“Coming out as Fred Is Literally What I Needed to Do”: A Narrative Case Study of One

Transgender and gender expansive (TGE) youth demonstrate additional risk for mental health issues compared to cisgender peers. Treatment options may include a referral to a residential center. TGE youth also experience unique aspects of gender identity development. Literature exists on TGE identity development and issues related to serving TGE youth in residential treatment. However, there is limited research on the intersection of these topics. This narrative case study presents one transman’s gender identity development during residential treatment. Two themes emerged: family support and affirming relationships, and the role of the residential treatment facility. We offer implications for counseling TGE youth.