International Journal of Coercion, Abuse, and Manipulation Volume 9 2026 10
remain trapped because abusers restrict access to
community, healthcare, or financial independence.
For TGD individuals, connecting them to affirming,
accessible supports directly challenges mechanisms
of coercive control, reduces isolation, and enhances
social safety nets. This reinforces the idea that healing
is communal and that survivors are not alone, which
greatly contributes to building relational safety and
social embedment (Bowling et al., 2020 Rogers,
2016 Singh &Moss, 2016). Equipping clients with
appropriate resources not only empowers them to find
community and support services but can also supply
them with new language to navigate experiences of
violence and abuse. IPV frequently causes survivors
to feel socially excluded or isolated therefore, making
it necessary for mental health workers to emphasize
social embedment as much as possible with this
population and assist survivors in identifying and
strengthening community support systems (Beyer et
al., 2022 Bowling et al., 2020). Staying in touch with
community resources is an invaluable step for mental
health counselors to take. A variety of resources can
be found on websites of TGD advocacy organizations,
and often on city, state, and government websites.
The Gay &Lesbian Alliance Against Defamation
(GLAAD) provides a plethora of legal and educational
resources on its website for TGD survivors of violence
(glaad.org). For the purpose of safety planning and
making appropriate referrals, counselors may consider
utilizing PFLAG’s directory of affirmative healthcare
providers and other affirmative resources. Similar
online resources include lgbtqhealthcaredirectory.org,
rainbowhealth.org, translifeline.org, hrc.org, vawnet.
org, and transequality.org.
Staying informed and engaged with local grassroots
initiatives, pro-bono legal services, accessible social
support systems, transitional housing programs,
community fridges, clinics, and affirmative care
providers equips counselors to connect survivors with
essential resources. This engagement also helps prevent
therapists from accidentally making inappropriate
referrals, shelter placements, or treatment suggestions.
To integrate effectively into the community, counselors
can establish meaningful connections with these
resources, build rapport with local organizations,
maintain working relationships with culturally
competent case managers, and volunteer with
community services.
Establishing
Finally, counselors should actively work towards
establishing a discernably safe environment and a
functional therapeutic alliance. Creating a visibly
affirming, accessible, and collaborative therapeutic
space fosters trust, stability, and relational safety.
Survivors are more likely to engage when they
perceive the environment as safe and inclusive.
During the therapy hour, clinicians should exercise
conscientiousness of the optics of their practice. Pride
flags and other similar forms of affirmative symbolic
representation are subtle yet powerful ways to construct
an affirming environment (Marrow et al., 2024).
Similarly, they should consider accessible architecture,
such as gender-neutral bathrooms and interior design
that accounts for clients of varying degrees of physical
mobility.
Clinicians might also consider offering telehealth
options to accommodate clients who face different
types of physical or transportation barriers, or who may
not feel safe going to therapy in person. These different
types of silent broaching set the tone for clients as soon
as they begin their counseling journey and contribute
largely to fostering an identity-affirming, accessible,
and safe environment, as well as a growth-fostering
therapeutic alliance. Broaching, both verbally and non-
verbally, is an ongoing effort that lasts the duration of
a clinician’s practice. Hence, they must consistently
foster an open recognition of both the internal and
external characteristics of ourselves and our clients
(ACA, 2010).
Given the relationally wounding nature of IPV,
establishing an authentic therapeutic alliance is key
in working with survivors. T-IPV often engenders
social isolation, which can be compounded by the fact
that members of the TGD community may already
have limited support from their families of origin and
can often leave T-IPV survivors feeling relationally
unstable, isolated, or unsupported (Beyer et al., 2022
Goode, 2023). From a coercive control perspective, IPV
erodes trust and autonomy in relational connections
(Tolmie, Smith, &Wilson, 2024). Establishing a safe
therapeutic alliance, therefore, directly counters
the effects of coercive control. When working with
TGD survivors, clinicians must create spaces where
identity and authenticity will not be weaponized or

11
Ruby Cramer and Sarah Stillwell |SINCERE: A Relational Safety Model for Counselors
scrutinized, thereby restoring a sense of interpersonal
liberty, mutuality, and relational safety. For this reason,
clinicians must establish themselves as a consistent,
unwavering presence of non-judgmental support and a
source of unconditional positive regard. Clinicians are
also advised to consider ways to incorporate community
building, community resilience, and support systems
into safety planning and treatment planning (Scheer
&Poteat, 2021 Bowling et al.,2020 Valentine et al.,
2017).
