Sex-Positive, Kink Allied Therapists in Coronado, CA

Photo of Kathleen (Katie) Shearman, Counselor, MS, LPCC, LIMHP
Kathleen (Katie) Shearman
Counselor, MS, LPCC, LIMHP
Coronado, CA 92118
Welcome! I have spent more than a decade in trauma work and understand the arduous process to release the debilitating grip past trauma can have on a client’s present-moment experience. I recognize the profound courage it takes to look deeply within. I prepare my clients to find that invisible line between comfort and discomfort to set the foundation for lifechanging results and encourage them to live in their own authentic truth. Trauma healing looks different for everyone and I work side by side with each of my clients to design a path of healing that feels right to them.
Welcome! I have spent more than a decade in trauma work and understand the arduous process to release the debilitating grip past trauma can have on a client’s present-moment experience. I recognize the profound courage it takes to look deeply within. I prepare my clients to find that invisible line between comfort and discomfort to set the foundation for lifechanging results and encourage them to live in their own authentic truth. Trauma healing looks different for everyone and I work side by side with each of my clients to design a path of healing that feels right to them.
(619) 492-5984 View (619) 492-5984
Photo of Constance leger - Relationship Counseling Center of California, Clinical Social Work/Therapist, LSCW
Relationship Counseling Center of California
Clinical Social Work/Therapist, LSCW
2 Endorsed
Coronado, CA 92118
Are you feeling stuck in intense emotions or behavioral patterns that don’t serve your best interest? Are you hoping to build more meaning and joy in your life? You may feel hesitant about reaching out for help, especially with pressure from all directions to “have it all together”. I’m here to join you on this journey to discover healing and build a balanced life. I provide collaborative, authentic, compassionate, client-centered and non-judgmental counseling. My goal is to help you find compassion for yourself, develop skills to help you navigate life stressors, identify how you can become the best version of you
Are you feeling stuck in intense emotions or behavioral patterns that don’t serve your best interest? Are you hoping to build more meaning and joy in your life? You may feel hesitant about reaching out for help, especially with pressure from all directions to “have it all together”. I’m here to join you on this journey to discover healing and build a balanced life. I provide collaborative, authentic, compassionate, client-centered and non-judgmental counseling. My goal is to help you find compassion for yourself, develop skills to help you navigate life stressors, identify how you can become the best version of you
(559) 337-6093 View (559) 337-6093
Photo of Sue Boyd - Personal Evolution Psychotherapy, Clinical Social Work/Therapist, LCSW, PhD, LMFT
Personal Evolution Psychotherapy
Clinical Social Work/Therapist, LCSW, PhD, LMFT
1 Endorsed
Serves Area
Is excessive worry or sadness limiting your life? Do you want to feel better and live a life worth living? Helping our clients overcome social anxiety, depression, communication & relationship issues, panic, excessive worry & depression is our primary focus. By using proven therapy methods (We are Dialectical Behavior Therapy - DBT specialists) we will focus on specific problems, solutions, skills & reachable goals. We provide much more than traditional talk therapy & help you get results to help control your emotions & your life. By doing this we can help more quickly.
Is excessive worry or sadness limiting your life? Do you want to feel better and live a life worth living? Helping our clients overcome social anxiety, depression, communication & relationship issues, panic, excessive worry & depression is our primary focus. By using proven therapy methods (We are Dialectical Behavior Therapy - DBT specialists) we will focus on specific problems, solutions, skills & reachable goals. We provide much more than traditional talk therapy & help you get results to help control your emotions & your life. By doing this we can help more quickly.
(619) 787-6676 View (619) 787-6676
Photo of Ryan Dumke, Psychologist, PsyD, ABPP
Ryan Dumke
Psychologist, PsyD, ABPP
1 Endorsed
Serves Area
Hello! In a world that can feel rough and insensitive, with pasts that feel like they can choke us, it can be hard to move past the weight of our histories and our own minds. I'm here to help you figure out problems you want to overcome, what goals and life you want, and work with you to get there. I work with mood disorders (depression), anxiety disorders (OCD, Generalized Anxiety, panic), trauma-spectrum disorders (PTSD), relationship problems, intimacy issues, emotional problems, work and academic issues, and generalized coaching. Reach out and we'll figure it out together! Call 619-500-8967 for a free consult.
Hello! In a world that can feel rough and insensitive, with pasts that feel like they can choke us, it can be hard to move past the weight of our histories and our own minds. I'm here to help you figure out problems you want to overcome, what goals and life you want, and work with you to get there. I work with mood disorders (depression), anxiety disorders (OCD, Generalized Anxiety, panic), trauma-spectrum disorders (PTSD), relationship problems, intimacy issues, emotional problems, work and academic issues, and generalized coaching. Reach out and we'll figure it out together! Call 619-500-8967 for a free consult.
(760) 239-5626 View (760) 239-5626

