INDIVIDUALS: Individuals often come to a therapist for the first time with a sense of confusion about what they feel. For many people, the first visit to a therapist is extremely anxiety provoking. They may never before have talked openly to another human being for fear that they would be censured or that their feelings would be dismissed or made light of.

In such a situation, it is extremely important that the therapist take time to help the patient feel comfortable. The patient should come to feel that the therapist can be trusted to understand and to maintain the patient’s confidentiality at all costs. Next, a thorough history should be taken. Each individual’s experience with gender variation is unique and different. Many people need to decide not only what to do about their feelings, but what their feelings mean to them. The patient needs the therapist to work with him or her to decide what the patient is dealing with and what course of action or inaction would be best for that particular individual.

COUPLES: A couple may present to the therapist after the spouse has found out about the patient’s cross dressing or gender variance. This incident often throws the couple into crisis. In the case of a biologic male cross dresser, many times the spouse insists that the patient stop dressing all together. What should be done? How should the cross dresser respond? How can the spouse come to understand the phenomenon? How can the couple deal with it? These issues must be thoroughly addressed. Solutions should be found that are uniquely applicable to that particular couple.

TRANSSEXUAL TRANSITION: When a gender variant individual decides that full transition to the opposite gender is the best course of action, he or she embarks upon a very complicated and difficult task. The role of the therapist is to assist the patient in getting what he or she wants out of life. Issues surrounding work, family and relationships become particularly thorny and painful. The therapist must work with the patient to help settle these dilemmas. When the patient becomes ready for sex change surgery, the therapist assists to patient by providing a letter of recommendation as required by the World Professional Association for Transgender Health.

FEMALE TO MALES: Although different from male to female transsexuals, F to M’s deal with many similar issues, especially in regard to transition. Decisions particularly unique to them involve choices regarding various surgeries and hormone treatments.

GENDER VARIANT CHILDREN AND ADOLESCENTS: Ms. Wojdowski is experienced and knowledgeable regarding treatment of gender variant children. She assists parents and others to become aware of the dilemmas their children experience and to explore how best to help the child in various situations as he/she grows.