‘I’m a Gender and Sex Therapist, and This Is How I Help People Transition With Agency and Authenticity’

When sex therapist Rae McDaniel, LCPC, CST, ramped up their work with queer, trans, and non-binary folks around 2015, they were struck by the negative narrative shrouding gender transition—a feeling that was only underscored by their personal experience coming out as non-binary in 2017. “The overarching idea was that transition was this terrible process, and there was so much self-doubt, anxiety, and rejection built into the core of it,” says McDaniel. So, they set out to flip the script on that narrative by spreading the message that gender transition can be an inherently positive experience.

Experts In This Article
  • Rae McDaniel, LCPC, CST, a certified sex therapist and the founder and CEO of Practical Audacity, a mental health practice specializing in gender and sex therapy.

To do so, McDaniel developed the methodology behind Practical Audacity, a private therapy practice in Chicago, and GenderFck, an online group-coaching platform. “I help trans and nonbinary folks transition with more ease, joy, curiosity, and pleasure,” McDaniel said at a recent Well+Good TALK centered around the role that the wellness industry can (and should) play in the fight for LGBTQ+ rights.

They believe that by reframing the gender narrative—so it’s not a restrictive barrier that needs to be pushed back against, but a concept from which we can all be liberated—gender transition becomes more of an opportunity than a challenge. “We’ve all been stuffed into these tiny boxes since before we were born, and we’ve lived in the thick of this gendered world so much so that it can create freedom for everybody if we can just put that down and question if that is really the most helpful frame,” McDaniel said during the TALK.

Watch the full conversation with Bethany C. Meyers, Erica Chidi, and Rae McDaniel, moderated by Well+Good co-founder Melisse Gelula:

To create a gender therapy practice rooted in positivity, McDaniel drew from research in resilience, identity development, mindfulness, and more. The result was their unique Gender Freedom Model, which works to reduce self-doubt at every turn of the transition journey—with the operative word being "journey," because transitioning is precisely that. “It’s a process of self-growth that happens slowly with time, instead of being somewhere that you arrive and then stop,” says McDaniel. “If we view gender identity and transition through that lens, then it’s just a way to become more of who you are over your lifetime, which takes the pressure off.”


"Gender transition is a process of self-growth that happens slowly with time, instead of being somewhere that you arrive and then stop." —Rae McDaniel, LCPC, CST

That said, McDaniel acknowledges the many systemic and interpersonal barriers that contribute to the difficulty and suffering surrounding gender transition (particularly as someone who’s personally undergone top surgery). “I never want to minimize that,” they say. “But what I want to ask is, 'Are there ways that we can acknowledge and accept those barriers being put up and still take hold of agency? How can we use our curiosity to find agency even in an unfair environment?'”

To help clients do that, the Practical Audacity process centers around a few key tenets for moving through gender transition as a means to an end—namely, “being the most lit-up, authentic version of yourself in the world,” McDaniel says. “When people are able to do that, they show up more fully alive and awake, and with more presence and intention.” Below, McDaniel walks us through several of those pillars.

1. You can explore your identity through curiosity and experimentation

Considering how kids and teens naturally develop identity, McDaniel approaches the process with something called “spaghetti-wall mode.” When you’re cooking spaghetti, you can throw it at the wall and see if it sticks—and if it does, it’s ready to go, but if it doesn’t, that doesn’t mean you failed at cooking spaghetti, but rather that you just need to cook it a little longer. “Instead of having to decide, ‘This is the person I’m going to be forever until I die,’ consider redefining identity through a series of experiments,” McDaniel says. In other words, you don’t have to make a permanent decision now (or ever) about how you show up in the world with regard to your gender identity.

With this in mind, McDaniel advocates for taking small, mindful steps: “Every time you take a step forward, you can stop and say, ‘Does this feel good? Does it feel affirming to me?’ If yes, take the next step, but if not, go back to the drawing board.”

2. You deserve pleasure, no matter what type of body you have

Feeling uncomfortable or disconnected from your physicality is a common and natural part of the gender-transition process. “Rather than pushing you to love every single part of your body—because it’s very possible and okay that you don’t—I focus more on how you can experience pleasure in the body that you have now, using your five senses,” says McDaniel, referencing the mindfulness practices they incorporate into their therapy.

For example, they suggest sitting down, drinking a cup of tea, and processing how it smells and tastes, or taking a bath, touching your skin, and acknowledging the warmth of the water. Then you can build on those sensual skills to bring the experience to a more sexual place.

“Rather than pushing you to love every single part of your body—because it’s very possible and okay that you don’t—I focus more on how you can experience pleasure in the body that you have now, using your five senses.” —McDaniel

Of course, that’ll be difficult if you’re experiencing pain with sex or as the result of surgery, in which case McDaniel recommends visiting a pelvic-floor specialist: These medical professionals can help alleviate pain from scar tissue or even from repeated tightening of the pelvic-floor muscles, perhaps from a lifetime of experiencing discomfort in your body, McDaniel says.

It’s also helpful to expand the definition of sex to include not just pleasure from genitals and not just partnered intercourse, either—a process that McDaniel calls queering up sex. Perhaps you bring in sex toys or adaptive devices like strap-ons in order to have the kind of sex you want to have, regardless of biology. Or, maybe you incorporate other erogenous zones or even other parts of the body beyond the spots typically stimulated during intercourse. “The skin is, after all, your body’s biggest sex organ, and it’s full of nerve endings,” McDaniel says.

3. You are the agent of your own gender transition

Because of the societal forces that create real and perceived limitations to gender expression, it can be easy to fall into the trap of learned helplessness, or giving up on finding a solution even when one exists within your reach, says McDaniel, adding that it’s essential to reframe the gender-transition experience to consider what elements of it are firmly within your control. “For example, we know that not everybody has the ability to present their gender or be out in all the areas of their life. Reframing authenticity doesn’t have to mean always being out, but instead choosing how you want to present yourself in line with what keeps you safe and feels the most affirming for you holistically,” McDaniel says.

That means, if you aren't out at work or in a cultural or religious institution, you might consider ways to affirm your gender identity that read as neutral to the general public—like, for example, wearing the kind of jeans or the type of underwear that feels right to you, McDaniel says.

Beyond the physical piece, they suggest affirming identity by way of your presence: “For example, to a trans-woman, does being feminine mean that they want to show up with a nourishing energy? Or, does it mean they want to be fierce at work? How can you inhabit those attitudes and values, no matter if you can be out in that area of your life or not?”

In terms of interpersonal relationships, McDaniel reminds clients that asking people to respect your identity is also an act of agency—and even if it makes someone uncomfortable, this discomfort does not equal harm. “By contrast, what is harmful is you not having your identity respected,” they say. “I tell my clients to act as if you had the pride you aspire to have, and consider what choices you would make if you were that person, what kind of boundaries you’d set, and what you’d ask for from those around you,” McDaniel says. “Sometimes, it’s simply enough to say, ‘I want to feel confident, I want to feel proud of my identity, and I want to live shame-free.’”

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