Recent studies have highlighted key elements of vocal
and nonvocal communication that promote authentic,
affirmative conversations with members of the TGD
community in clinical settings (Coleman et al., 2022
Dolan &Conroy, 2021 Leitch, 2022 von der Warth,
2023). TGD research participants reported that they felt
most validated by providers who implemented active
listening, collaborative treatment methods, presence,
taking time, friendly voice, open body language, use of
gender-neutral language, and use of gender affirming
language. Research has also found that communication
with providers is perceived well by clients if clinicians
espouse values of acceptance and open-mindedness
and display a non-judgmental attitude towards the
complexity of an individual’s situation (Scheer &
Poteat, 2021). Additionally, clinicians working with
this community, as well as any other population,
should exercise a critical awareness and insight into the
ways in which stigmatization, bias, internalized bias,
and any potential power dynamics may manifest in the
therapeutic alliance (ACA, 2010 Ratts et al., 2018).
This is not only critical in maintaining rapport and
preventing harmful social narratives from being reified
within the therapeutic space but is also in itself a form
of advocacy and self-advocacy.
Case Study: Putting SINCERE Into Action
Jordan (they/them) is a black 29-year-old pansexual
freelance graphic designer, who was assigned female
at birth but identifies as nonbinary. Jordan presented
to counseling for anxiety, hypervigilance, difficulty
sleeping, loss of creative motivation, and recent panic
attacks. Jordan recently ended a two-year relationship
with a cisgender man. They report escalating
emotional and psychological abuse, including frequent
misgendering, threats of outing them to family and
clients, and controlling behaviors around their gender
expression and work. Jordan also discloses that their
partner withheld access to their hormone therapy
prescriptions and used their financial dependence as
leverage for sexual coercion.
Jordan has not reported the abuse to law enforcement
due to past negative experiences with police and fears
of being misgendered or disbelieved. They were denied
access to a local domestic violence shelter due to their
nonbinary identity and are currently couch-surfing
with friends. Jordan expressed deep shame, confusion
about whether their experiences “count” as abuse, and
fear of being retraumatized by systems meant to help.
Clinical Application of the SINCERE Model
Signs
The clinician identifies several indicators of T-IPV
in Jordan’s situation, including emotional and
psychological abuse, such as gaslighting, misgendering,
sexual coercion linked to restricted access to gender-
affirming care, financial control resulting in housing
instability, and symptoms like hypervigilance,
disrupted sleep, and self-doubt. Additionally, the
clinician recognizes systemic risk factors that further
impact Jordan’s circumstances, such as their intersecting
identities as a Black, nonbinary person assigned
female at birth, experiences of housing insecurity,
and a history of institutional betrayal. The counselor
taking note of these signs is not only diagnostic but
also a way to validate Jordan’s lived experience, which
builds safety. By naming these signs without judgment,
the clinician communicates attunement and fosters
relational safety, assuring Jordan that their experiences
are real, witnessed, and worthy of care.
Information
The clinician actively seeks to educate themselves
on local and federal protections for transgender
and gender diverse (TGD) survivors, familiarizes
themselves with the WPATH Standards of Care and
SAIGE competencies, and stays informed about local
affirming shelters, legal aid resources, and current
research on T-IPV and coercive control. In addition
to their self-education, the clinician provides Jordan
with psychoeducation regarding T-IPV, validating
Jordan’s experiences and explicitly recognizing
identity abuse as a legitimate form of intimate partner