiences of trans* and nonbinary clients. By doing so, we create an environment where individuals feel empowered to express their authentic selves without fear of judgment or rejection. Singh and Burnes (2013) also highlight how important it is for therapists to understand the cultural and systemic factors that influence gender identity, such as racism and classism, and incorporate this understanding into the therapeutic process.

Gender identity exploration often involves navigating internalized oppression and societal expectations. For many clients, this can mean confronting deep-seated shame or fear, often as a result of the societal, cultural, and/or religious rejection of trans* identities. Hakeem (2018), in Trans: Exploring Gender Identity and Experience, reminds us that this process is not linear. Some clients may arrive at a point where they fully embrace a trans* or nonbinary identity, while others may find peace without adopting a specific label. Regardless, the goal is to support clients in moving toward a place of self-acceptance and authenticity.

Intersectionality plays a profound role in gender identity exploration, as many clients are not only questioning their gender but also navigating the complexities of their racial, cultural, and socioeconomic identities. For example, individuals who are Black, Indigenous, or people of colour (BIPoC) may face additional challenges when exploring their gender because of the compounded effects of racism and transphobia. Therapists must be mindful of these intersecting identities and recognize that gender exploration is just one piece of a much larger puzzle for many clients (Singh & Dickey, 2017).

In therapy, it’s crucial to normalize the process of questioning one’s gender. Many adults and older teens come to therapy feeling down or anxious about not having everything “figured out,” but there is no right or wrong way to explore gender identity. As therapists, we can help clients feel at ease by affirming that this process is a natural part of self-discovery. As Janssen and Leibowitz (2018) note in Affirmative Mental Health Care for Transgender and Gender Diverse Youth, creating a space where clients feel safe to question, explore, and reflect is vital for fostering growth and self-acceptance.

By holding space for gender identity exploration, therapists build trust—not just in the therapeutic relationship, but in the client’s ability to navigate their own journey. This trust is foundational for personal growth, allowing clients to embrace their gender identity in their own time and in their own way, without external pressure or expectations.

How I Create an Affirming Therapeutic Space for Gender Identity Exploration

In my practice, I have found that both art therapy and body-centred approaches offer transformative ways for clients to explore their gender identity. Gender, like many deeply personal experiences, is often difficult to capture with words alone. For many clients, especially those who have internalized societal expectations about gender, traditional talk therapy may not access the full depth of their experience. That’s where creative and somatic therapies come into play, offering a more embodied and holistic way of exploring identity.

Art therapy allows clients to express feelings and insights that might otherwise remain unspoken. As Susan Hogan (2020) notes in Gender and Difference in the Arts Therapies, art therapy creates a dynamic space where clients can engage with their gender identity on their own terms, using visual metaphors and symbols to represent their internal experience. This process is particularly powerful for clients who feel restricted by verbal expression or are still grappling with their understanding of gender. Through the act of creating, clients can externalize and visualize their inner world, often uncovering aspects of their identity they may not yet fully understand (Hogan, 2020).

For instance, Kelly Darke and Shannon Scott-Miller (2021) discuss in Art Therapy with Transgender and Gender-Expansive Children and Teenagers how visual art allows clients to experiment with their gender identity in a safe, supportive environment. Using art as a tool for self-exploration, clients can symbolically express the fluidity, uncertainty, or conflict they may feel about their gender (Darke & Scott-Miller, 2021). By externalizing these feelings, clients gain clarity and ownership over their gender journey.

Beyond visual expression, body-centred therapies such as Focusing Oriented Therapy (FOT) and Sensorimotor Psychotherapy (SP) offer clients another route for exploring their gender identity—this time through the felt sense of the body. In Focusing, originally developed by Dr. Eugene Gendlin, clients are invited to tune into the subtle, bodily sensations that arise when thinking about or discussing their gender. These sensations—often described as a “felt sense”—carry emotional meaning that may not yet be accessible through conscious thought. By helping clients bring awareness to these bodily sensations, therapists can support deeper understanding of how gender is experienced within the body.

