Dealing with a mismatch between your assigned sex and your gender identity can be extremely stressful.
Gender therapy helps you answer questions about your gender identity and/or the transition process, and is usually performed by a therapist who specializes in gender issues. An online gender therapist can give you accessible help for an affordable price, from the comfort of your own home.
This article will compare two of the top online gender therapy services available at the moment. We’ll also cover gender therapy more broadly, so you can learn more about treatments for gender dysphoria, and help you discover your gender identity.
Top online gender therapy services – summary
Note: we may receive compensation if you become a paying customer of a therapy service we link to.
Best online gender therapy services
Looking for a gender dysphoria therapist who can help you over the internet?
Below, we’ve looked at two of the best online gender therapist services, who can provide professional advice.
Pride Counseling is a part of BetterHelp – the world’s largest e-counseling website. Basically, Pride Counseling is their service that connects you with a licensed gender therapist, specializing in LGBTQ or gender identity issues.
With Pride Counseling, you can get access to online video counseling, as well as chat or messaging sessions at your convenience – or you can get in touch with a traditional phone call.
As you sign up, Pride Counseling will ask you to fill out an online form about your therapy needs, preferences in a therapist, and your demographics. After, they help to match you with one of their online gender therapists. You can always choose to change your counselor at any point in time.
For those seeking gender therapy, Pride Counseling will also ask a few questions in the form of an online questionnaire about your gender (eight options), sexual orientation (ten options) and your preferred pronouns. The answers usually give you the option to select “I don’t know” or “other” if you’re unsure.
The best thing about Pride Counseling is they match you with an online gender therapist who is part of the transgender community. This ensures that you get connected with a professional who understands how best to provide mental health care – you might like to speak to a therapist who is experienced with lesbian issues specifically, for example.
Pride Counseling pricing is subscription-based. You pay $60-$90 per week to use the platform, based on the type of help you need, and where in the world you are located.
Given that they also provide a financial assistance program for certain socioeconomic groups, such as students, Pride Counseling can be quite an affordable choice when compared to in-person therapy.
Talkspace is another platform that provides therapy for LGBTIQ people from licensed mental health professionals.
Their service is primarily focused on providing support through the TalkSpace mobile app. They’re a great option if you’re looking to get in contact via live chat, or text message – you can make contact whenever you’d like to speak with your gender therapist. However, you can also schedule phone calls and video calls as well.
Both platforms offer a similar service, however Talkspace forces you to make an account before gaining access and seeing what questions they ask you. This makes it a bit more difficult to evaluate the service.
Another key difference between the two platforms is how they match you with a gender identity therapist. While Pride Counseling has you fill out an online therapy questionnaire, Talkspace has you speak to a matching agent, who follows a script and asks you questions. Later, you will be given a number of mental health professionals to choose from.
This system works well, but can be a bit daunting when first beginning to get counseling. If you’d prefer to avoid too much interaction to begin with, Pride Counseling might be worth exploring first.
Is online therapy right for me?
Research has shown that online counseling can be as effective as getting face-to-face gender dysphoria therapy. It can help you avoid waiting lists, and might also help you find better-quality support, since it can be hard to find good gender counselors in certain areas.
Plus, choosing online counseling allows you to have a conversation from the comfort of your own home – you can choose to interact over chat or email if you’d prefer. For some people, this makes it much easier to talk and get help.
The disadvantage of online gender therapy is it might not be covered by your health insurance, although online sessions are generally very affordable.
If you have a serious problem and are looking for urgent help, rather than seeking advice to improve your quality of life, it is generally best to see someone in person.
Sex and gender: explained
When born, people usually show different anatomical and physiological characteristics. Our internal and external genitalia and hormonal and chromosomal makeup are used by doctors to assign us a sex, known as our “natal sex”.
Western culture and society often views this as a binary concept, with two distinct genders. Yet, it is shown that some babies develop differently (i.e. male babies with two x chromosomes, or atypical genitalia). We can conclude therefore that there are at least three biological sexes:
On the other hand, gender refers to the identity, expression and societal norms of a person. For example, a cisgender person identifies with their natal sex.
