Therapist Reactions to Transgender Identity Exploration

Effects on the Therapeutic Relationship in an Analogue Study

Bettergarcia, Jay N.
Israel, Tania

Counseling, Clinical, and School Psychology, University of California, Santa Barbara and Psychology and Child Development California Polytechnic State University, San Luis Obispo
Counseling, Clinical, and School Psychology, University of California, Santa Barbara

This research was supported in part by the American Psychological Association of Graduate Students Psychological Science Research Grant, the American Psychological Association Society for the Advancement of Psychotherapy Diversity Research Grant, and the Hosford Memorial Dissertation Research Grant.

Jay N. Bettergarcia, Department of Psychology and Child Development, California Polytechnic State University, San Luis Obispo, San Luis Obispo, CA 93405 [email protected]

Received September 18, 2017

revised February 8, 2018

Accepted February 12, 2018

Psychology of Sexual Orientation and Gender Diversity 5(4):p 423-431, December 2018. | DOI: 10.1037/sgd0000288

Transgender individuals seek mental health counseling for a variety of reasons (); however, their experiences in therapy are not always positive, and some experiences are quite negative (). The present study utilizes an analogue research design and video vignettes to investigate how a therapist’s response to transgender identity exploration affects participants’ perceptions of the therapist and the therapeutic relationship. The study utilized a series of mock therapy video vignettes that vary the way that a therapist responds to the client including transition affirming, nonbinary affirming, and nonaffirming responses. Transgender participants were asked about their plan to transition or not transition and were then randomly assigned to watch 1 of 3 mock therapy clips. Participants then completed a series of questions about their perception of the therapist’s expertness, likability, trustworthiness, the session smoothness and depth, and their own feelings of positivity and arousal. Results indicate that the nonaffirming video condition had a significant negative effect on the participant’s perceptions of the therapist and the quality of the therapeutic relationship. No significant differences were found between the transition affirming and nonbinary affirming conditions. This study provides a more nuanced understanding of the ways in which transgender individuals experience various affirming and nonaffirming therapeutic approaches.