Person-Centred Therapy for Two Spirit, Trans, Nonbinary, and Gender Nonconforming Clients

Introduction

Person-centred therapy (PCT), developed by Carl Rogers, emphasizes the client’s capacity for self-healing and self-actualization within a non-directive, empathic, and supportive environment that positions the client as the expert in their own experience (Rogers, 1951). For therapists like us—Audrey Wolfe, RCC, and myself, Clayre Sessoms, RP, RCT, RCC, RCAT, CCC, ATR-BC—who are neurodivergent, trans, and queer, PCT is more than a method; it’s a powerful framework that aligns with our lived experiences and guides our anti-oppressive and accessible online therapy practice.

Reflecting on my journey, I recall how person-centred therapy became a lifeline as I navigated my gender identity and came out. Initially, I grappled with feelings of disconnection and incongruence that seemed insurmountable. Through a person-centred approach, I found the space to explore these feelings without fear of judgment or pressure to conform. My therapist’s empathy, unconditional positive regard, and congruence created a safe, affirming environment where I could unpack internalized narratives and explore my true self.

The non-directive stance of my therapist allowed me to guide my process, giving me the freedom to imagine a life congruent with my true self. This was transformative. For the first time, I was seen not as someone to be ‘fixed’ but as someone with the capacity to navigate my own experience. Over time, I envisioned a future where I could live authentically, with my gender identity aligned with my sense of self. This reimagining brought a profound sense of freedom and empowerment—a feeling I strive to foster in my clients, especially those who are Two Spirit, trans, nonbinary, and gender nonconforming (2STGNC).

Our practice is built on the belief that every client has the innate wisdom to navigate their own journey. We work with 2STGNC clients, their partners, and families, recognizing the unique challenges they face in a world that often marginalizes their experiences. Person-centred therapy aligns with our commitment to providing inclusive, affirmative, and effective care to individuals of all gender identities and expressions, ensuring everyone has a therapeutic space where they are respected, understood, and empowered to direct their path toward healing and growth.

Overview of the Approach

Person-centred therapy (PCT), introduced by Carl Rogers in the mid-20th century, was revolutionary for its shift away from directive and interpretative methods like psychoanalysis and behaviourism. Rogers posited that therapy should not focus on diagnosing or fixing a person but on creating the right conditions for personal growth and self-discovery. This approach is built on three core principles: empathy, unconditional positive regard (UPR), and congruence (Rogers, 1961). These principles are more than therapeutic techniques; they are fundamental attitudes that therapists bring to each session, creating a safe, supportive environment where clients can explore their authentic selves.

Empathy involves the therapist’s ability to deeply understand and reflect the client’s experience from their perspective. This requires active, engaged listening and genuine attunement to the client’s emotions, thoughts, and values. For 2STGNC clients, who often navigate a world that misunderstands or invalidates their identities, experiencing empathy in therapy can be profoundly healing. It fosters a sense of belonging and acceptance that may be scarce in their daily lives (Cornelius-White, 2016).

Unconditional Positive Regard (UPR) refers to the therapist’s acceptance and support of the client, no matter their thoughts, feelings, or behaviours. For 2STGNC clients, who may face significant external and internalized stigma, UPR is crucial. In a therapeutic setting free from judgment or conditional acceptance, clients can safely explore their gender identities and experiences without fear of rejection. This supports clients in embracing their authentic selves (Rogers, 1957).

Congruence, or genuineness, is the therapist’s authenticity within the therapeutic relationship. Rather than adopting a detached stance, the therapist is encouraged to be real and transparent. This fosters trust and safety, vital for 2STGNC clients who may have encountered mistrust or dismissal. When therapists model congruence, it encourages clients to be more open, honest, and engaged in therapy. A therapist might share their experiences with navigating gender or discuss challenges in facing societal marginalization, creating a space of shared humanity and mutual growth (Cornelius-White, 2016).

These core conditions have become foundational across many types of therapy, influencing practices such as cognitive-behavioural therapy (CBT), dialectical behaviour therapy (DBT), and emotion-focused therapy (EFT). They emphasize meeting clients where they are and understanding them as whole, self-determining individuals who have the capacity for growth and healing. This approach is especially relevant for 2STGNC clients, who may experience their identities as fluid or evolving and benefit from a flexible and responsive therapeutic environment.

