Results suggest the need for practitioners to focus on interventions that reduce avoidant coping strategies, while simultaneously increasing social support, in order to improve mental health for transgender individuals. Individuals who are in the beginning stages of their transition will use different coping strategies than those who are in later stages; interventions should be adjusted on the basis of the transition status of transgender clients.

This study explored the work experiences of individuals who have started transitioning from their biological sex to a different gender expression through 18 interviews of transgender-identified individuals. Thirteen of the participants identified as male-to-female transsexuals, 2 participants identified as female-to-male transsexuals, 2 participants identified as female-bodied gender queer individuals, and 1 participant identified as a biological male cross-dresser. Using a grounded theory (K. Charmaz, 2006) approach, 2 separate work experience models emerged: (a) the process of gender transitioning at work and (b) the career decision-making process. The 3 phases of the first model included a pretransition phase, during the transition phase, and posttransition phase. Within these 3 phases, the following 5 major themes emerged: preparation for the work transition, coming out at work, presentation and appearance at work, others' reactions at work, and affective/coping experiences related to work. The second model resulted in 6 major themes related to career decision making: occupational barriers, occupational prospects, occupational aspirations, taking action, occupational gratification, and contextual influences.

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This study examined transgender community belongingness as a mediator between strength of transgender identity and well-being. A total of 571 transgender adults (n = 209 transgender women, n = 217 transgender men, and n = 145 nonbinary-identified individuals) completed an online survey assessing transgender community belongingness, strength of transgender identity (operationalized as the extent to which a person self-categorizes their identity as transgender and the extent to which they believe their gender transition to be important to their self-definition), and well-being (using measures of self-esteem, satisfaction with life, and psychological well-being). Structural equation modeling was used to analyze the data. When controlling for participants' income, age, and stage of gender transition, transgender community belongingness fully mediated the relationship between strength of transgender identity and well-being. Strength of transgender identity was indirectly and positively related to well-being through community belongingness, but was not directly related to well-being. Results suggest that transgender community belongingness is an important construct in the mental health of transgender people. The strength of a person's transgender identity also appears to be a significant construct in transgender people's well-being via its relationship with transgender community belongingness. Implications of the findings are discussed. (PsycINFO Database Record

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Therapeutic alliance has a moderate relationship with perceptions of therapist empathy and genuineness. Of note, there may be reason to believe that when rated by the same person, these constructs have significant overlap and lack discreteness. Future directions for study of the therapeutic relationship are discussed. Implications for practice are provided.

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Therapists should consider the rates of change for their own clients as well as by outcome.