Gender Affirming Care: Guidelines for Working Systemically with Transgender, Nonbinary, and Gender Expansive Clients

The Queer and Trans Advocacy Network (QTAN) in collaboration with AAMFT, has released GENDER-AFFIRMING CARE: Guidelines for Working Systemically with Transgender, Nonbinary, and Gender Expansive Clients.

These guidelines provide best practices for working systemically with trans, nonbinary and/or gender expansive clients (TNBGE) and are a starting point for further reading, learning, unlearning, discussion, teaching, and improving both supervision and clinical practices with TNBGE individuals and families.

Rooted in systemic theory and aligned with AAMFT’s Code of Ethics and Gender-Affirming Care Position Statement, the guide offers practical approaches to clinical work, supervision, and ongoing professional development.

Created by a majority-TNBGE team of clinicians and scholars, the document embraces the principle of “nothing about us without us,” centering the lived experiences of TNBGE professionals. It includes recommended practices, key terminology, and additional resources to help MFTs provide inclusive, affirming, and ethical care.

Systemic family therapists have a crucial role to play in gender-affirming care—particularly in helping families navigate emotional conversations and remain connected through times of uncertainty or change. While gender identity has become a topic of national political debate, for marriage and family therapists, this work is about saving lives through suicide prevention and supporting families in staying intact. Our ability to foster communication, compassion, and care is needed now more than ever.

This living document is intended to evolve alongside the field and serves as an essential resource for MFTs committed to equitable, client-centered practice.