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5 Ways Therapists Can Serve Non-Binary Clients Better

Some therapists know the basics of working with with trans clients, but they might need some help stepping up their game with non-binary and genderqueer folks. These 5 tips were developed them from a focus group research project a few years ago. They were developed by non-binary folks to help therapists and counselors do a better job meeting our needs.

They are:

  1. Validate Your Clients’ Gender
  2. Hold Space for Complexity
  3. Create Safe Spaces (and Help Clients Find Them)
  4. Recognize and Mitigate Non-Binary Erasure
  5. Be Trauma-Informed and Acknowledge Intersectionality

These cultural competency tips are great for psychologists, counselors, clinical social workers, and marriage and family therapists. (Other mental health providers, like nurse practitioners and psychiatrists, could benefit as well.) This article lays out 5 great ways to enhance your competency with non-binary and other gender diverse clients. (If you’d like additional info, including 12 best practices and other aspects of non-binary/genderqueer cultural competency, check out the book chapter or poster from the same project.)

These tips aren’t a replacement for your other therapy skills, and you don’t have to totally change what you’re doing. Rather, they will help you make non-binary, genderqueer, and other gender-diverse clients and patients feel at home and comfortable alongside what you’re already doing well. It just takes a little knowledge and practice to serve non-binary clients better.

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1. Validate Your Clients’ Gender

To practice with non-binary and genderqueer cultural competency, therapists need to validate clients’ gender in a basic way. That doesn’t mean lecturing people or being the expert on their gender; rather, that means trusting in the client’s gender journey and supporting them in their process of becoming.

Too often, clients have experienced therapists that doubted their gender or treated them as a special case or odd specimen that the therapist didn’t understand. If you don’t understand, that’s okay, but you should be the one to educate yourself about your client’s gender position, generally. (It’s okay to ask your client about things that are specific to them, or what particular words mean for them— but ideally you’ve already looked things up and gotten familiar with the terminology before asking your client about it.)

Take Them Seriously— Don’t Tell Them It’s Just a Phase

Sometimes non-binary and gender-diverse people have gotten the message that their gender is ‘just a fad’ or ‘just a stepping stone’ along the way to a binary gender position. While it’s true that for some people, a non-binary gender identity can be one step along the way, for many people, it isn’t— and some people have assumed a binary gender identity before later shifting more towards a non-binary space. Taking people’s gender identity seriously is a great move at any step of the way, and affirming clients in their gender experience will help them feel that you hear, respect, and understand them.

Read and Lend Out Affirmative Books & Get More Specialty Training

Another great way to signal to clients that you validate their gender is to keep trans- and non-binary affirmative books around your office. This also provides a ready store of bibliotherapy resources that you can loan out to client so they can learn more, too. Attending appropriate trainings, consulting with other professionals who are trans and non-binary, and building relationships with the trans and non-binary communities can also help you learn more ways to validate non-binary people.

Learn What You Can & Don’t Fake Awareness

What about if you don’t know about a client’s gender identity or position? Not a problem— gender is a shifting field, and there will always be something you don’t know about yet. Letting clients know that you don’t know can serve to enhance the therapeutic relationship, because non-binary people can tell when their therapists are faking competency. (That said, if you do tell the client that you don’t understand their gender, it’s a good idea to then say that you want to, and then to go ahead and learn more on your own time.)

There are some big no-nos that get in the way of validating clients’ genders: doubting the validity of a person’s gender, viewing a client’s gender situation as a problem, and feeling uncomfortable about it and therefore ignoring it are a top three of gender invalidation. A lot of non-binary clients will ‘vote with their feet’ if their therapist can’t get up to speed about their gender being a real thing. So learn more, build those relationships, and validate!

A hand holding a complex-looking wooden puzzle.

2. Hold Space for Complexity

Non-binary and genderqueer people often experience complex thoughts and feelings as they start to figure out who they are and who they want to be in the world. Gender can get tangled up with all kinds of developmental, social, and relational issues, and it’s also connected to the sense of self, who one is as a family member, sexuality, career, etc. (Basically gender is kind of connected to everything!)

But because non-binary and other gender diverse folks have a gender that is outside of the binary, and beyond the typical cultural narratives of how to be a person, they have to chart their own course in terms of becoming who they want to be. At the same time, they face enormous pressure to conform to cisgender and gender binary cultural patterns and stories.

This simultaneous experience of not enough cultural guidance about how to be non-binary, and too much binary and cisgender social norming, makes non-binary transition and non-binary life especially complex. So it can be really helpful to hang in there with a complex situation, and to get comfortable with not knowing what’s going on. (This goes for clients and therapists both!)

As part of that, let clients know that even though the process of becoming who they are is complex and not always straightforward, you are in it for the long haul. Communicate your trust in their ability to find their way— and that you’re here to help.

Umbrella with panels in different rainbow colors

3. Create Safe Spaces (and Help Clients Find Them)

Ideally, non-binary and genderqueer people should be able to feel safe anywhere that other people do. Unfortunately, due to social norming, cisgenderism, and transphobia, this ideal is far from a reality in many places. So much of what non-binary and gender-diverse people need is to experience social spaces that are safe enough for them to relax and let their guard down. This can really help people build resilience and find belonging.

