ABSTRACT
The supervision of therapists working with transgender and gender nonconforming clients presents special challenges. First, both the supervisor and therapist must have medical, legal, and sociopolitical knowledge as well as clinical expertise. The paradigm for understanding the transgender phenomenon has changed so recently that many counselors will have to “unlearn” the old, pathologizing model before understanding the new. Working with this population forces both therapists and their supervisors to confront ingrained attitudes about gender binaries, roles, and expression. Interventions such as the use of puberty blockers and early social transition are so new as to be untested and uncertain. Supervisors have a responsibility to keep close watch on the research literature as new findings about medical treatments and outcome can appear overnight. Finally, supervisors have to manage their own countertransferential feelings as well as guide their supervisees in self-analysis: in few other areas of mental health do decisions facilitated by clinicians have such permanent, life-altering consequences.
