For the therapist who chooses to specialize in transgender issues, the learning processes is never ending because social change continues to happen within the world of transgender and in the larger society. Each of these realms impacts the other, resulting in changes on both sides. When I fi rst began writing this book, the term transgenderism was considered acceptable. Now, the reader will note that this term has been eliminated from the pages of this book. Th is is because so many transgender people now consider this term, specifi cally the ism, to be pathologizing, so, out of respect, I have changed it.