For example, a client exploring their gender might notice a tightness in the chest or a heaviness in the stomach when discussing societal expectations around masculinity or femininity. In Focusing, we would gently guide the client to stay with that sensation, helping them explore what it might be communicating. This practice allows clients to become more attuned to their internal experience, fostering a connection between mind and body that enhances the process of gender identity exploration.

Similarly, Sensorimotor Psychotherapy, pioneered by Dr. Pat Ogden, emphasizes the importance of body awareness in processing identity-related trauma and emotions. By focusing on physical sensations and movement patterns, clients can access and process feelings related to gender that may not be fully available through verbal dialogue alone. This can be especially useful for clients who have experienced dysphoria or disconnection from their bodies. Through body-centred interventions, clients can explore their gender in a more grounded, embodied way—connecting with their sense of self through the language of the body.

By combining art therapy with body-centred practices, we can offer clients multiple avenues to explore their gender identity in ways that feel natural, intuitive, and expansive. For some, visual art may provide the medium for expressing complex emotions about gender, while for others, connecting with their bodily experience may open new pathways for understanding and acceptance.

Practical steps for integrating these approaches:

•Art-based exploration: Invite clients to create art that reflects their current experience of gender. Encourage them to use symbols, colours, and shapes to represent feelings that might be difficult to put into words. Afterwards, engage in reflective dialogue, asking questions like, “What do you notice about how you represented your sense of self?”

•Exploring the felt sense: During discussions about gender identity, invite clients to tune into their body’s sensations. For example, ask, “What do you notice in your body when we talk about your gender?” or “How does this conversation feel in your body?” Allow space for clients to explore these sensations without needing to immediately interpret them.

•Combining art and body awareness: After a client has created a piece of art, ask them to sit with it and notice how their body responds. Encourage them to track any physical sensations that arise while looking at their work, which may lead to deeper insights about how they experience gender.

These approaches foster a sense of self-exploration that moves beyond the confines of language. By integrating art therapy and body-centred techniques like Focusing and Sensorimotor Psychotherapy, we can create an affirming space where clients can safely explore their gender identity with their whole being—mind, body, and spirit.

Helping Clients Unlearn Internalized Oppression and Transphobia in Gender Identity Exploration

When working with trans* and nonbinary clients, therapists often encounter the painful effects of internalized oppression and transphobia—feelings of shame, inadequacy, and self-doubt that are shaped by years of societal messaging. These negative beliefs, embedded in societal structures, can create barriers for clients as they explore their gender identity. As therapists, it’s our role to recognize and address these beliefs within an anti-oppressive framework, offering support that allows clients to embrace their authentic selves.

For many clients, the journey of unlearning internalized transphobia is an essential part of gender identity exploration. It’s important for therapists to acknowledge that these internalized beliefs are not a reflection of the client’s worth, but rather a response to the oppressive forces that stigmatize trans* and nonbinary identities. Singh and Dickey (2017) remind us that recognizing the systemic forces—such as colonialism, racism, and classism—that shape an individual’s experience of gender is key to offering gender-affirming therapy. This acknowledgment creates space for clients to reflect on their identities without self-blame or shame.

One of the most effective tools for helping clients unlearn harmful internalized beliefs is cognitive restructuring, commonly used in Acceptance and Commitment Therapy (ACT). Cognitive restructuring allows clients to identify and challenge harmful thoughts, such as “I’m not enough” or “I’ll never belong,” and reframe them in a more compassionate, affirming light. This technique doesn’t aim to eliminate doubt altogether but helps clients loosen the grip of self-critical thoughts, allowing them to move forward in their gender exploration despite lingering fears or uncertainties (Blackledge & Biglan, 2014).

Here are a few practical steps you can take to help your clients unlearn these internalized beliefs:

•Gentle reframing: When a client expresses a deeply ingrained negative belief, help them gently reframe the thought. For instance, if a client says, “I don’t belong anywhere,” you might guide them to explore the sources of this belief and ask, “What would it feel like to belong to yourself first?” This encourages clients to shift their focus toward self-acceptance.

