ABSTRACT
Evidence-based approaches to treat Gender Dysphoria that is complicated by emotional and behavioral dysregulation in transgender clients have been quite limited. Identification of evidence-based treatment options for complex Gender Dysphoria is an ethical imperative for scholars and mental health professionals alike. The chapter addresses this need by describing the application of Dialectical Behavior Therapy (DBT) to the conceptualization and treatment of clients with Gender Dysphoria. It associates mental health problems such as suicidality, substance abuse, risky sexual behavior, and other interpersonal challenges mindfulness and distress tolerance are acceptance-based skills, while interpersonal effectiveness and emotion regulation are change-based skills. The chapter argues that the theoretical underpinnings and treatment targets of DBT, including keeping clients alive, engaged in treatment, and effectively working to reduce barriers to high quality of life, are of great applicability to transgender clients, particularly those who present with high-risk behavior.
