Free Gender Therapy: How To Find Gender-Affirming Mental Health Care

If you are questioning your gender identity or exploring what gender means to you, you may benefit from speaking to a gender identity therapist. Gender therapy can help you better understand your sense of self, your relationship to your body, and the way you view your gender identity. This type of therapy can also help you navigate the challenges that may come with living outside of societal expectations regarding gender. 

Finding affordable gender therapy

Therapy can be expensive, so you may be interested in accessing gender therapy at a lower cost or even for free. Free or discounted gender therapy services can be hard to find, but they do exist. If you are seeking therapy from a licensed and credentialed therapist, you will likely have to pay some out-of-pocket expenses. Still, you may pay less with options like online therapy. 

What is gender therapy?

Gender therapy, also referred to as gender-affirming therapy or gender identity therapy, is a form of affirmative therapy. Therapists practicing affirmative therapy accept your identity and don't try to change who you are. 

A professional who practices gender therapy may have specialized training and experience related to the challenges faced by people who fall outside of societal expectations around gender. This includes those who are questioning or exploring their gender identity and expression.

Who can benefit from gender-affirming therapy?

You may benefit from talking to a gender therapist if you feel any of the following:

• Confined by other people’s expectations of how you should express your gender
• Constrained by gender stereotypes
• Discomfort related to your gender or certain parts of your body
• Gender dysphoria, the feeling that your gender identity and the sex you were assigned at birth are not in alignment
• Desire to expand your understanding of your gender identity or the concept of gender identity in general
• Exploring gender-affirming medical interventions such as hormone therapy
• Interested in supporting a loved one who's questioning or exploring their gender identity

It is important to note that you do not have to be transgender or identify with any particular gender identity to benefit from gender therapy. 

Gender identity, gender expression, and mental health

How to access low-cost or free gender therapy

If cost is a concern for accessing mental health services related to gender, there may be options that are free or low-cost. In some cases, the therapy itself might not be free, but you may be able to access it without paying full price out of pocket. This could be the case in situations where your therapy is covered by insurance or a provider offers sliding scale pricing. 

Insurance coverage and gender-affirming mental health care

The Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (MHPAEA) require insurance companies to cover mental health conditions in the same way they provide coverage for physical health conditions. Employer-sponsored health insurance, public health insurance offered through the federal health insurance marketplace, insurance under the Children’s Health Insurance Program (CHIP), and several forms of Medicaid are all required to comply with the ACA and MHPAEA. If you have health insurance, there's a good chance it is required by law to cover support for mental health conditions, which may include gender therapy.

Even if insurance covers your gender therapy, you may still have to pay copays out of pocket. However, copays are likely much cheaper than the cost of therapy accessed without insurance coverage. Therapy with insurance is generally significantly cheaper than therapy without. 

Local mental health and social services

Your state, county, or city may have local mental health offices that can connect you to free or low-cost gender therapy. These services might involve lengthy application processes and long waiting lists, though. You may also need to meet certain income requirements. In some cases, individuals might find themselves in a "coverage gap," which means they make too much money to be eligible for subsidized therapy, but too little money to pay for it out of pocket.

Social services may be able to help you in other ways, though. In addition to connecting you to potential subsidized care options, they may be able to help you find therapists who accept payments in installments. They might also know of mental health professionals willing to lower their costs for therapy sessions booked in advance. Similarly, they might be able to recommend therapists who offer sliding scale services, which means they charge different prices for people in different income brackets.

Social services might also be able to help you apply for Medicaid, which can expand the number of fully covered treatment options you can choose from. Finally, they may be able to assist you with grants and funding for other expenses such as bills, rent, or groceries. This can help you free up money for mental health care. 

Nonprofits

Nonprofits are another resource that can help connect you to local support systems and help you find gender therapy. Some nonprofits, like the National Alliance for Mental Illness, provide information about gender-affirming therapy options. They don't directly provide gender therapy, however. That said, they do offer a crisis line during certain hours, called the NAMI HelpLine, available at (800) 950-NAMI (6264).

The Trevor Project does not provide ongoing therapy, but its crisis line provides free 24/7 support services for young lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) people. The crisis line number is (866) 488-7386. They also have a service known as TrevorSpace, a free online community where LGBTQIA+ individuals can connect with each other. Here, they can share mutual support as they navigate the challenges of daily life as a person living outside of the gender and sexuality binary. TrevorSpace is also a place to share knowledge and resources related to gender. While this support system is not the same as gender therapy, it can still help you feel less alone and provide a sense of community. 

Online gender therapy for transgender and gender-diverse individuals

Online therapy is usually not free, but there may be a discounted introductory period. Many online therapy services cost less than traditional in-person therapy. Thus, online options can be a helpful way to access gender therapy at a lower price. This remote form of therapy can be accessed from the comfort of your home, which could be helpful if you experience social anxiety related to gender dysphoria. 

Effectiveness of online gender-affirming mental health care

Research demonstrates that online therapy can yield comparable outcomes to in-person therapy. One study surveyed people identifying as LGBTQIA+ who participated in an online therapy program and found that they experienced lower levels of mental health symptoms and higher levels of confidence in resilience and coping skills when the program ended. If your health insurance doesn't cover gender therapy, and you're unable to use the other resources to access therapeutic treatment, online therapy could be an effective, low-cost alternative.