•Mindfulness practices: Encourage clients to notice their negative thoughts without becoming consumed by them. By acknowledging the thought but redirecting attention toward the values driving their gender exploration—such as authenticity or self-compassion—you can help clients build resilience in the face of self-doubt.

In addition to addressing internalized transphobia, it’s important to recognize that many clients will be navigating their gender identity in the context of other intersecting identities. While you may not explicitly teach the concept of intersectionality to clients, being aware of how factors like race, class, disability, and culture shape their gender exploration can deepen your understanding and support.

For example, clients who are Black, Indigenous, or people of colour (BIPOC), or those from marginalized socioeconomic backgrounds, may experience additional layers of oppression that affect their willingness to explore their gender. Janssen and Leibowitz (2018) highlight how these overlapping identities can impact gender exploration, especially for those who are part of multiple marginalized groups. A Two Spirit client, for instance, may be navigating their gender identity through both Indigenous traditions and the legacies of colonialism. Recognizing and validating these experiences is crucial for creating a truly affirming therapeutic space.

You don’t need to introduce complex frameworks like intersectionality into the therapeutic process directly, but your awareness of these intersections allows you to ask more nuanced, supportive questions. Here are some strategies you can incorporate into your practice:

•Ask open-ended questions: Questions like, “How has your background influenced your experience of gender?” or “What challenges have you faced in exploring your gender identity given your culture or race?” invite clients to reflect on the broader context of their identity without overwhelming them with theory.

•Acknowledge systemic barriers: By recognizing the societal forces at play in a client’s experience, you validate their struggles. For example, discussing how racism or ableism may complicate gender exploration gives clients permission to feel what they feel without internalizing societal messages as personal failings.

Finally, working within an anti-oppressive framework requires ongoing self-reflection. As therapists, it’s essential to acknowledge how our own identities and privileges may shape the therapeutic relationship. Whether it’s our race, gender, or socioeconomic background, our positionality can influence how we approach our clients’ gender journeys. Singh and Burnes (2013) remind us that ongoing reflection is key to ensuring that we’re dismantling any power imbalances within the therapy room, allowing clients to feel fully empowered in their gender exploration.

In summary, supporting clients in their gender identity exploration means more than addressing individual feelings of doubt or transphobia. It involves recognizing how oppressive societal structures contribute to internalized beliefs, and guiding clients through the process of unlearning those harmful messages. By offering gender-affirming care that acknowledges these broader contexts, you create a space where clients can explore their gender with greater freedom and authenticity.

Normalizing the Gender Identity Questioning Process

Questioning one’s gender identity is not a sign of confusion or instability; rather, it is a natural and healthy part of self-discovery. Many individuals—particularly adults and older teens—may feel a sense of shame or worry during this process, especially if they have spent much of their life conforming to rigid gender expectations. These feelings can be exacerbated by societal norms that pressure people to “know who they are” early on, leading some clients to believe they’re “too old” to explore their gender or that their questioning is invalid.

As therapists, one of the most powerful ways to support our clients is by normalizing this questioning process. It’s essential to affirm that taking time to explore one’s gender identity, moving through uncertainty, and not having immediate answers is not only acceptable but expected. By validating that it’s okay to feel uncertain or to need time to explore, we reduce the shame clients may carry and foster an environment of self-compassion and growth.

For adults in particular, the fear of being “too late” to explore their gender identity can feel overwhelming. Many have internalized the idea that self-discovery is reserved for youth, and by the time they reach adulthood, they are expected to have their identity firmly established. This belief can be especially strong for individuals who have followed traditional gender roles or who have built their lives around societal expectations of gender. Normalizing their journey as one that is still unfolding—and emphasizing that it’s never too late to discover their true selves—can alleviate much of the pressure they feel.

Singh and Dickey (2017) emphasize that part of the therapist’s role in gender-affirming care is to challenge the societal expectations that suggest gender identity is static or that questioning one’s gender is only for young people. Therapists can gently remind clients that self-exploration is an ongoing process, regardless of age. Encouraging clients to see gender identity as fluid, dynamic, and deeply personal can help them release the false sense of urgency or inadequacy they may carry.