Person-Centred Therapy for 2STGNC Clients: A Deeply Affirming Practice

As therapists deeply engaged with our experiences and identities, we often work with clients navigating the complexities of gender identity and expression in a world that may not fully understand or respect them. Person-centred therapy offers a uniquely affirming approach to supporting 2STGNC clients. The flexibility of PCT allows therapists to adapt to each client’s unique lived experience, ensuring that therapy is inclusive and empowering.

In my practice, I strive to provide an environment where clients feel safe to explore their identities without fear of judgment. The non-directive stance of PCT allows me to honor each client’s autonomy and self-determination. When clients come to therapy with concerns about their gender identity or experiences, I focus on providing the empathy, UPR, and congruence that I know from my experience can be transformative.

Through PCT, clients, especially those who are 2STGNC, can reclaim their narratives and envision new possibilities. The approach creates a space for healing from societal trauma and for affirming each client’s experience. In therapy, 2STGNC clients often articulate challenges like misgendering, discrimination, and internalized oppression. The empathic and accepting environment of PCT allows for deep exploration and validation of these experiences. Clients are empowered to rewrite their stories, moving from vulnerability and pain to resilience and self-affirmation.

PCT’s flexibility also supports culturally sensitive practices that incorporate clients’ intersectional identities, including race, class, ability, and spirituality. Recognizing these identities is essential for 2STGNC clients, whose experiences are often shaped by complex intersections of marginalization and privilege. By holding space for all aspects of a client’s identity, PCT not only supports gender congruence but also encourages holistic healing and self-acceptance.

Key Concepts of Person-Centred Therapy

Person-centred therapy is grounded in three core conditions that are fundamental to fostering an environment where clients feel empowered, validated, and understood. These conditions—empathy, unconditional positive regard (UPR), and congruence—are integral attitudes that therapists must embody to create a truly person-centred experience. Each element plays a distinct role, and together they form a robust framework that is particularly affirming for Two Spirit, trans, nonbinary, and gender nonconforming (2STGNC) clients.

Empathy in PCT involves more than understanding a client’s feelings; it requires a profound engagement to truly ‘enter into’ the client’s world and experience it without losing the ‘as if’ quality (Rogers, 1957). For 2STGNC clients, this deep empathy is vital, as it acknowledges the emotional, social, cultural, and political contexts that shape their realities. Empathy becomes a vehicle for both connection and advocacy, fostering a sense of solidarity in the therapeutic alliance.

Unconditional Positive Regard (UPR) goes beyond acceptance; it is an active, intentional stance of valuing the client as a whole person. For 2STGNC clients, who may internalize societal messages of inadequacy, UPR can be transformative. It encourages clients to see themselves through a lens of inherent worth and dignity, empowering them to construct a more affirming self-narrative.

Congruence, or genuineness, is the therapist’s authenticity in the therapeutic relationship. A congruent therapist is unafraid to bring their full self into the therapeutic space, including vulnerabilities and reflections on gender and identity. This authenticity can dismantle traditional power dynamics in therapy, fostering a more collaborative approach that resonates with 2STGNC clients.

Intersubjectivity in Person-Centred Therapy

An important dimension to consider in person-centred therapy is the concept of intersubjectivity, which refers to the shared psychological space between the therapist and the client. Intersubjectivity emphasizes the mutual influence that both parties have on the therapeutic relationship. Unlike classical non-directive person-centred approaches that prioritize the client’s experience as the primary focus, intersubjective perspectives also recognize the relational space where both the therapist’s and the client’s experiences interact. This dynamic is especially relevant when working with Two Spirit, trans, nonbinary, and gender nonconforming (2STGNC) clients, as it allows for a deeper, more authentic engagement in therapy.

The intersubjective approach in person-centred therapy acknowledges that a client is not an isolated individual but exists within a web of relationships that influence their sense of self and well-being. This perspective considers both the client’s and the therapist’s subjectivities and their impact on the therapeutic encounter. For 2STGNC clients, who may frequently experience invalidation or misrecognition in various aspects of their lives, an intersubjective approach can provide a powerful corrective emotional experience by validating their lived experiences and identities within the therapeutic space .

