Publication Date


Document Type

Masters Thesis


School for Social Work


Transgender people-Mental health, Transgender people-Counseling of, Psychotherapy-Evaluation, Psychotherapist and patient, Transgender, Transgender mental heealth, Perceived discrimination, Discrimination and mental health, Treatment satisfaction, Working alliance, Transgender affirmative therapy, Psychotherapists-Attitudes, Discrimination in mental health services, Therapeutic alliance


This study was undertaken in order to examine transgender individuals' experiences in therapy and the impact that clinicians' affirmative behaviors and their heteronormative and gender normative biases may have on the treatment experience. Despite an extensive history in the mental health field of pathologizing alternative gender identities and the well-researched detrimental impact that experiences of discrimination have on one's mental health, there has been no research on experiences of bias and discrimination in mental health treatment settings. Similarly, there has been a great deal of research on the role of affirmative therapy techniques relating to gay, lesbian, and bisexual persons, and it has been theorized to be beneficial for transgender persons, but there has been no definitive research addressing the impact of affirmative therapy techniques in treatment with this population. The purpose of this quantitative survey of 46 transgender persons who have had at least one experience in mental health treatment was to evaluate the treatment experience and impact of therapist behaviors from the client's perspective. Findings include a confirmation that affirmative therapy techniques are significantly related to positive working alliance with the therapist and reports of treatment satisfaction. Similarly, discriminatory therapist behaviors were found to be significantly related to lower working alliance and lower treatment satisfaction.




v, 73 p. Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2009. Includes bibliographical references (p. 55-58)