More Therapists Nearby

Photo of Rachelle Ann Ramos, Marriage & Family Therapist, MS
Rachelle Ann Ramos
Marriage & Family Therapist, MS
Online Only
I would describe the therapy I offer as client centered, nonjudgmental, collaborative, affirming, multiculturally responsive, and sex positive.
Clients who seek me out for therapy often identify with historically underrepresented groups such as Black, Indigenous, people of transnational-immigrant diaspora, LGBTQIA+ individuals/couples/CNM configurations, sex workers, and more. My therapy services include but are not limited to supporting individuals/couples/CNM configurations navigating life transitions, processing trauma to release the influence of the past on the present, as well as finding/developing their emotional balance. I have experience working with Consensually Nonmonogamous Configurations as well as Kinky populations in regard to my relational work.
I would describe the therapy I offer as client centered, nonjudgmental, collaborative, affirming, multiculturally responsive, and sex positive.
Clients who seek me out for therapy often identify with historically underrepresented groups such as Black, Indigenous, people of transnational-immigrant diaspora, LGBTQIA+ individuals/couples/CNM configurations, sex workers, and more. My therapy services include but are not limited to supporting individuals/couples/CNM configurations navigating life transitions, processing trauma to release the influence of the past on the present, as well as finding/developing their emotional balance. I have experience working with Consensually Nonmonogamous Configurations as well as Kinky populations in regard to my relational work.
(619) 732-3255 View (619) 732-3255
Photo of Elin Kiyoko Campbell, Clinical Social Work/Therapist, MSW, LCSW
Elin Kiyoko Campbell
Clinical Social Work/Therapist, MSW, LCSW
1 Endorsed
Online Only
I'm a sex-positive therapist who is aware and affirming of: LGBTQIA+, ethical nonmonogamy, kink, and am Neurodiversity Affirming.
Imagine being in a space that feels open, accepting, free of judgment—where you can show up as your full self without ever needing to censor or adjust who you are. I understand how challenging it can be to find a therapeutic environment where you feel like you truly belong, and it’s deeply meaningful to witness the relief clients experience when they’re able to engage authentically in the therapeutic journey. My primary focus is supporting individuals navigating complex trauma, sexuality-related concerns, and Neurodiverse clients. I have completed and continue to pursue specialized training and education in Sex Therapy.
I'm a sex-positive therapist who is aware and affirming of: LGBTQIA+, ethical nonmonogamy, kink, and am Neurodiversity Affirming.
Imagine being in a space that feels open, accepting, free of judgment—where you can show up as your full self without ever needing to censor or adjust who you are. I understand how challenging it can be to find a therapeutic environment where you feel like you truly belong, and it’s deeply meaningful to witness the relief clients experience when they’re able to engage authentically in the therapeutic journey. My primary focus is supporting individuals navigating complex trauma, sexuality-related concerns, and Neurodiverse clients. I have completed and continue to pursue specialized training and education in Sex Therapy.
(415) 570-6476 View (415) 570-6476
Photo of Bayley Raiz, Clinical Social Work/Therapist, DBH, LCSW
Bayley Raiz
Clinical Social Work/Therapist, DBH, LCSW
2 Endorsed
Online Only
You’re a gay man in mid-life. You’ve done the work. You’ve built a life with depth, identity, and probably a few scars. You’ve found strength in community—maybe in leather, chosen family, or relationships that don’t fit the mainstream mold. And yet… certain patterns still show up. Emotional walls. Disconnection. That old feeling like something’s missing—or still running the show. Daddy Issues Therapy is built for you. We take your lived experience seriously and use evidence-based tools to help you heal, grow, and lead with emotional clarity—on your own terms.
You’re a gay man in mid-life. You’ve done the work. You’ve built a life with depth, identity, and probably a few scars. You’ve found strength in community—maybe in leather, chosen family, or relationships that don’t fit the mainstream mold. And yet… certain patterns still show up. Emotional walls. Disconnection. That old feeling like something’s missing—or still running the show. Daddy Issues Therapy is built for you. We take your lived experience seriously and use evidence-based tools to help you heal, grow, and lead with emotional clarity—on your own terms.
(213) 787-7499 View (213) 787-7499
Photo of Kendell Walker, Marriage & Family Therapist Associate, AMFT, HHP
Kendell Walker
Marriage & Family Therapist Associate, AMFT, HHP
San Diego, CA 92103
It’s never just one thing that ails us, it’s never just one thing that heals us. Many times it is easy to forget the path that was walked and the longevity of challenges that had to be worked through. As you begin your healing journey, know that this path requires longevity as well and the patience to honor each step, trusting that consistent effort and compassion for yourself will bring lasting transformation. I believe that the wholeness of the Self, comes from treating the mental, emotional, physical, and energetic bodies collectively. The shadow and forgotten wounds seek resolution as much as the symptoms.
