Th e primary focus of this book is sexual orientation of MTF transgender people. It is intended for the therapist who is still establishing a foundation of experience while working with transgender clients. It might be possible to address this topic without providing context, but the result would not only lack heart, but also probably not be an accurate refl ection of the population we seek to understand. Th erefore, the reader will fi nd digressions related to things such as the process of transition or how to talk with a child about someone who is transgender. But suppose a child asks innocently, “But, who will she marry?” and suddenly, talking with a child about transgender has implications related to sexual orientation. Without some basic understanding, the reader may not know how to answer the child.