The Gender Affirming Program (GAP) serves trans, gender-expansive, gender-questioning, and nonbinary individuals. We also have services and expertise that benefit LGBQIA+ people. We are honored to work with queer and trans people throughout their lifespan, serving children as young as 5 all the way up to elders. We are here to assist you whether you are just beginning to question your gender and wish to talk about it, on the path of medical transition and in need of letters of support or looking for help with mental health challenges that intersect with your identities. Our GAP clinicians are passionate about working with the trans community and equipped with experience and knowledge of the challenges unique to trans lives. We will treat you with the understanding and respect that you deserve.

Our services are offered in-person for the St. Louis area and virtually through telehealth. Many of our providers are also able to practice across Missouri state lines in other states located across the country. Please check with our Intake Team for more information about availability of our providers in your state.

Wherever you’re at in your journey, GAP is here to support you.

Issues We Treat

Many people experience mental health difficulties in addition gender dysphoria, and our clinicians have specialty and generalist training in issues such as:

• Problems related to gender dysphoria
• Exploring gender identity and congruent gender expression
• Issues related to LGBQA+ sexual orientation
• Disordered eating associated with gender presentation
• Recovering from trauma and PTSD
• Anxiety disorders
• Depression and bipolar disorder
• Stress and adjustment issues
• Obsessive-compulsive disorder
• Emotion regulation issues
• Rigid or overcontrolled behaviors
• Addictive behaviors
• Self-harm and suicidality
• Phase of life issues, including aging, adolescence, and partnership changes following transition
• Improving communication with families who struggle to be supportive

Our Treatment Approach

We offer individual therapy, medical letter of support assessments, therapy for clinical problems that may be unrelated to gender, group therapy, and even art therapy.

Gender Affirming Techniques

The only known treatment for gender dysphoria is gender affirmation. Affirming someone’s gender and helping them bring their external presentation in line with their experienced, internal gender means meeting them where they’re at, not trying to change them. This process can alleviate stress related to gender and begin to heal alienation from the self. Therapy can be a place to try out names, pronouns, and styles of dress and behavior, as well as explore the roles associated with various genders. We can also help you navigate social and medical transition in order to live your most authentic life.

Therapeutic Styles

Our GAP therapists are trained in a variety of therapy styles. Depending on their training, your therapist will be able to integrate specific therapies such as Cognitive Behavioral Therapy, which helps us deal with unhelpful thoughts and make changes to our behavior; Dialectical Behavior Therapy and Radically Open Dialectical Behavior Therapy, which help us communicate, connect, and relate to others more effectively and stop destructive behavior patterns to live a more valued life; Acceptance and Commitment Therapy, which uses mindful awareness and cognitive techniques to move us towards living actively in the life we have instead of getting stuck on the way we wish things were; Mindful Self-Compassion, which focuses on healing our relationship with ourself; and specific structured treatments for trauma, like Cognitive Processing Therapy and Prolonged Exposure.

What all our therapists have in common is that we will meet you wherever you are and help you head in the direction you want to go. Therapy isn’t determined by your therapist’s style; therapy is defined by the goals, problems, and needs brought in by each client. Especially in gender-related care, we know there is no one path or way of life that fits everyone.

Expressive Techniques

Gender can be an active, creative, and social experience! We have therapists trained in expressive techniques to help explore gender and imagine future possibilities in creative ways. Art therapy, play therapy, and psychodrama are available in GAP.

We also offer expressive therapy which uses makeup practice and education as part of exploring and affirming your most authentic gender expression. We offer this service as an adjunct to your individual or group therapy care.

Couples+ Therapy

GAP therapists are familiar with a wide range of relationship styles and practices. We have therapists who can work individually with people navigating nonmonogamy, and we have therapists trained to provide couples and relationship therapy, integrating Gottman Institute and eclectic approaches.

Family Consultation

GAP clinicians often consult with family members to help them learn about their loved one’s identity and how best to support them. We can facilitate difficult conversations with family members who are struggling to understand your path and what you need from them. In the past, GAP therapists have also facilitated conversations with employers or educators who needed guidance to best support a transition in the workplace or at school.

Evaluation for Letters of Support

Some gender-affirming medical interventions require a letter of support written by a mental health professional. Typically, these letters can be created in 1-2 evaluation sessions with a GAP therapist. You will answer standard interview questions designed to document your gender journey, evaluate your preparedness for a medical intervention, and complete standardized questionnaires about mental health and dysphoria. These evaluations are covered by many insurance plans.

Please note, Missouri is an informed consent state for Hormone Replacement Therapy. This means that if you are over 18, clinics in the area may be able to start you on HRT without a letter of support. If you need referrals to clinics like this in St Louis, or require a letter of support for insurance eligibility, GAP is happy to help.

Pharmacotherapy

If medication for mental health issues is part of your treatment plan, you can meet with a gender-affirming SLBMI psychiatrist. Your therapist can also help communicate with your psychiatrist about needs related to your gender identity.

Referral to Specialized Intensive Outpatient Programs
SLBMI has several specialized intensive outpatient programs (IOP), including Eating Disorders, Center for OCD and Anxiety Disorders, and Dialectical Behavior Therapy. If you need more intensive care than outpatient therapy can provide, your GAP therapist can coordinate with these IOPs to get you the necessary support and treatment.

Group Therapy
The opportunity to be in community with people who share some of your experiences is a key part of resilience, the quality that lets you overcome difficulties linked with your identities and celebrate the joy and euphoria unique to being you. We offer a number of groups for trans and LGBQIA+ individuals. To find out which groups are currently available, visit the group therapy section.

Services for Professionals and the Community

Training healthcare professionals across disciplines in the specialty needs of gender minority people, improving access to care for trans and gender-expansive people, and reducing stigma by providing public education are all part of our mission in GAP.

Community and Professional Presentations

GAP clinicians are available to present on transgender healthcare topics to community organizations and healthcare professionals, both in-person and online.

Consultation Services

GAP clinicians are available to practitioners seeking consultation or supervision on clinical cases, as well as to organizations seeking to develop programming for transgender and queer individuals or increase their diversity and inclusion for gender and sexual minorities.

Specialist-in-Training Employment Track

Postgraduate training in working with LGBTQIA+ populations can be hard to find. If you are a licensed mental health provider interested in working with this population but lack specific training, you may be a good candidate for specialist-in-training employment. This is a salaried, benefits-eligible employment track that devotes 3-6 months to training, supervision, didactics, and applied practice within GAP, with the goal of transitioning to a full, independent clinical caseload at the end of the training period. Specialist-in-Training applicants are accepted year-round. Please see more information located on our careers page.

SLBMI Pride

Watch this space for updates on community events and activities by GAP.

Contact Us

Contact [email protected] for general questions and inquiries. Contact our intake department at 314-289-9411 or [email protected] to get started with a GAP therapist or group.