Sitting with Our Transgender Community: Collective Care in Troubling Times

Introduction: The Urgency of Collective Care in the Transgender Community

As global politics shift toward rising fascism and the transgender community—including Two Spirit, transgender, non-binary, gender non-conforming, gender expansive, gender-free individuals, and those questioning their gender—faces increasing threats, mental health care must go beyond traditional, cisnormative models of support. Too often, well-meaning cisgender therapists, even those who consider themselves allies, unintentionally minimize or dismiss the lived experiences of their transgender community clients. When a trans woman expresses feeling excluded, she is told, “Welcome to womanhood!” When a non-binary person is asked to “regulate their emotions” to make space for cis people learning their pronouns, they are left feeling unheard, gaslit, and alone.

The rise in anti-trans legislation and healthcare discrimination has left many in the transgender community feeling abandoned by systems that should be sources of support. According to the Trevor Project’s National Survey on LGBTQ Youth Mental Health (2023), more than 50% of trans and nonbinary youth considered suicide in the past year, with lack of affirming support listed as a major contributing factor. When trans+ individuals seek therapy, they often encounter microaggressions or outright dismissals of their lived experiences. Instead of being encouraged to navigate systemic oppression with agency and empowerment, they are often told to adjust to it.

The transgender community does not need to be told to be more patient, more understanding, or more willing to endure systemic injustice with a smile. What we need—what we deserve—is collective care that acknowledges our grief, our rage, and our right to exist fully. As Malatino (2020) describes, “The secret power of the care web…is its expansiveness; the force of traumas psychic and physical is dispersed throughout its filigree of filaments” (p. 2). In these troubling times, our genuine care for one another must be expansive, deeply affirming, and rooted in community healing.

The Harm of Cisnormative Therapy in the Transgender Community

Gaslighting and Epistemic Injustice in Therapy

Many transgender community clients encounter a subtle yet damaging form of gaslighting when seeking therapy from cisgender professionals. McKinnon (2017) describes this as “epistemic injustice,” where the experiences of marginalized individuals are dismissed in favour of an external, dominant narrative. For example, when a trans woman expresses frustration at exclusion within feminist spaces, being told “Welcome to womanhood!” disregards the layers of transphobia she may be experiencing. It frames exclusion as a universal experience rather than one that uniquely impacts trans women.

Similarly, non-binary clients often hear phrases such as, “People are trying their best; you just need to regulate your emotions.” While emotional regulation is an important skill, expecting transgender community individuals to minimize their own pain to accommodate cisgender people’s learning curves reinforces structural oppression. McKinnon (2017) critiques ally culture for its tendency to “reaffirm the authority of the ally rather than centre the lived knowledge of the marginalized person” (p. 5).

Medical Gatekeeping, Pathologization, and Historical Trauma

In many therapeutic and medical settings, transgender community individuals face gatekeeping that denies their agency over their own bodies and identities. As Koyama (2001) states in The Transfeminist Manifesto, “Trans women often find themselves having to ‘prove’ their womanhood by internalizing gender stereotypes in order to be acknowledged as women or to receive hormonal and surgical interventions” (p. 2). This kind of pathologization upholds a rigid gender binary and forces transgender community individuals to navigate a system that questions their authenticity at every turn.

Iantaffi (2021) in Gender Trauma expands on this by framing the rigid gender binary as a form of historical trauma linked to settler colonialism. They argue, “The current rigid, binary, essentialist system of gender harms us all: how it is—in itself—a form of trauma” (p. 10). Therapy that does not recognize these broader systemic forces risks perpetuating harm instead of facilitating healing.

Self Advocacy in Gender-affirming Therapy

Many trans+ individuals enter therapy with the hope of receiving affirming support, only to experience subtle microaggressions or outright dismissal of their lived experiences. While therapists hold power in the room, trans+ clients can practice self-advocacy by setting clear expectations for care.

Before beginning therapy, it can be helpful to interview potential therapists by asking questions such as:

• “What training have you completed in working with transgender clients?”
• “How do you incorporate intersectionality into your therapeutic approach?”
• “Do you have supervision or consultation with trans+ professionals to ensure affirming care?”

Additionally, if a therapist engages in harmful language or gaslighting, clients can set boundaries and redirect the conversation.

Transgender Community Collective Care as a Radical Act of Survival

Intersectionality in Collective Care

Trans+ individuals exist at the intersection of multiple identities, and one-size-fits-all approaches to collective care fail to meet the needs of marginalized trans+ people. Black, Indigenous, and racialized trans individuals face disproportionately higher rates of violence, healthcare discrimination, and economic insecurity. In You Are Your Best Thing, Burke & Brown (2021) emphasize that collective healing must address systemic oppression rather than merely treating its symptoms.