What does it mean to be transgender?
Transgender people have a different gender identity (or expression) than the sex they were assigned at birth.
Non-binary or genderqueer people can also fall under this umbrella – these groups usually don’t identify with a gender. People identify as queer or non-binary when they identify with more than one gender, or they fluctuate between genders.
Some identify as a third gender – not all genderqueer people feel that the term transgender is a good fit for them.
What is gender dysphoria?
The terms “gender dysphoria” and “transgender” are not the same thing. Gender dysphoria relates to the distress that can be caused by incongruence between your natal sex and gender identity.
The problem is not your gender identity, but the discomfort you are feeling. Not all trans people experience such a strong level of distress, and do not experience gender dysphoria. However, if you do feel distressed, a gender therapist can help you to overcome gender dysphoria.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines how gender dysphoria is officially diagnosed. For example, it states that the distress you feel should be present for more than six months. You should also feel the impact of your dysphoria in multiple aspects of your life, such as social, occupational, and mental factors. Getting a gender dysphoria diagnosis can help you get more access to treatment and health care options.
What are some symptoms of gender dysphoria?
Symptoms of gender dysphoria are a little different for adults than for children. For a diagnosis, adults should experience two or more of the following symptoms:
- A mismatch between the expressed gender and their primary/secondary sex characteristics (or anticipated characteristics for teenagers).
- Wanting to get rid of or prevent their biological sex characteristics (because of this incongruence).
- Wanting sex characteristics of the other gender.
- Wanting to be the other gender/an alternative gender different from one’s assigned gender.
- Wanting to be treated as the other/alternative gender.
- A sense of having typical emotions/characteristics of another gender.
Children usually express these symptoms slightly differently. They should show at least six or more of the following symptoms. The first symptom must be included in every diagnosis.
- A desire or the insistence that they are of the other gender.
- A strong preference for wearing only typical clothing associated with the other gender. Boys (assigned gender) prefer to cross-dress or simulate female attire. Girls (assigned gender) prefer to wear only masculine attire and strongly resist wearing typical feminine clothing.
- A preference for cross-gender roles in make-believe or fantasy play.
- A preference for the toys, games or activities stereotypical for the other gender.
- A preference for playmates of the other gender.
- A strong rejection of stereotypical toys, games and activities. Boys (assigned gender) also tend to strongly avoid rough-and-tumble play.
- A dislike of one’s sexual anatomy.
- A desire for the physical sex characteristics that match the experienced gender.
Causes of gender dysphoria
The cause or causes of gender dysphoria are not yet clear. It is thought that the mental illness might be an interplay between the following factors:
- Hormonal influences during prenatal development.
We also know that gender dysphoria usually starts in childhood, when people first notice the incongruence between their assigned gender and their gender identity. Quickly, the child feels a mismatch between the gender that is expected of them (based on social interactions and their upbringing) and how they feel about their gender. This can lead to gender dysphoria.
Why do transgender people have an increased risk of mental health problems?
Research shows that trans children that get help in their transition are better off in the long run. Trans children who have undergone treatment have almost the same mental health risks as cisgender children (such as symptoms of anxiety and depression).
Intervening with the proper help is essential, as there is a stark difference in outcomes for these children and those that don’t get help, as shown by a 2013 study conducted at the Children’s Hospital Los Angeles.
Trans individuals can face many forms of stigma. They might be confronted with abuse, incarceration and/or economic and societal marginalization, depending on their sociocultural environment. These problems can lead to an increased risk of anxiety and depression, and other mental health concerns.
Family and peer assistance can help to support you during psychological stress you may be experiencing. In other words, managing stigma begins with you and your network. If your family is unsupportive for example, talking to someone who knows how to help, such as a transgender therapist, is generally a good idea.
