Gender-affirming care
Gender-Affirming Care and Counseling in Grand Blanc, Michigan
Respectful therapy for transgender, nonbinary and gender-diverse people — including letters of support when clinically appropriate. In person in Grand Blanc or by secure video across Michigan and 14 other states.
You shouldn’t have to explain yourself first
A lot of gender-diverse people arrive at therapy having already done unpaid work: correcting a name, explaining a pronoun, teaching a professional the basics before getting to why they came. That is exhausting, and it is not what the hour is for.
Here you don’t start there. Your name and pronouns are simply used. Your gender isn’t the presenting problem unless you say it is — plenty of trans and nonbinary clients come in about anxiety, grief, work, or a relationship, and want a therapist who won’t make everything about their transition.
I’m Kevin B. Stachowiak, MSW, LMSW. The practice is listed with OutCare Health as an LGBTQ+ competent provider.
The mental health part of gender-affirming care
“Gender-affirming care” covers a lot of ground — hormones, surgery, voice work, therapy. I provide the therapy and, where appropriate, the letters. I don’t prescribe hormones or perform procedures, and I work alongside your medical providers rather than in place of them. If you’re looking for the medical side, I can help you think about where to start.
I write letters of support for gender-affirming medical care when it is clinically appropriate, working collaboratively with you and your medical team.
What that involves in practice: we meet, we talk properly about your history and where you are, and I write an accurate letter. It is an assessment, so I can’t promise the outcome in advance of doing it — any therapist who guarantees a letter before meeting you is not doing an assessment. What I can promise is that the process will be transparent, that you’ll know what I’m considering, and that you won’t be strung along.
Requirements vary by surgeon, clinic and insurer. Bring whatever your provider has told you they need, and we’ll work to it rather than guessing. If you’re at the beginning and don’t know what’s required yet, that’s a fine place to start too.
What people bring in
What this isn’t
This is not therapy aimed at changing who you are. So-called conversion or reparative practice is discredited and harmful, and I don’t provide it under any name.
It is also not a checkpoint you have to pass. Exploring gender does not commit you to a conclusion, and coming to therapy does not mean signing up for a particular path. Some people arrive certain and want practical support. Others arrive unsure and want somewhere to think without being hurried in either direction. Both are legitimate.
If you’d like more on how this actually works, I’ve written about it at more length: gender dysphoria, body dysphoria, and how therapy helps →
Good to know
Gender-affirming therapy: common questions
Do you write letters of support for gender-affirming care?
Yes, when it is clinically appropriate, working collaboratively with you and your medical team. It involves an assessment, so I can't commit to the outcome before meeting you — but the process will be transparent and you won't be left guessing where you stand.
How many sessions does a letter take?
It depends on what your surgeon, clinic or insurer requires and on what we cover together. Bring their requirements to the first conversation and I'll tell you honestly what I think is involved rather than leaving it open-ended.
Do I have to be sure about my gender to come?
No. Uncertainty is a completely legitimate reason to start. Therapy here is not a gate you pass through and it does not commit you to any particular outcome.
Do you work with teenagers?
I work with clients age 12 and up. For younger children I'm glad to point you toward a clinician whose practice is a better fit. Family sessions are available where that would help.
Do you offer this by telehealth?
Yes — secure video across Michigan and 14 other states. For people in parts of the state where affirming providers are thinly spread, that is often the practical route.
You can ask questions before committing to anything
A free 15-minute consultation is a low-pressure way to see whether this feels like the right fit.
Also available
Other ways we can work together
If you’re in crisis: this website isn’t for emergencies. If you or someone you love is in danger or thinking about suicide, call or text 988 (Suicide & Crisis Lifeline) or call 911. The Trevor Project supports LGBTQ+ young people at 1-866-488-7386, and Trans Lifeline is peer-run at 1-877-565-8860. You deserve immediate support.