Exposure Therapy with a First-Generation, Latino Transgender Man: A Dialectical Behavior and Feminist Therapy Framework

Abstract Transgender and Gender Expansive (TGE) individuals with multiple marginalized identities are at increased risk of minority stress and trauma because of intersecting systems of oppression, such as transphobia and racism. There is limited evidence-based guidance for TGE individuals experiencing trauma, especially TGE individuals of color. This case study describes the implementation of Prolonged Exposure and informal emotion exposure with a first-generation Latino transgender man using a Feminist Therapy and Dialectical Behavior Therapy lens. Seven clinical considerations drawing from the integration of these approaches are discussed, including recognition of the sociocultural context in shaping the client’s behaviors, balancing flexibility and accountability, and balancing exposure with validation of avoidance.