It’s never just one thing that ails us, it’s never just one thing that heals us. Many times it is easy to forget the path that was walked and the longevity of challenges that had to be worked through. As you begin your healing journey, know that this path requires longevity as well and the patience to honor each step, trusting that consistent effort and compassion for yourself will bring lasting transformation. I believe that the wholeness of the Self, comes from treating the mental, emotional, physical, and energetic bodies collectively. The shadow and forgotten wounds seek resolution as much as the symptoms.
(619) 853-3094 View (619) 853-3094
Photo of Dr. Matthew Seitman, Psychologist, PsyD
Dr. Matthew Seitman
Psychologist, PsyD
San Diego, CA 92108
I currently serve on the APA Kink & BDSM Taskforce.
I believe in the importance of honoring individual experiences, I work collaboratively with clients to provide individualized mental health care to support authentic living and healing. I ensure that my therapy space is a safe, sex-positive, LGBTIA+, ENM/Polyamory, and Kink affirming.
I currently serve on the APA Kink & BDSM Taskforce.
I believe in the importance of honoring individual experiences, I work collaboratively with clients to provide individualized mental health care to support authentic living and healing. I ensure that my therapy space is a safe, sex-positive, LGBTIA+, ENM/Polyamory, and Kink affirming.
(619) 558-1076 View (619) 558-1076
Photo of Olivia Duprez, Pre-Licensed Professional
Olivia Duprez
Pre-Licensed Professional
1 Endorsed
Online Only
Waitlist for new clients
I believe that therapy should be an adaptable process tailored to who someone is and what they need. I aim to meet clients with compassion and curiosity, creating an intentional, present, and client-centered space for healing. I am passionate about offering non-judgmental support and helping people live more authentically. I work collaboratively with clients to explore their uniqueness, build insight, and strengthen relationships. My approach empowers clients through open communication and a deep respect for their lived experiences, encouraging growth that extends beyond the individual.
I believe that therapy should be an adaptable process tailored to who someone is and what they need. I aim to meet clients with compassion and curiosity, creating an intentional, present, and client-centered space for healing. I am passionate about offering non-judgmental support and helping people live more authentically. I work collaboratively with clients to explore their uniqueness, build insight, and strengthen relationships. My approach empowers clients through open communication and a deep respect for their lived experiences, encouraging growth that extends beyond the individual.
(858) 365-9733 View (858) 365-9733
Photo of Maya Attia - Maya Attia- Poly & ENM Therapist, Marriage & Family Therapist, LMFT
Maya Attia- Poly & ENM Therapist
Marriage & Family Therapist, LMFT
2 Endorsed
Online Only
You’ve read all the books and did all the research, but being in an open relationship is more complicated than it sounded. You thought you had it all figured out, but it turns out you’re just as lost as before. It was supposed to be an exciting time to explore and spice things up, but right now you’re overwhelmed with anxiety and fear. You’re scared this will ruin your relationship and jealousy has become a familiar presence. Something has to change.
You’ve read all the books and did all the research, but being in an open relationship is more complicated than it sounded. You thought you had it all figured out, but it turns out you’re just as lost as before. It was supposed to be an exciting time to explore and spice things up, but right now you’re overwhelmed with anxiety and fear. You’re scared this will ruin your relationship and jealousy has become a familiar presence. Something has to change.
(949) 832-6138 View (949) 832-6138
Photo of Emily Davis, Licensed Professional Clinical Counselor, LPCC
Emily Davis
Licensed Professional Clinical Counselor, LPCC
Online Only
My training specializes in human sexuality, gender exploration, and kink or ethical non-monogamy curiosity.
Sexual liberation and exploration can help uncover psychosomatic healing and self empowerment. My priority is to offer a nurturing, non-judgmental and collaborative space where I support my clients integrate pleasure and autonomy into their lives. My services include, but aren't limited to, navigating desire discrepancies, processing sexual and relational trauma, releasing shame related to sexuality, supporting parents of LGBTQIA+ children and management of anxiety or depression. I work with individuals, couples, ENM configurations, sex workers, queer, trans or neurodivergent individuals.
My training specializes in human sexuality, gender exploration, and kink or ethical non-monogamy curiosity.
Sexual liberation and exploration can help uncover psychosomatic healing and self empowerment. My priority is to offer a nurturing, non-judgmental and collaborative space where I support my clients integrate pleasure and autonomy into their lives. My services include, but aren't limited to, navigating desire discrepancies, processing sexual and relational trauma, releasing shame related to sexuality, supporting parents of LGBTQIA+ children and management of anxiety or depression. I work with individuals, couples, ENM configurations, sex workers, queer, trans or neurodivergent individuals.
