Transgender emergence describes an adaptive stage model for transgender men and women who are coming to terms with their own gender variance and moving from an experience of denial and self-hatred to one of self-respect and gender congruence. The process of developing a gender identity is a normative process that everyone experiences, but for gender-variant people the process is complicated by cultural expectations that are dissonant with their core sense of self. These stages are not meant to “label” people or to define transgender maturity. They describe what clinicians may witness when clients seek help for “gender dysphoria.” Many transgender people negotiate these stages without professional assistance.

I. Awareness. In this first stage, gender-variant people are often in great distress; the therapeutic task is the normalization of the experiences involved in emerging transgender.

II. Seeking information - Reaching out. In the second stage, gender-variant people seek to gain education and support about transgenderism; the therapeutic task is to facilitate linkages and encourage outreach.

III. Disclosure to significant others. The third stage involves the disclosure of transgenderism to significant others - spouses, partners, family members, and friends; the therapeutic task involves supporting the transgender person’s integration in the family system.

IV. Exploration - Identity and self-labeling. The fourth stage involves the exploration of various (transgender) identities; the therapeutic task is to support the articulation of and comfort with one’s gendered identity.

V. Exploration - Transition issues/possible body modification. The fifth stage involves exploring options for transition regarding identity, presentation, and body modification; the therapeutic task is the resolution of the decisions and advocacy toward their manifestation.

VI. Integration - Acceptance and post-transition issues. In the sixth stage the gender-variant person is able to integrate and synthesize (transgender) identity; the therapeutic task is to support the person’s adaptation to transition-related issues.