Table of Contents

To be truly comprehensive ACT For Gender Identity is divided into six key sections.

Gender Affirmative ACT covers the foundational knowledged required for mental health therapists wanting to implement Acceptance and Commitment Therapy with diverse, multicultural gender minorities. This includes understanding the principles of ACT, how relational frame theory shapes how people think about gender, how sexuality, gender, race, ethnicity, ability, and spirituality intersect, and how clinicians can check their own personal bias.

Awareness explores how gender becomes a difficult sticking point for a lot of people, and how to mindfully defuse from reasons, judgements, and roles a persons gender identity may get trapped in. Awareness also troubleshoots how to practice sensory mindfulness techniques with people struggling with gender dysphoria, body dysmorphia, or depersonalization from minority stress.

Acceptance introduces the heart of Acceptance and Commitment Therapy, demonstrating how to accept not only gender, but all the corresponding emotions therein. Tackling emotional avoidance as well as fear and denial, the subsequent chapters address how parents can accept gender explorative children, how teenagers can build their self worth, and how adults can rediscover a sense of personal pride.

Mapping value congruent action with the ACT Matrix, Actualization explores the power of personal disclosure and gender expression, including everything from fashion, body language, and voice training to hormone therapy and gender confirmation surgery.

In Adaptation, the complex mental health issues facing gender variant individuals are re-examined as maladaptive coping mechanisms trying to resolve an unmet need. By identifying what’s most important, Adaptation shows how to apply evidence based ACT techniques when addictive behavior, body dysmorphia, anxiety and trauma, depression, or suicidal ideation intersect with gender based issues.

Filling the blank in so many lifespan and development classes, Affirmation explores how to continue self acceptance and personal affirmation as social roles change, romantic relationships develop, and within both the Family of Origin and Family of Choice. Subsequent chapters also address how to navigate transphobia and systematic oppression in both the workplace and in medical settings, as well as how therapists can validate the legacy of gender variant seniors.

Intro: Storm Cloud Butterflies

Gender Affirmative ACT:

  • Gender and Relational Frame Theory
  • Gender and Functional Contextualism
  • Translating Gender: Sex, Gender Identity & Gender Expression
  • Translating Sexuality: Transitional, Fluid, Dynamic & Asexuality
  • Translating Intersectionality
  • Racial Discrimination & Empowerment
  • Ethnocultural Gender Legitimacy, Mimicry & Otherness
  • Differently-Abled Visibility
  • Spiritual Rejection & Incorporation

The Mindful Clinician

Safe Space, Rapport Building & Introducing ACT


Gender Fusion & The Agenda of Emotional Control

  • Fusing With Rules, Reasons, Judgements, Roles
  • Defusion Exercise: Internal Volume & Proximity
  • Defusion Exercise: I’m Having the Thought
  • Defusion Exercise: Personify the Distress                                      

Mindfulness & The Observational Self

  • Mindful Dissonance
  • Mindfulness Exercise: Interpretation
  • Mindfulness Exercise:  Antonym & Alternative
  • Mindful Resonance
  • Mindfulness Exercise: A Day In the Life
  • Mindfulness Exercise: Daydream
  • Somatic Mindfulness
  • Mindfulness Exercise: Sensory Awareness
  • Mindfulness Exercise: Contextual Body Language
  • Emotional Mindfulness
  • Mindfulness Exercise: Painting Rainbows
  • Mindfulness Exercise: Yes, and…
  • Mindfulness Exercise: Pizza Words
  • Social Mindfulness
  • Mindfulness Exercise: Social Belief Inventory
  • Mindfulness Exercise: Trans Gazing


Presenting Creative Hopelessness

Presenting Emotional Acceptance

  • Accepting Dysphoria: Schrödinger’s Gender
  • Mindfulness Exercise: Instability or Fluidity
  • Mindfulness Exercise: Where’s Your Charge?
  • Accepting Gender: Defusing Fear & Denial
  • Accepting Kids: Mindful Parenthood
  • Accepting Teens: Building Playful Resilience
  • Accepting Adults: Defusing Cissexism & Inadequacy


  • Identifying Values & Defusing Gender Roles
  • Value Exercise: I should, If Only…
  • Value Exercise: Colorful Circles
  • Value Congruent Action & the ACT Matrix
  • Value Integration
  • Value Congruent Disclosure
  • Value Congruent Expression
  • Value Congruent Self-Actualization


  • Old Stories & New Resources: ACT for Risk Taking Behavior
  • Befriending Bodies: ACT for Body Dysmorphia
  • Driving Dazed: ACT for Dissociation
  • Hedgehogs & Butterflies: ACT for Anxiety & Trauma
  • Elephants & Velvet Cages: ACT for Depression
  • Building Bridges: ACT for Suicidal Ideation


  • Rolling Dice: Defusing Social Roles
  • Spiral In, Spiral Out: Lovers, Partners & Abusers
  • The Affection Effect: Defusing Relationship Norms
  • Family Fusion: Family of Origin & Choice
  • Occupational Chess: Gender, Academia, & the Workplace
  • Health, Stealth & Hospitals: Gender Affirmative Medicine
  • Legacy & Life: ACT for Gender Variant Seniors

Epilogue: Of Moths & Meaning

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