(619) 350-0930 View (619) 350-0930
Photo of Dr. Jem Powell, Psychologist, PsyD, MA, HSP-P
Dr. Jem Powell
Psychologist, PsyD, MA, HSP-P
7 Endorsed
Online Only
Updated:10/2/25 I believe that people want a life full of joy, challenge and deep connection with their loved ones and larger community. Unfortunately, many of us desire those qualities of life-but have trouble accessing them in the moment. I am here to encourage you to explore your joy, challenge areas where you struggle to connect and create a path to a life that is full of resonance and enthusiasm. If your goal is to address issues related to society and culture or have someone who deeply understands alternative lifestyles, those are my favorite types of clients. You can rely on my approach to be practical, candid and relatable.
Updated:10/2/25 I believe that people want a life full of joy, challenge and deep connection with their loved ones and larger community. Unfortunately, many of us desire those qualities of life-but have trouble accessing them in the moment. I am here to encourage you to explore your joy, challenge areas where you struggle to connect and create a path to a life that is full of resonance and enthusiasm. If your goal is to address issues related to society and culture or have someone who deeply understands alternative lifestyles, those are my favorite types of clients. You can rely on my approach to be practical, candid and relatable.
(818) 639-8939 View (818) 639-8939
Photo of Stacey Jackson-Roberts, Clinical Social Work/Therapist, MSW, LCSW
Stacey Jackson-Roberts
Clinical Social Work/Therapist, MSW, LCSW
San Diego, CA 92108
This includes queer and trans individuals, parents and partners of LGBTQ+ individuals, practitioners of ethical non-monogamy, and those involved in kink.
I offer therapy to individuals exploring various aspects of gender (transgender, cisgender, and gender diverse) and sexuality (LGBTQ+, ENM/Poly) as well as general mental health. My goal is to create a supportive environment where we can tackle challenges related to sexuality, relationships, personal growth, and overall mental health. Together, we’ll engage in empathetic, nonjudgmental conversations to identify areas for growth and celebrate your achievements. I’ll customize our sessions using diverse therapeutic techniques to meet your unique needs, values, and goals, helping you define your journey in life and relationships.
This includes queer and trans individuals, parents and partners of LGBTQ+ individuals, practitioners of ethical non-monogamy, and those involved in kink.
I offer therapy to individuals exploring various aspects of gender (transgender, cisgender, and gender diverse) and sexuality (LGBTQ+, ENM/Poly) as well as general mental health. My goal is to create a supportive environment where we can tackle challenges related to sexuality, relationships, personal growth, and overall mental health. Together, we’ll engage in empathetic, nonjudgmental conversations to identify areas for growth and celebrate your achievements. I’ll customize our sessions using diverse therapeutic techniques to meet your unique needs, values, and goals, helping you define your journey in life and relationships.
(323) 417-5441 View (323) 417-5441
Photo of Bart Golub, Associate Clinical Social Worker, ASW
Bart Golub
Associate Clinical Social Worker, ASW
1 Endorsed
Serves Area
Do you ever feel trapped by societal expectations about how relationships "should" work, whether that's pressure to find "the one," get married, have kids, or maintain relationships that feel restrictive? Experience anxiety around disclosure—constantly calculating what parts of yourself are safe to reveal in different contexts? Have a pattern of people-pleasing or code-switching that leaves you exhausted and unsure of your own desires? Question your sexuality, relationship orientation, or other aspects of identity but fear the consequences of exploration? Feel isolated, unseen, or misunderstood despite having social connections?
Do you ever feel trapped by societal expectations about how relationships "should" work, whether that's pressure to find "the one," get married, have kids, or maintain relationships that feel restrictive? Experience anxiety around disclosure—constantly calculating what parts of yourself are safe to reveal in different contexts? Have a pattern of people-pleasing or code-switching that leaves you exhausted and unsure of your own desires? Question your sexuality, relationship orientation, or other aspects of identity but fear the consequences of exploration? Feel isolated, unseen, or misunderstood despite having social connections?
(415) 475-3558 View (415) 475-3558
Photo of Stephanie Trecha, Clinical Social Work/Therapist, LCSW
Stephanie Trecha
Clinical Social Work/Therapist, LCSW
1 Endorsed
Serves Area
I'm ENM, Poly, LS/BDSM/ Kink aligned.
Are you longing for a deeper sense of self and struggling to identify or voice your own needs? Falling back into old patterns of thinking and behaving that derail your relationships, your life goals, or trigger diminished feelings of self-worth? Are you struggling to connect intimately with your partner and can't find the words to talk it about it without shame, blame or conflict? Do you struggle to feel connected to people in your life, feel isolated, or overly anxious? Has trauma or past experiences been the building blocks of unhelpful core beliefs you wish to change? You're not alone, let's talk!