The Role of Relational Depth

Relational depth, a concept developed by Mearns and Cooper (2005), is a key aspect of intersubjective person-centred therapy. It refers to a state of profound connection between the therapist and the client, where both are fully present and engaged with each other’s experiences. Achieving relational depth can be transformative for 2STGNC clients who may feel marginalized or misunderstood in other areas of their lives. In such a deep therapeutic connection, clients often experience a heightened sense of being truly seen and understood, which can be incredibly healing and empowering .

Balancing Autonomy and Connection

Intersubjectivity in person-centred therapy also involves navigating the dialectic between autonomy and connection. The therapist must balance honoring the client’s individuality and autonomy with engaging in a genuine, authentic relationship that acknowledges both parties’ contributions. For therapists working with 2STGNC clients, this means being aware of one’s biases and maintaining transparency in the therapeutic process. By doing so, therapists model what it means to be both self-aware and connected to another, creating a space where clients can explore their own identities in the context of a supportive, reciprocal relationship .

Implications for Therapeutic Practice

The intersubjective approach has significant implications for practice. It challenges therapists to move beyond mere empathy and unconditional positive regard by actively participating in the therapeutic relationship. This involves being open about one’s reactions, experiences, and thoughts when appropriate, to facilitate deeper relational engagement. For 2STGNC clients, whose experiences often involve navigating complex social dynamics, this level of transparency can foster a stronger therapeutic alliance and enhance the overall effectiveness of therapy.

Incorporating an intersubjective perspective allows for a richer understanding of the client-therapist relationship, making it a valuable addition to person-centred therapy when working with 2STGNC clients. This approach helps clients feel more connected and supported in their journey toward self-acceptance and personal growth.

Supporting Two Spirit, Trans, Nonbinary, and Gender Nonconforming Clients

For 2STGNC clients, therapy is often shaped by the broader societal contexts in which they live. Misgendering, unconscious bias, and lack of understanding are common challenges these clients face—even in therapeutic settings. As person-centred therapists, we must critically examine our biases and assumptions to provide truly affirming care. This involves more than using correct pronouns and language; it requires deep respect for each client’s self-determination and unique lived experience (Rogers, 1980; Brodley, 2005).

Supporting 2STGNC clients means creating a space where they are celebrated for who they are. This requires a stance of cultural humility—recognizing that, as therapists, we are collaborators, not experts, in our clients’ experiences. By approaching therapy with curiosity rather than assumptions, we foster meaningful engagement that honors the complexities of gender, identity, and lived experience.

Addressing Complex Trauma in the Context of Systemic Oppression

Many 2STGNC clients experience complex trauma stemming from systemic oppression, including hate crimes, discrimination, marginalization, and internalized stigma. Traditional therapeutic models may unintentionally pathologize these experiences, focusing solely on symptom reduction or diagnoses. In contrast, person-centred therapy (PCT), with its emphasis on empathy, unconditional positive regard (UPR), and client-directed outcomes, provides a supportive space for processing trauma without framing it as inherent dysfunction. This approach aligns with recognizing the impact of external factors on well-being and emphasizes empowerment over victimhood (Cornelius-White, 2016).

For 2STGNC clients, trauma often intersects with societal oppression. PCT integrates these experiences without reducing the client to their trauma. Instead, it emphasizes the client’s strengths, resilience, and capacity for growth. Therapists might explore how clients have navigated past challenges, help them construct a narrative of survival and resistance, and co-create strategies for moving forward that align with their values and identities. By centering the client’s voice and agency, therapists help clients reclaim their narratives from a framework of empowerment rather than deficit.

Implementing Trauma-Informed Principles in Person-Centred Therapy

Integrating trauma-informed care principles with PCT is crucial when working with 2STGNC clients, who face disproportionately high rates of trauma, including microaggressions, discrimination, and violence. A trauma-informed approach, as defined by the Substance Abuse and Mental Health Services Administration (SAMHSA, 2014), recognizes the widespread impact of trauma, identifies paths for recovery, integrates trauma knowledge into all aspects of care, and seeks to actively resist retraumatization. Person-centred therapy’s core conditions—empathy, UPR, and congruence—align well with these trauma-informed care principles, providing a particularly effective framework for 2STGNC clients.

