13
Ruby Cramer and Sarah Stillwell |SINCERE: A Relational Safety Model for Counselors
focused research and treatment information available
to professionals working with IPV survivors, several
studies provide a foundational understanding of the
disparities between cis-IPV survivors and T-IPV
survivors. T-IPV survivors encounter distinct obstacles
and forms of abuse, manipulation, and coercion, and
require unique treatment planning considerations.
To support counselors in serving this population, the
proposed seven-factor SINCERE relational model
is fundamental for conducting ethically sound and
competent therapy. Future research and community
services must adopt trauma-informed counseling
models to be effective for TGD individuals, ensuring
a sense of safety during their healing process. The
SINCERE model represents a trauma-informed
counseling approach crucial for mental health
professionals seeking to effect meaningful change for
this vulnerable and underserved group.
Limitations
While the SINCERE model offers a flexible, trauma-
informed framework for counselors working with
TGD survivors of IPV, several limitations must be
acknowledged. First, the model is conceptual and
not yet empirically validated. Although grounded in
existing literature and clinical best practices, further
research is needed to assess its efficacy across diverse
clinical settings and populations. Future studies
should explore how each component of the SINCERE
framework impacts therapeutic outcomes, client
engagement, and counselor competency when applied
in real-world contexts.
Second, the current paper draws primarily from U.S.-
based research and sociopolitical contexts, which may
limit its applicability in international or culturally
distinct settings. Experiences of T-IPV and access to
affirming care vary widely across regions, and the model
may require adaptation to reflect local legal frameworks,
cultural norms, and resource availability. Additionally,
while the paper highlights intersectional factors such as
race, disability, and socioeconomic status, the literature
base itself remains disproportionately focused on
White, binary-identified TGD individuals. This limits
the generalizability of findings and underscores the
need for more inclusive, representative research that
centers trans women of color, nonbinary individuals,
and those with multiple marginalized identities (de
Vries, 2014).
Finally, the SINCERE model is designed for use by
mental health professionals, and its implementation
may be constrained by systemic barriers such as lack of
training, institutional transmisia, and limited access to
gender-affirming services. Without broader structural
change and investment in counselor education, the
model’s potential impact may be diminished. These
limitations point to the importance of ongoing advocacy,
interdisciplinary collaboration, and empirical inquiry
to refine and expand the framework’s reach.
Future Direction of Research
As the SINCERE model advances a relational safety
framework for counseling TGD survivors of IPV,
future research must prioritize empirical validation,
intersectional expansion, and systemic integration.
First, there is a critical need for outcome-based studies
that examine the effectiveness of each SINCERE
component in clinical settings. Research should explore
how relational safety impacts therapeutic alliance,
symptom reduction, and survivor empowerment,
particularly in comparison to traditional trauma-
informed models that may not fully account for
identity-based abuse or systemic transmisia.
Second, future studies must address the persistent
underrepresentation of multiply marginalized TGD
populations—including trans women of color, disabled
TGD individuals, sex workers, and those living in rural
or low-resource settings. Expanding research samples to
reflect these communities will allow for a more nuanced
understanding of IPV dynamics, barriers to care, and
culturally responsive interventions. Additionally,
longitudinal research is needed to examine the long-
term mental health outcomes of TGD IPV survivors,
especially in relation to institutional betrayal, identity
abuse, and access to affirming care.
Finally, research should investigate how mental health
professionals implement and adapt relational safety
frameworks within diverse systems of care. This
includes examining counselor training, supervision
models, and organizational policies that either support
or hinder trauma-informed, identity-affirming practice.
By bridging theory, practice, and policy, future research
can help refine the SINCERE model and contribute to
Ruby Cramer and Sarah Stillwell |SINCERE: A Relational Safety Model for Counselors
focused research and treatment information available
to professionals working with IPV survivors, several
studies provide a foundational understanding of the
disparities between cis-IPV survivors and T-IPV
survivors. T-IPV survivors encounter distinct obstacles
and forms of abuse, manipulation, and coercion, and
require unique treatment planning considerations.
To support counselors in serving this population, the
proposed seven-factor SINCERE relational model
is fundamental for conducting ethically sound and
competent therapy. Future research and community
services must adopt trauma-informed counseling
models to be effective for TGD individuals, ensuring
a sense of safety during their healing process. The
SINCERE model represents a trauma-informed
counseling approach crucial for mental health
professionals seeking to effect meaningful change for
this vulnerable and underserved group.
Limitations
While the SINCERE model offers a flexible, trauma-
informed framework for counselors working with
TGD survivors of IPV, several limitations must be
acknowledged. First, the model is conceptual and
not yet empirically validated. Although grounded in
existing literature and clinical best practices, further
research is needed to assess its efficacy across diverse
clinical settings and populations. Future studies
should explore how each component of the SINCERE
framework impacts therapeutic outcomes, client
engagement, and counselor competency when applied
in real-world contexts.
Second, the current paper draws primarily from U.S.-
based research and sociopolitical contexts, which may
limit its applicability in international or culturally
distinct settings. Experiences of T-IPV and access to
affirming care vary widely across regions, and the model
may require adaptation to reflect local legal frameworks,
cultural norms, and resource availability. Additionally,
while the paper highlights intersectional factors such as
race, disability, and socioeconomic status, the literature
base itself remains disproportionately focused on
White, binary-identified TGD individuals. This limits
the generalizability of findings and underscores the
need for more inclusive, representative research that
centers trans women of color, nonbinary individuals,
and those with multiple marginalized identities (de
Vries, 2014).
Finally, the SINCERE model is designed for use by
mental health professionals, and its implementation
may be constrained by systemic barriers such as lack of
training, institutional transmisia, and limited access to
gender-affirming services. Without broader structural
change and investment in counselor education, the
model’s potential impact may be diminished. These
limitations point to the importance of ongoing advocacy,
interdisciplinary collaboration, and empirical inquiry
to refine and expand the framework’s reach.
Future Direction of Research
As the SINCERE model advances a relational safety
framework for counseling TGD survivors of IPV,
future research must prioritize empirical validation,
intersectional expansion, and systemic integration.
First, there is a critical need for outcome-based studies
that examine the effectiveness of each SINCERE
component in clinical settings. Research should explore
how relational safety impacts therapeutic alliance,
symptom reduction, and survivor empowerment,
particularly in comparison to traditional trauma-
informed models that may not fully account for
identity-based abuse or systemic transmisia.
Second, future studies must address the persistent
underrepresentation of multiply marginalized TGD
populations—including trans women of color, disabled
TGD individuals, sex workers, and those living in rural
or low-resource settings. Expanding research samples to
reflect these communities will allow for a more nuanced
understanding of IPV dynamics, barriers to care, and
culturally responsive interventions. Additionally,
longitudinal research is needed to examine the long-
term mental health outcomes of TGD IPV survivors,
especially in relation to institutional betrayal, identity
abuse, and access to affirming care.
Finally, research should investigate how mental health
professionals implement and adapt relational safety
frameworks within diverse systems of care. This
includes examining counselor training, supervision
models, and organizational policies that either support
or hinder trauma-informed, identity-affirming practice.
By bridging theory, practice, and policy, future research
can help refine the SINCERE model and contribute to