I'm ENM, Poly, LS/BDSM/ Kink aligned.
Are you longing for a deeper sense of self and struggling to identify or voice your own needs? Falling back into old patterns of thinking and behaving that derail your relationships, your life goals, or trigger diminished feelings of self-worth? Are you struggling to connect intimately with your partner and can't find the words to talk it about it without shame, blame or conflict? Do you struggle to feel connected to people in your life, feel isolated, or overly anxious? Has trauma or past experiences been the building blocks of unhelpful core beliefs you wish to change? You're not alone, let's talk!
(442) 313-2556 View (442) 313-2556
Photo of Danielle Nelson, Clinical Social Work/Therapist, MSW, LCSW
Danielle Nelson
Clinical Social Work/Therapist, MSW, LCSW
1 Endorsed
Online Only
You're not going crazy- you're doing the best you can under crazy circumstances. I offer compassionate, open-minded therapy in Louisiana and California. My focus is to understand things from your perspective and work with you as a team to identify and meet your goals for growth. I know from personal experience that finding a therapist can be overwhelming- especially when you need one. The good news: just being here means you're on the right track. To get you started, I offer a free 15 minute phone consultation, so reach out. Even if we aren't the right fit, I'll try to refer you to someone who might be.
You're not going crazy- you're doing the best you can under crazy circumstances. I offer compassionate, open-minded therapy in Louisiana and California. My focus is to understand things from your perspective and work with you as a team to identify and meet your goals for growth. I know from personal experience that finding a therapist can be overwhelming- especially when you need one. The good news: just being here means you're on the right track. To get you started, I offer a free 15 minute phone consultation, so reach out. Even if we aren't the right fit, I'll try to refer you to someone who might be.
(619) 825-2414 View (619) 825-2414
Photo of Lauren Bountiful - Bountiful Wellness, Marriage & Family Therapist, LMFT
Bountiful Wellness
Marriage & Family Therapist, LMFT
1 Endorsed
Serves Area
We offer telehealth therapy for queer and gender-diverse, kinky, nonmonogamous, and neurodiverse folks across California. While these aren’t the only topics we explore, they are areas where we bring deep, lived-experience expertise. That means you don’t have to explain your identity, define your terms, or worry about judgment. We’re here to see you as you are, support you in reaching your goals, and celebrate every step along the way.
We offer telehealth therapy for queer and gender-diverse, kinky, nonmonogamous, and neurodiverse folks across California. While these aren’t the only topics we explore, they are areas where we bring deep, lived-experience expertise. That means you don’t have to explain your identity, define your terms, or worry about judgment. We’re here to see you as you are, support you in reaching your goals, and celebrate every step along the way.
(805) 926-6950 View (805) 926-6950
Photo of Jonathan D Raymondi, Clinical Social Work/Therapist
Jonathan D Raymondi
Clinical Social Work/Therapist
Online Only
Do you value self-authenticity, self-improvement, and helping others but feel stuck and struggle at times with being overly critical with yourself, self-limiting beliefs, burnout, or seeking a higher connection with a community (friends, social groups, colleagues)? Maybe your seeking more purpose, value-aligned work or friendships?
Do you value self-authenticity, self-improvement, and helping others but feel stuck and struggle at times with being overly critical with yourself, self-limiting beliefs, burnout, or seeking a higher connection with a community (friends, social groups, colleagues)? Maybe your seeking more purpose, value-aligned work or friendships?
(619) 651-9699 View (619) 651-9699
Photo of Heidi Beckenbach McGann - Heidi McGann Intuitive Healing Services, Counselor, MA, LPCC
Heidi McGann Intuitive Healing Services
Counselor, MA, LPCC
1 Endorsed
San Diego, CA 92108
Hi, I'm Heidi. I believe in approaching healing from an integrative and holistic lens (mental, emotional, physical, energetic, and spiritual). I am a Licensed Professional Clinical Counselor, a certified Hypnotherapist, a Goal Success Life Coach and a Master Practitioner of Energy Medicine. I utilize a person centered approach and I have training in hypnotherapy, energy psychology, mindfulness, somatic therapy and Rapid Resolution Therapy. I integrate techniques and tools that allow for deeper level processing and shifting in order to clear old wounds and traumas that are holding clients back from living the lives they want.
Hi, I'm Heidi. I believe in approaching healing from an integrative and holistic lens (mental, emotional, physical, energetic, and spiritual). I am a Licensed Professional Clinical Counselor, a certified Hypnotherapist, a Goal Success Life Coach and a Master Practitioner of Energy Medicine. I utilize a person centered approach and I have training in hypnotherapy, energy psychology, mindfulness, somatic therapy and Rapid Resolution Therapy. I integrate techniques and tools that allow for deeper level processing and shifting in order to clear old wounds and traumas that are holding clients back from living the lives they want.
(619) 695-1712 x101 View (619) 695-1712 x101

