Treatment at Muir Wood is built around evidence-based modalities adapted to the developmental needs of adolescents. For teens with gender dysphoria as part of their picture, the clinical work is focused on the mental health conditions that have brought them to a higher level of care — not on the dysphoria itself, and not on changing the teen’s identity. Our role is to support the teen’s mental health while supporting the developmental process of identity formation in whatever direction that process unfolds.
Trauma-Informed Mental Health Care
Most transgender and gender-diverse teens who come to Muir Wood have experienced some form of adversity related to their gender or to other aspects of their lives. Bullying, family conflict, peer rejection, and harassment are common; sometimes, there is more acute trauma in the picture as well. Our trauma-informed approach treats these experiences as central to the clinical picture, not peripheral. We understand that protective behaviors — withdrawal, anger, shutdown, defiance — often make sense as responses to what the teen has been through, and we work with rather than against those responses as treatment progresses.
Individual Therapy
Each teen receives at least two individual sessions per week, led by our team of therapists and recovery counselors. The therapeutic relationship is the foundation of treatment — a space where teens can speak freely about what they’re feeling, including the parts of their experience they may not yet feel safe sharing in group or family sessions. For teens with gender dysphoria, individual therapy is often the place where the most personal material is processed: the body, the dysphoric distress itself, family dynamics, fears about the future, the experience of being misgendered or rejected. Our therapists are trained to hold this material with respect and clinical skill.
Psychiatric Evaluation and Medication Management
Some teens benefit from psychiatric medication as part of their mental health treatment — particularly for depression, anxiety, mood dysregulation, or other co-occurring conditions. At Muir Wood, our psychiatric team follows a non-ideological, least-necessary approach: medication is used only when clinically indicated, always in combination with therapy, and always in close collaboration with families. Medication decisions are individualized and parents are full partners in those decisions.
Important scope note: Muir Wood’s psychiatric care is focused on co-occurring mental health conditions. We do not prescribe puberty blockers, hormone therapy, or any gender-affirming medications. For teens whose families are working with outside providers on those medical aspects of care, we coordinate as part of the broader treatment picture.
Group Therapy for Connection and Peer Support
Group therapy at Muir Wood gives teens an experience that individual sessions cannot — the recognition that other teens are working through similar challenges. For transgender and gender-diverse teens, group can be a particularly powerful space, both because shared experience reduces isolation and because the practice of being in community with peers is itself therapeutic. Our groups are led by experienced adolescent clinicians who set norms of mutual respect and protect the safety required for honest clinical work.
Family Therapy and Parent Support
Family therapy is conducted weekly by your teen’s primary therapist. For families navigating a teen’s gender identity alongside mental health challenges, the family work often involves both emotional and practical territory — working through grief, fear, and unfamiliarity that parents may be experiencing; helping the whole family system find ways to communicate and support each other; and building patterns at home that will support the teen’s mental health going forward. We view a teen’s individual development, identity and otherwise, as occurring within the context of the family’s relationships. To that end, our focus is on engaging our clients and their families in a collective process that aims to shape and strengthen collaborative, supportive, aligned, and loving relationships.
This work is not about assigning blame, and it is not about changing anyone’s mind — the teen’s or the parents’. It’s about helping families find their footing during a stretch of life that has been hard on everyone. Parents who come to family therapy uncertain, conflicted, or actively struggling are welcomed without judgment. Twice-weekly parent education classes and a weekly parent support group offer additional spaces for parents to learn, connect with peers, and process their own experience.