Disability justice also plays a key role in trans+ and queer community healing. Many trans+ individuals experience medical trauma, neurodivergence, or chronic illness, requiring accessibility-focused support networks rather than assuming that all care models work for everyone. This is especially true when discussing mental health therapies that rely on neurotypical and able-bodied assumptions of emotional regulation.

What Collective Care Looks Like in Practice

Collective care within the transgender community is already happening, but it is often informal, underfunded, and unrecognized by mainstream institutions. Trans-led organizations, such as peer-run crisis lines, support groups, and mutual aid networks, provide vital resources that go beyond traditional therapy. Malatino (2020) refers to this as aftercare—the intentional work of caring for one another beyond structured mental health frameworks.

Therapists who work with trans+ clients should integrate LGBTQ+ collective healing into their practice by connecting clients with community resources, recommending trans-led wellness spaces, and considering alternatives to individualistic therapeutic models. Instead of treating distress as an individual issue, therapy can become a space where clients develop the skills to participate in and build their own networks of care.

Trans-Led Healing Modalities

Therapists who work with trans+ clients should integrate collective care into their practice by connecting clients with community resources, recommending trans-led wellness spaces, and considering alternatives to individualistic therapeutic models.

Addressing Trans+ Burnout and Compassion Fatigue

Many trans+ individuals feel the weight of systemic oppression and take on emotional labour to support their peers, often at great personal cost. Burnout is not a personal failing—it is a symptom of systemic harm.

Building the Collective Care Networks the Transgender Community Needs

Reaffirming Trans+, Nonbinary, and Gender Expansive Realities

The most essential shift for therapists working with transgender community collective care is moving from an “ally” framework to a collaborative care framework. This means:

• Validating lived experiences without comparison to cisnormative struggles.
• Recognizing and dismantling personal biases that may influence clinical interventions.
• Connecting clients to trans-led support spaces, mutual aid networks, and advocacy groups.

Highlighting International Collective Care Efforts

While collective care is often discussed in a Western context, trans-led community efforts are happening globally in ways that reflect local cultural needs. These initiatives demonstrate that transgender community collective care is a global movement—one that extends beyond therapy rooms into real-world survival strategies.

Conclusion: Affirmation is Resistance

The transgender community does not need to be told to “grin and bear it” or “regulate” their way to acceptance. We need care that affirms our rage, our grief, and our resilience. We need therapeutic spaces that centre our collective care rather than dismissing it in favour of cisgender understandings of gender and oppression. We do not need to be told to endure; we need spaces to heal, build, and imagine something better—together.

Affirmation is more than just a word; it is an act of defiance against systems that seek to erase trans+ identities. It is the refusal to diminish ourselves to fit within cisnormative expectations. Collective care is not just a strategy for survival but a vision for a future in which trans+ people thrive.

Trans+ resilience has always been about more than just enduring harm—it is about creating joy, connection, and spaces of belonging. By fostering networks of support, advocating for policy changes, and prioritizing trans-led healing modalities, we reclaim agency over our own well-being. We are not alone, and we do not have to heal alone.

The call to action is clear: therapists, allies, and community members must commit to dismantling the barriers that hinder trans+ access to affirming care. We must invest in our collective futures by ensuring that no trans+ person is left to navigate oppression in isolation. Healing is not just individual work; it is shared, and it is radical. Together, we affirm our right to exist, to heal, and to flourish.

References

Benson, K. (2021). Transgender mental health disparities: Understanding systemic barriers and improving care. Journal of LGBTQ+ Studies, 14(2), 112-130.

Burke, T., & Brown, B. (Eds.). (2021). You are your best thing: Vulnerability, shame resilience, and the Black experience. Random House.

Iantaffi, A. (2021). Gender trauma: Healing cultural, social, and historical gendered trauma. Jessica Kingsley Publishers.

Koyama, E. (2001). The transfeminist manifesto. Retrieved from https://eminism.org/readings/pdf-rdg/tfmanifesto.pdf

Lester, C. (2018). Trans like me: Conversations for all of us. Seal Press.

Malatino, H. (2020). Trans care. University of Minnesota Press.

McKinnon, R. (2017). Allies behaving badly: Gaslighting as epistemic injustice. Social Epistemology, 31(5), 543-556.

Sharman, Z. (Ed.). (2016). The remedy: Queer and trans voices on health and health care. Arsenal Pulp Press.

Trevor Project. (2023). National survey on LGBTQ youth mental health 2023. Retrieved from https://www.thetrevorproject.org/survey-2023/

Turban, J. L., King, D., Reisner, S. L., & Keuroghlian, A. S. (2020). Pubertal suppression for transgender youth and risk of suicidal ideation. Pediatrics, 145(2), e20191725.

White Hughto, J. M., Reisner, S. L., & Pachankis, J. E. (2015). Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions. Social Science & Medicine, 147, 222-231.