Treatments for gender dysphoria
Treatment of individuals who suffer from gender dysphoria can be multi-faceted. Since gender dysphoria is a dynamic issue that affects different people in different ways, based on different hormonal and environmental factors, these treatments are typically adapted to meet your personal needs.
Individual – treatment is firstly focussed on the distress accompanying the misalignment between your assigned sex and your gender identity. A specialized clinician can help you explore the gender identities and roles that you are comfortable with.
When selecting a mental health provider, whether online or in-person, it is essential to choose someone who is open-minded. Your gender dysphoria therapist should let you express your own thoughts and feelings, and should not have a preconceived opinion about what your gender expression should be.
Avoid healthcare providers that use gender conversion therapy, which focuses on converting you to be cisgender. Research shows that this can be extremely damaging to your psychological health.
Couples and family – affirming your gender identity or transitioning is not an easy process to go through by yourself. Your family and close friends might also need some extra help in how to make your transition easier.
Getting your network involved and teaching them how to be supportive can help your mental health in the long term. Parents or partners of transgender individuals can also benefit from therapy or peer support groups. For them, this might also be a big transition.
Hormone therapy can align your sexual characteristics with your gender identity. The following two options are possible:
- Feminizing hormone therapy: suppressing testosterone, and boosting estrogens and progestogens hormones.
- Masculinizing hormone therapy: suppressing estrogen, and boosting testosterone.
Gender confirmation surgery
Gender affirming surgery, gender confirmation surgery and gender reassignment surgery are all terms used to refer to the surgeries used to change one’s body to fit their gender identity.
The following types of surgeries are available:
- Top surgery (i.e. mastectomy, chest reconstruction, breast augmentation).
- Bottom surgery (surgical construction of a penis or a vagina).
- Facial feminization surgery (for example shaving the Adam’s apple).
- Vocal surgery (usually a last resort when trans women are not happy with the effects of their voice therapy sessions, which we’ll discuss below).
Voice therapy sessions can help those that want to change the pitch of their voice. A higher pitch is usually associated with a more feminine voice. A lower pitch is usually associated with a more masculine voice. Voice therapy involves going through training and exercises to help you change the way you sound when speaking.
Other helpful resources
Further mental health care options you have as a transitioning individual include:
- Social gender role transitioning (i.e. correct pronouns).
- Peer support groups.
- Legal affirmations (such as changing your name and sex).
Steps you can take yourself
As mentioned above, research shows that connecting with others can help you address gender dysphoria and manage any potential stigma you may face.
Getting social support with your gender identity is the first step you can take yourself, assuming you have a supportive network. This can be in the form of your parents or friends. Further, it is shown that contact with like-minded people can help you with affirmation and reduce the distress you are feeling.
How a gender therapist near me can help
With counseling services like Pride Counseling, a mental health provider can help you by providing advice via one-on-one phone calls, video calls, and chat sessions. These sorts of online sessions are best suited for those that want to improve their quality of life.
Relying on online counseling is not suited for those that are in an urgent situation. If you are in an emergency or need crisis care, you can always call 911 or a mental health service in your neighborhood. You can also contact the National Suicide Prevention Hotline on 1-800-273-8255.
Feeling safe and free from judgment is essential for trans people. For some, this means seeking external help from gender therapists.
Research shows that trying to convince people to be cisgender is an attack on their mental health. Not only is it unethical and ineffective, but these conversion efforts can also increase psychological stress and the likelihood of depression.
Trans people can experience stigma, discrimination, prejudice and violence, which is why talking to open-minded gender therapists, specializing in gender identity issues, can make your life and your potential transition process that much easier.
About the author
I’m a registered psychologist in Belgium, with a BSc and MSc in clinical psychology. I also have an Acceptance and Commitment Therapy training certificate, which is a form of cognitive therapy that utilizes a mindfulness and value-based approach.
My focus is on helping people who feel stuck or don’t know what they want anymore in life. I hope to provide tools and information that people can use in their day-to-day routine to reach a higher level of autonomy and improve their overall wellbeing.