See more therapy options for Coronado

Sex-Positive, Kink Allied Therapists

Why might an individual want to see a sex-positive, kink-allied therapist?

A sex-positive or kinky individual may want to see a sex-positive, kink-allied therapist because the client may feel safer and more supported discussing their experiences and challenges. A therapist who identifies as kink-friendly will have experience with clients having diverse sexual preferences and will likely be nonjudgmental and supportive about issues brought to the table. It is important to note that sex-positive, kink-allied individuals may find equal success with therapists who do not have such specialized knowledge and background. The most important factor in the success of therapy is for the client and practitioner to form a strong, trusting bond.

Do therapists have special training to gain expertise in sex-positive, kink-allied treatment?

Generally, no. There are limited training programs and unofficial accreditations that therapists can pursue, but a therapist’s expertise will ultimately come from their previous experience with similar clients, their engagement with organizations that promote sex positivity or kink-allied lifestyles, and the importance they place on safety and cultural sensitivity.

How can individuals recognize a good sex-positive, kink-allied therapist?

An experienced therapist is able to help clients explore their sexual identity and expression and relieve any discomfort or stigma attached to discussing such matters and the client’s overall challenges. A therapist who is sex-positive and kink-allied is able to create an environment that honors a client’s experience and sexual preferences. To recognize a good therapist, clients can simply ask directly about topics and issues important to them and gauge their comfort level and connection with a clinician based on the responses.

Can clients benefit from having a therapist with a focus on sex positivity and alternative sexual lifestyles?

Some individuals may feel most comfortable knowing that the clinician they’re working with has a commitment to creating an atmosphere of sex positivity and has experience with relationship diversity and alternative relationship structures. Working with a sex-positive, kink-allied therapist may help clients respect their own challenges and improve identity-affirming treatment.