To implement trauma-informed care within PCT, therapists should focus on the following strategies:

• Building Trust and Safety: Given the history of discrimination and invalidation many 2STGNC clients have experienced in healthcare, it is essential for therapists to prioritize building trust and safety. This involves being transparent, consistent, and attuned to the client’s needs and boundaries, creating a reparative emotional experience that counters past negative experiences.
• Emphasizing Client Autonomy and Empowerment: For 2STGNC clients, whose autonomy is often undermined by systemic gatekeeping, a trauma-informed, person-centred framework supports self-determination. This means allowing clients to lead their therapeutic journey, make informed choices, and reclaim power in a space where they have often been disempowered.
• Active Listening and Validation: Recognize and validate the client’s experiences of trauma, discrimination, and resilience. This helps reflect an understanding that these experiences are integral to their current mental health.
• Cultural Humility and Sensitivity: Be sensitive to the diverse cultural, social, and political contexts that shape 2STGNC clients’ experiences. This involves ongoing education, self-reflection, and a commitment to challenging one’s biases.
• Flexible Therapeutic Boundaries: Offer flexibility in therapy sessions to accommodate the client’s needs, such as adjusting the frame of therapy or session structure, especially when trauma symptoms are acute.
• Resisting Retraumatization: Avoid practices that may feel intrusive or invalidating to clients, such as making assumptions about their gender identity or past experiences. Instead, create space for clients to share at their own pace and comfort level.

By integrating these trauma-informed principles with person-centred therapy, clinicians can provide more comprehensive, sensitive, and effective support to 2STGNC clients. This combined approach not only fosters a safer therapeutic environment but also enhances the overall therapeutic experience by recognizing and affirming the complexities of each client’s lived experience.

Integrating a Global and Multicultural Framework

The person-centred approach, with its emphasis on empathy, unconditional positive regard (UPR), and congruence, inherently supports a global and multicultural framework that acknowledges and validates diverse gender experiences. For Two Spirit, trans, nonbinary, and gender nonconforming (2STGNC) clients, gender is not merely a personal identity; it is intricately shaped by cultural, familial, societal, and historical contexts. Effective trans-affirming counselling integrates an understanding of how systemic oppression and cultural narratives influence self-determination and adopts an inclusive, nonbinary perspective on gender. This perspective recognizes that gender exists beyond a binary framework and that clients may hold fluid, nonconforming, or culturally specific understandings of their identities (Williams, Prior, & Wegner, 2013).

Acknowledging Cultural Contexts in Gender Identity

For 2STGNC clients, their experiences of gender often intersect with cultural, racial, and social contexts that affect how they are perceived and how they navigate the world. For instance, Indigenous concepts such as Two Spirit challenge Western binary understandings of gender and embody a holistic integration of spiritual, sexual, gender, and community roles that may not fit neatly into Western categories (Driskill, 2010). In some cultures, gender nonconformity is not viewed as abnormal but rather as a revered and sacred role within the community. Understanding these perspectives is crucial for therapists who wish to provide affirming and competent care to Indigenous and other culturally diverse 2STGNC clients.

The flexibility of person-centred therapy allows it to adapt to the cultural and individual needs of each client, making it ideal for working with a diverse range of 2STGNC individuals and their allies. This means not only affirming the client’s gender identity and expression but also recognizing the importance of cultural identity and its influence on how gender is experienced and expressed. By honoring the client’s cultural background, therapists can more effectively support the client in navigating their unique intersectional experiences.

Incorporating Intersectionality into Person-Centred Practice

Integrating an intersectional approach within person-centred therapy is essential for understanding the complexities of 2STGNC clients’ experiences. Intersectionality, a term coined by Kimberlé Crenshaw (1989), refers to the interconnected nature of social categorizations such as race, class, gender, and sexual orientation, which can create overlapping systems of discrimination or disadvantage. For 2STGNC clients, their experiences cannot be separated into discrete categories of identity; rather, they are shaped by the interplay of multiple identities and the systemic inequalities associated with them.