Here are a few ways therapists can normalize the questioning process for their clients:

•Affirm the fluidity of identity: Remind clients that gender identity is not a fixed destination but an evolving understanding of the self. It’s common for people to question and re-question their gender throughout different stages of life. Helping clients see this as a strength rather than a flaw fosters resilience and acceptance.

•Encourage self-compassion: Many clients are hard on themselves for not having all the answers. Normalizing the process means encouraging clients to be gentle with themselves as they explore. Self-compassion allows clients to approach their gender identity with curiosity rather than fear or shame.

•Reframe timelines: Reassure clients that there is no “correct” timeline for discovering one’s gender. Whether someone is questioning their gender as a teen, in mid-life, or later, their exploration is valid. Providing examples from therapeutic case studies or lived experiences of others can help clients see that gender exploration is a lifelong process, not one confined to youth.

•Support the client’s pace: Every client moves through their gender exploration at their own pace. Some may need time to process their feelings before taking any steps toward change, while others may move more quickly. By supporting the client’s individual pace and respecting where they are in the process, therapists can create a safe and affirming space for reflection and discovery.

Finally, for older clients who feel isolated in their gender exploration, it can be helpful to introduce the idea that many adults and older teens experience these same feelings. Providing examples from research or stories of others in similar situations can foster a sense of community and shared experience, helping to reduce the isolation clients may feel.

By normalizing the questioning process and reframing it as an essential and healthy part of identity development, therapists can help clients embrace their journey with curiosity and self-acceptance. In doing so, we create an environment where exploration is celebrated rather than feared, allowing clients to feel seen, supported, and empowered as they move toward greater self-understanding.

Conclusion

Supporting gender identity exploration requires empathy, openness, and a deep commitment to anti-oppressive practices. For therapists, this means creating a space where clients can safely question their identities without the pressure to define, express, or conform to societal expectations. By honouring the unique journey of each individual, while considering the broader societal systems that influence their experiences, we help those questioning their gender find the clarity, acceptance, and peace they deserve.

This work is ongoing—not just for the clients we serve, but for us as therapists and practitioners. It calls us to continuously reflect on how we can foster more inclusive, affirming spaces, and how we can challenge oppressive systems both within and beyond the therapeutic alliance.

Let’s Continue the Conversation

If the ideas in this blog resonate with you or someone you’re supervising, I invite you to take the next step. Whether you’re a therapist seeking guidance on gender-affirming practices or have a specific question about how to better support your client, I’m here to help. I’m qualified to provide clinical supervision for RPs, RCCs, CCCs, and any art therapist seeking RCAT or ATR registration. I provide peer consultation to RPsychs, MSWs, and LMFTs. If you’d like to discuss supervision, connect with me first through my contact form. You may book peer consultations online. Be sure to bookmark this blog for future insights, reflections, and updates on gender-affirming care.

References

Darke, K., & Scott-Miller, S. (2021). Art therapy with transgender and gender-expansive children and teenagers. Jessica Kingsley Publishers.

Gendlin, E. T. (1996). Focusing-Oriented Psychotherapy: A Manual of the Experiential Method. Guilford Press.

Hakeem, A. (2018). Trans: Exploring gender identity and experience. Phoenix Publishing.

Hogan, S. (2020). Gender and difference in the arts therapies: Inscribed on the body. Routledge.

Janssen, A., & Leibowitz, S. (2018). Affirmative mental health care for transgender and gender diverse youth. Springer.

Ogden, P., & Fisher, J. (2015). Sensorimotor Psychotherapy: Interventions for Trauma and Attachment. Norton.

Rogers, C. R. (1951). Client-centered therapy: Its current practice, implications, and theory. Houghton Mifflin.

Singh, A. A., & Dickey, L. M. (2017). Affirmative counseling and psychological practice with transgender and gender nonconforming clients. Washington, DC: American Psychological Association.

Singh, A. A., & Burnes, T. R. (2013). Affirming Counseling and Psychological Practice with Transgender and Gender Nonconforming Clients. Feminist Psychology, 23(1), 55–64.