Transgender and non-binary adults’ recommendations for relational, couple, marriage and family therapy: A Canadian qualitative study

OBJECTIVE: Transgender and non-binary (TNB) individuals experience elevated mental health risks related to minority stress and marginalization. Although relational, couple, marriage and family therapy (RCMFT) services may support TNB clients, limited existing studies have examined how RCMFT interventions may be adapted to meet their needs. The present study explored TNB adults' recommendations for improving therapeutic interventions in RCMFT in Canada. METHODS: Twelve TNB adults across Canada were recruited through snowball sampling and community-based advertising. Semi-structured interviews were conducted via Zoom and analyzed using interpretative phenomenological analysis. RESULTS: Four themes were identified: Therapeutic Skills, Connections, Preferred Interventions and Culturally Attuned Approaches. Participants emphasized the importance of active listening, validation, balanced relational engagement, experiential and relationally attuned interventions and culturally attuned practice in fostering safety, trust and meaningful engagement in therapy. The findings also suggest that commonly valued therapeutic processes may take on particular significance within contexts shaped by minority stress and relational marginalization. CONCLUSION: By centring TNB adults' recommendations, the present study highlights the importance of culturally attuned and relationally responsive approaches in RCMFT with TNB clients. The findings may inform RCMFT training, supervision and clinical practice in Canada.