For example, a Black trans woman may face a different set of challenges than a White nonbinary person, even if both share experiences of gender marginalization. The Black trans woman may face compounded discrimination due to the intersection of racism, transphobia, and sexism, affecting her access to safe spaces, employment, and healthcare. In person-centred therapy, recognizing these intersecting identities allows therapists to better understand the unique lived experiences of each client and provide more nuanced and effective support (Collins, 2000).

By incorporating an intersectional perspective, therapists are better equipped to understand how different forms of oppression interact and affect their clients’ mental health and well-being. This approach moves beyond a one-size-fits-all model and provides space for clients to explore how their multiple identities interact, how they navigate various social contexts, and how they can develop strategies for resilience and empowerment.

Promoting Cultural Humility and Competence

Person-centred therapy requires therapists to practice cultural humility, which involves a lifelong commitment to self-reflection, learning, and challenging one’s biases (Tervalon & Murray-García, 1998). Cultural humility goes beyond the mere acquisition of knowledge about different cultures; it is about recognizing the power dynamics in the therapeutic relationship and being open to learning from clients about their cultural experiences. For therapists working with 2STGNC clients from diverse backgrounds, cultural humility is key to providing respectful and affirming care.

Cultural competence involves actively acquiring and integrating cultural knowledge into therapeutic practice to better serve clients. This includes understanding specific cultural norms and values, such as the role of extended family in certain cultures or the significance of spirituality in others, and how these elements intersect with a client’s gender identity. For 2STGNC clients, who may often feel misunderstood or invisible within both their cultural communities and broader society, encountering a therapist who demonstrates cultural competence and humility can be transformative.

Practical Applications for Therapists

To effectively integrate a global and multicultural framework into person-centred therapy, therapists should consider the following practical applications:

• Educate Yourself Continuously: Engage in ongoing education about different cultures, gender identities, and the intersection of these experiences. Attend workshops, read books, and seek out resources that enhance your understanding of 2STGNC experiences across diverse cultural contexts (Sue & Sue, 2016).
• Acknowledge Cultural and Historical Trauma: Understand how historical and intergenerational trauma may impact 2STGNC clients from Indigenous, Black, and other racialized communities. Recognize how these traumas intersect with experiences of gender marginalization, and provide space for clients to process these layers of trauma in therapy.
• Use Culturally Relevant Interventions: Adapt interventions to be culturally relevant and responsive. For example, for an Indigenous Two Spirit client, integrating traditional practices and spiritual beliefs into therapy might be more meaningful than Western-centric approaches. Be flexible and co-create interventions that resonate with the client’s cultural and personal beliefs.
• Collaborate with Community Resources: Build connections with community organizations, leaders, and resources that are relevant to the client’s cultural background. Collaborating with culturally specific organizations can enhance support and reinforce the therapeutic work being done.
• Create a Welcoming Environment: Ensure that your practice is visibly inclusive and affirming. This might include displaying symbols of inclusivity, such as Two Spirit or Pride flags, or providing literature that represents diverse gender and cultural experiences. A welcoming environment signals to clients that their full selves are valued and respected.

By integrating a global and multicultural framework within person-centred therapy, therapists can provide more inclusive, culturally sensitive, and effective support for 2STGNC clients. This approach not only recognizes the diverse and intersectional nature of clients’ identities but also empowers them to heal, grow, and thrive in a space where all aspects of their being are acknowledged and affirmed.

Building Resilience and Agency

At the heart of person-centred therapy is the belief in each client’s capacity for self-directed growth and self-actualization. For 2STGNC clients, who may often be told—explicitly or implicitly—that they are “less than” or “wrong,” the person-centred approach’s emphasis on building resilience and agency is vital. By fostering an environment of safety, trust, and authenticity, therapists help these clients reconnect with their inherent strengths and capacities. This empowerment process involves helping clients develop a stronger sense of self, navigate relationships that may or may not be affirming, and advocate for their own needs across various contexts.

By engaging in this work, therapists not only support their clients but also become allies in challenging systemic injustices and advocating for broader social change. As person-centred practitioners, we are not neutral observers; we are active participants in co-creating a more inclusive and affirming world, one therapeutic relationship at a time.

