Seeking Current Recommendations for Therapist for Teen

I highly recommend Catherine Metzger at Still Waters Psychotherapy.  She is very intelligent, intuitive, insightful and an expert in adolescents with a specialty in gender dysphoria.  The fact that she has in person openings will not last long - she just started her private practice.  She has been working with my family for over 5 years while she was gathering her clinical hours.  Her website is: https://stillwaterspsychotherapy.com/catherine-metzger%2C-amft

Please go to "therapy first" if gender dysphoria is involved. Or a therapist who knows what exploratory therapy is and will consider it.  A gender clinic in the US tends to follow, especially here in the bay area,  the "affirmation only" model, which affirms rather than trying to understand the gender dysphoria. Affirmation tends to provide medical intervention as requested (see Reuters' Youth in Transition as well), but these interventions have not been shown to be safe, effective or even necessary. No one can show they know what is likely if a young person is given medical intervention or if they aren't. (whether it will help or harm their mental health, gender dysphoria, or quality of life....long term...short term there is a placebo effect, "honeymoon," that has been reported).

The US affirmative model is being discarded by countries which are looking at the evidence behind medical intervention.  There is a great medical article reviewing it by Jennifer Block (Gender dysphoria is rising in young people and so is professional disagreement), peer reviewed, in the British Medical Journal. She also wrote an information packed op ed for the Boston Globe last fall on the "hall of mirrors" aspect of treating gender dysphoria in this country. Pamela Paul also wrote two articles in the NYT last month, which highlighted one of the therapists leading "therapy first."

In particular, a lot of people in the US don't realize that it is unknown for whom gender distress/trans identification will not go away without any medical intervention (social transition seems to make gender distress persist). That is, it can be transient and there is a huge ethical problem in trying to know what to do. This is made worse because the medical interventions also haven't been demonstrated to help (anyone who tells you it will affect suicide risk is misinformed, point them to Ruuska et al., 2024, or the systematic review by Baker et al., 2021). Anyone who doesn't know the expected outcomes are not well determined is not giving informed consent. There's information about gender dysphoria for instance in the Cass Review's interim report, a thorough overview involving systematic reviews of the evidence, and discussions with clinicians, patients, families, stakeholders, etc. 

A lot of US "major medical associations" follow "WPATH", a group which just had a lot of its internal documents put out there for the public, so that you can see how much is (not) understood by this group.  I think Ben Ryan had a really good summary in the NY Sun? The peer reviewed investigative article by Block in BMJ talks about the evidence base (needed to understand risks, benefits, alternatives and what happens if you do nothing) behind different treatment recommendations, including WPATH's. 

Chloe Jhangiani (https://www.psychologytoday.com/us/therapists/chloe-jhangiani-berkeley-ca/865080 ) is an excellent local therapist, is well versed with queer and questioning youth of many backgrounds, and has been in practice for about 15 years. She was a therapist for our middle child for two years and was incredibly helpful to understanding and guiding her through questions of gender and sexuality. Good luck!!

Hello - We had similar issues with our academically gifted, artistic and neurodiverse teen, whose depression and anxiety skyrocketed over the course of remote learning (preceded by a case of sexual assault and some pretty awful bullying). Our kid announced a trans identity literally overnight (with no history of gender incongruence) a year or so into the isolation, accompanied by a deep, deep dive online as required by online school. Though we were (and are!) supportive of our kid and used the new name and pronouns, it felt like exploration rather than a a truly authentic identity. It is these kids jobs to explore identity at this time, and also to individuate. 

The suffering our kid was feeling was very real, whatever its source (and there were so many things that clearly contributed). We had an extremely hard time finding a therapist who would help gently guide our teen through the issues of trauma and not focus solely on the gender dysphoria. What was helpful (also for me as a parent as the class is attended by both the teen and a caregiver), was Dialectical Behavior Therapy. We only did one of the modules, which, rather being individual talk therapy focused instead on recognizing patterns of behaviors and thinking and figuring our helpful ways to shift these. We went to Clearwater Clinic (in both Oakland and Orinda clearwaterclinic.com). It is pricey, but did offer a pathway to become more self aware and help with the constant anxiety and worry. 

It is not anti trans to question an overnight identity shift that is often swiftly accompanied by medicalization with risky and has irreversible consequences, and we are in an era where this is being applied to a young cohort that the CDC itself recognizes is in the middle of a mental health crisis. It is not anti trans to be concerned about the physical, mental, sexual and reproductive health of one's child. There has to be room for thoughtful, nuanced, balanced care. We are being told as parents that our kids are in danger of committing suicide if we even question the medicalization, and current "hide any identity change from the parents" laws are creating a triangulated situation with schools and other institutions and the kids who are told that the parents are the enemies. (While there are inevitably exceptions, in 16 years of experience of shepherding my kid from preschool - high school I have yet to meet a parent who did not love and prioritize their children, and none who would kick them out for being gay or identifying as trans.) 

It is possible to support a trans identity and not support medicalization. It is possible to be trans, and not to immediately medicalize. That medical and surgical gender affirmative care is available is vital (especially for those who have been on the hormones long enough that their bodies no longer produce their birth hormones, so they need the other hormones to function), but the idea that they are absolutely required for every 15 year old who announces overnight that they are trans is absurd. 

The trans community is vulnerable, and needs support, especially in states where the dangerous bans are being enacted. Kids with mental and other health issues are also vulnerable, and caution should be taken before irreversible medical steps. Both are true. It is not anti trans to seek and exercise nuanced care. What does your gut say as a parent? You know your kid. 

I wish you and your teen all the best. It's a tough time, but also can be wonderful.