First of all, therapists can ensure that the contexts they do therapy in are safer— whether that’s online or in person. Forms, processes, intake paperwork, nearby businesses, and gender-neutral bathrooms are all issues to think about to help non-binary and genderqueer clients feel more comfortable. The therapist’s own work also goes a long way in building that kind of safety in therapy. Analyzing and working through one’s own gender socialization is a basic discipline for creating safer spaces for trans and non-binary people, because unconscious and unprocessed gender socialization runs the risk of recreating harmful gender dynamics.

Secondly, clients need to be supported in finding and creating gender-validating spaces outside of therapy. This can include support groups, building trans and non-binary friend groups, and reaching out to supportive family members. Clients can also benefit from guidance in finding support in their institutions, such as queer resource centers in universities, queer-straight alliance clubs in secondary schools, or trans and queer affinity spaces at larger employers. Organizations like PFLAG can also be helpful for finding and building community. In addition to seeking out existing resources, clients can benefit from creating their own activity groups, skillshare workshops, and other social opportunities.

Non-binary and trans-validating media can also be a way to cultivate a safer cultural space. Podcasts such as Gender Reveal offer online social media opportunities, and reading, listening to, and viewing media that offer positive portrayals of gender-diverse people can be a powerful way to counteract damaging cultural messages.

Close-up of a pencil eraser with blue and pink eraser bits on a piece of white paper.

4. Recognize and Mitigate Non-Binary Erasure

A big issue that non-binary and other gender non-conforming people deal with is erasure. Basically, anytime the people, the culture, or the built environment assume there are only two genders, people with other gender identities are being erased. This happens with bathrooms, medical forms, paperwork, forms of address (i.e. ‘ladies and gentlemen’), clothing, toys, team sports, and all sorts of other situations in which people are divided based on gender.

Another type of erasure that non-binary people experience is when strangers (or therapists!) address them in ways that assume they know the person’s gender. Although it’s quite common for people to address each other informally in gendered ways (i.e. ‘hello sir,’ ‘hey man,’ ‘hey girl,’ etc.), it can feel very invalidating and erasing for non-binary people to be addressed in this manner. So practicing non-gender-imposing ways of communicating can help therapists make non-binary and genderqueer clients feel more seen.

Helping clients build resilience against these experiences can be a powerful therapeutic intervention. Resilience-building practices include processing such experiences in therapy, connecting with friends, journaling, and doing practices that promote gender euphoria. Gender invalidation can feel like the world tearing you down; these practices can help a person build back up again.

Mitigating non-binary erasure can also happen at the advocacy level, which can include therapists rallying to get gender-neutral bathrooms at their practice location, influencing their EHR provider to create more gender-inclusive forms, and speaking to other professionsals, legislators, or the public to improve how gender diverse people are treated in social life.

4-way traffic control signal showing red stop light against a bright sky.

5. Be Trauma-Informed and Acknowledge Intersectionality

Our last tip covers trauma and multiple social identities. First of all, although many non-binary and gender-diverse people have experienced trauma, trauma does not cause gender diversity. The matter is further complicated by the fact that many non-binary people have been targeted because of their gender diversity, such that gender and trauma can seem linked in a significant way. However, many non-binary people do not have clear traumatic experiences— so it’s clear that one doesn’t cause the other.

Nonetheless, the combination of trauma and the ongoing experience of erasure and exclusion due to gender can create significant obstacles in peoples’ lives. Being a trauma-informed therapist includes not doing harm and understanding common trauma triggers. However, it goes beyond that to having competency with trauma treatment.

Ideally, therapists should having a sensitive and finely honed relational capacity with clear boundaries, to address social trauma. Trauma-informed therapists should also pursue training in trauma modalities such as EMDR, somatic experiencing, sensorimotor psychotherapy, attachment therapy, IFS, or other evidence-supported trauma-specific approaches.

An additional component of this tip is for therapists to understand the unique social positionalities of the client and the therapist. We each inhabit multiple social identities, and most people occupy some positions that are marginalized and others that are privileged in mainstream US society. These multiple social identities combine to create unique experiences of privilege and oppression, and understanding clients’ different positionalities can help therapists provide better treatment.

Therapists should have a clear social justice analysis that acknowledges these intersecting identities and their impact on clients’ well-being. This makes it possible for therapists to understand the interplay of power and privilege in the therapeutic encounter. It also enables therapists to help clients recognize when psychological distress and trauma are arising due to systemic forces that maintain privilege and oppression, rather than due to any fault of the client’s. Finally, naming and understanding systemic social ills helps therapists and clients build resilience and skillful resistance to these forces.

A blue wrapped parcel tied with a bow.


Understanding and deepening into these five themes is a great way to cultivate more cultural competency in working with non-binary, genderqueer, gender non-conforming, and gender-diverse clients. Combining these perspectives with your existing training can be a great way to start improving services now, and it’s also important to seek further training if you want to hone your abilities and develop a specialty working with non-binary folks.

Our research group also came up with a list of 12 best practices for working with non-binary and genderqueer people— to be featured in a future blog post. If you’d like more detail, (If you’d like additional details, including the 12 best practices, the book chapter and poster are free to download.) Thanks for learning more about non-binary and genderqueer competency! If you’re ready to take your learning to the next level, and you’d like to book a training or consultation, get in touch!

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