Reflecting on Clinical Supervision and Peer Consultation

For psychotherapists, counsellors, and art therapists interested in deepening their practice through a person-centred approach, particularly when working with trans, queer, and 2STGNC individuals, clinical supervision and peer consultation are invaluable. Clinical supervision provides a structured space to explore how to embody empathy, unconditional positive regard, and congruence in a culturally responsive and affirming manner. Peer consultation, in contrast, offers mutual support and shared learning among clinicians, facilitating the navigation of complex cases and refinement of therapeutic skills.

If you are looking to enhance your practice in these areas, I, Clayre Sessoms, RP, RCT, RCC, RCAT, CCC, ATR-BC, offer both clinical supervision and peer consultation to support therapists in providing inclusive, transformative care. To book a session, schedule a consultation here. Let’s work together to create more affirming spaces for 2STGNC individuals and their communities.

How This Therapeutic Approach Impacts Therapists and Clients

Working with Two Spirit, trans, nonbinary, and gender nonconforming (2STGNC) clients requires therapists to continually evolve their understanding and approach. This involves actively engaging in anti-oppressive frameworks and embracing ongoing learning to ensure that therapy is person-centred, affirming, and inclusive. We strive to create an environment that honors each client’s unique lived experience while also recognizing the broader social and relational contexts that impact their lives. This commitment extends to supporting individual clients, their partners, and families by integrating family systems and relational approaches to provide comprehensive care (Williams, Prior, & Wegner, 2013).

For clients, engaging in person-centred therapy offers a deeply respectful and empowering therapeutic relationship. It provides a space where clients can explore their identities and experiences without judgment, allowing them to reconnect with their own voice and navigate their journey according to their self-identified goals. This process is particularly liberating for 2STGNC clients who may have felt constrained by societal norms or expectations. Through person-centred therapy, clients are supported in envisioning and creating a life that aligns with their authentic selves.

For clinicians seeking to deepen their understanding and skills in this area, clinical supervision and peer consultation are available to support growth in providing inclusive, affirming care. Engaging in these professional development opportunities helps refine your practice, foster resilience in your clients, and ensure that your therapeutic relationships remain impactful and transformative.

Conclusion

Person-centred therapy offers a transformative and affirming approach for Two Spirit, trans, nonbinary, and gender nonconforming clients, as well as their partners and families. By fostering empathy, unconditional positive regard, and congruence, this approach creates a therapeutic space where all individuals can explore their identities, heal from past trauma, and build resilience for the future. Supporting 2STGNC clients is both a privilege and a responsibility, requiring a commitment to anti-oppressive frameworks and continuous learning.

For those interested in delving deeper into these topics, you can access valuable resources by borrowing books from your local library or by purchasing them from queer-inclusive bookshops, such as Cross and Crows Books and Little Sisters in Vancouver, Glad Day Bookshop in Toronto, and Halifax Bookmark in Halifax, NS. Supporting these independent bookstores not only enriches your understanding but also helps sustain a diverse and inclusive literary community across Canada.

If you are a therapist, counsellor, or art therapist looking to incorporate person-centred approaches in your work with 2STGNC clients, consider clinical supervision or peer consultation. These reflective spaces can enhance your skills and confidence in providing affirming care. To connect with me, Clayre Sessoms, RP, RCT, RCC, RCAT, CCC, ATR-BC, and explore these opportunities, schedule a peer consultation here. Together, we can continue building more inclusive and supportive therapeutic environments for all.

If you are a client seeking a person-centred approach, book a 15-minute consultation with trans and queer therapist Audrey Wolfe, RCC.

We are here to support you on your journey, whether as a client or a fellow clinician, committed to fostering spaces where everyone can thrive authentically.

References

Chang, S. C., Singh, A. A., & dickey, l. m. (2018). A Clinician’s Guide to Gender-Affirming Care: Working with Transgender and Gender Nonconforming Clients. New Harbinger Publications.

Cornelius-White, J. H. D. (2016). Person-Centered Approaches for Counselors. SAGE Publications.

Rogers, C. R. (1951). Client-Centered Therapy: Its Current Practice, Implications, and Theory. Constable.

Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95–103.

Rogers, C. R. (1961). On Becoming a Person: A Therapist’s View of Psychotherapy. Constable.