Presenting Issues in Relational, Couple, Marriage, and Family Therapies Among Transgender and Non-Binary Adults in Canada

Abstract

Transgender and non-binary (TNB) adults frequently experience mental health, relational, and systemic challenges; however, little is known about how these concerns become presenting issues within relational, couple, marriage, and family therapy (RCMFT) contexts. This interpretative phenomenological analysis (IPA) explored how TNB adults in Canada experienced and made meaning of the issues they brought into systemic therapy services. Twelve TNB adults participated in semi-structured Zoom interviews. Five interconnected domains of presenting issues were identified: (1) Personal issues in relational contexts (e.g. trauma); (2) Couple or marriage relationship issues (e.g. relational insecurity); (3) Family-related concerns (e.g. rejection); (4) Community-based challenges (e.g. discrimination); and (5) Issues triggered within therapy (e.g. distress associated with therapist assumptions). Findings highlight how participants described their presenting issues as embedded within relational, community, and therapeutic contexts rather than solely as individual concerns, offering implications for culturally responsive clinical practice, therapist training, supervision, and service delivery with TNB communities.