To support gender diversity in clinical practice, psychotherapists need to provide culturally competent, developmentally appropriate and trans-affirmative care with trans and gender nonconforming people. This article explores the trans body, the trans identity, and the issues that arise in psychotherapy. It examines psychological wellbeing within the trans population and offers a rationale for body psychotherapy approaches to these issues, before exploring the politicisation of the trans body in our culture and the ethical issues that surround trans youth. The increased political focus on the topic has bought about legislation affecting trans rights. Psychotherapists need to be at the forefront of engagement with these changes and their implications for this population. To achieve this, this paper concludes that therapists today must build political and personal selfawareness, taking care to examine their biases and avoid perpetuating unethical, harmful or limited perceptions of gender in the psychotherapy encounter. K E Y W O R D Sgender identity, relational, trans