My Story

how i came to be doing this work

I am a Licensed Marriage and Family Therapist in Oregon. In 2013, I graduated with my Masters in Counseling Psychology from the California Institute of Integral Studies. My pre-licensure clinical internship experiences took place in California and Oregon, and included residential treatment, psychosis, personality disorders, complex trauma, post-hospitalization, foster youth, DHS-involved families, high-risk adolescents, and high-conflict couples.After completing my licensure examination and requirements in 2016, I spent the next four years working at a group practice treating common issues such as anxiety, depression, family conflict, adjustment disorders, breakups, divorce, grief, ADHD, PTSD, and relationship problems. I also ran therapeutic groups ranging from assertive communication skills training to helping healthcare professionals manage vicarious trauma and burnout. I enjoyed working in a clinical setting that gave me exposure to a wide range of people from all walks of life.During this time I saw a number of trans-identified, gender-dysphoric youth and was taught that “gender affirmation” was the best way to help them. However, in the back of my mind, I developed concerns about this approach as I noticed that in almost all cases there were multiple confounding variables, such as complex trauma, eating disorders, signs of autism, family conflict, unaddressed matters of sexuality, and much more. At the same time, I was learning that the steps required to “transition” medically were quite serious, and were being pursued at vulnerable ages with seemingly wild abandon. I began to question if this was truly the best way to help people, and what place a therapist should have in encouraging someone to make decisions with permanent medical consequences.In 2020, I opened my private practice and called it Real Talk Therapy, a play on words meant to reflect the down-to-earth style many of my patients have found refreshing. That same year, I learned about detransitioners. Once I heard their stories — as soon as I learned there were people who had been harmed by therapists who’d taken the affirmation path — I could no longer abide by “affirmation” practices in good conscience. I spent the next year delving into the culture wars and questioning everything I knew.In 2021, I launched my podcast, You Must Be Some Kind of Therapist, which has since grown into a successful weekly long-form interview podcast in the top 1.5% according to ListenNotes. I have interviewed dozens of therapists, medical professionals, writers, detransitioners, ROGD parents, and anyone I see as doing inspiring work or having a fascinating story.That same year, activists stumbled upon my work and launched a campaign to mass-report me to my licensing board. I was accused of “conversion therapy,” and had to face down those charges. I was ultimately successful, and my license remains in good standing. I discussed this at length with Helen Joyce in episode 11 of my podcast.In 2022, I was recruited to participate in the film NO WAY BACK: The Reality of Gender-Affirming Care, and became its Associate Producer, responsible for promoting the film on a variety of podcasts and other platforms. You can find my guest episodes here.In 2023, I was recruited to join the wonderful medical ethics organization Do No Harm as a Senior Fellow.Through my involvement in podcasts, the film, organizations, and other endeavors, I have had the pleasure of networking with many inspiring and courageous individuals.I still enjoy counseling individuals and couples, and continue learning and developing my skills. But given that I have become known for my stance on gender issues, the nature of my one-on-one work has shifted significantly. Now a significant number of my patients are ROGD (Rapid-Onset Gender Dysphoria) parents, detransitioners, and others who have been harmed by gender ideology, such as rape victims who have not been able to access single-sex safe spaces and services.I have also opened a consulting practice, primarily in response to hearing from parents around the country who were desperate to talk to me for help understanding, protecting, and communicating with their trans-identified child. These parents didn’t care about a diagnosis or treatment for themselves. In fact, many had lost respect for counseling and healthcare professionals. They often felt dismissed, gaslit, disempowered, triangulated, and lied to by those who were supposed to help. The fact that there were a handful of people like me speaking out about the issue felt like a life raft. The consulting model offers freedom to step outside the traditional therapist role and offer clients the information, feedback, ideas, and skills coaching they’re looking for.Since I began expanding my offerings, the second most common issue people seem to want to consult with me about has to do with assertive communication and self-expression. Many of my coaching clients are going through a similar process to what I went through in 2020: questioning everything they know and trying to figure out how they can express their concerns to those around them while also reassessing their place in the world. Some of these clients are themselves therapists.Depending on the nature of the relationship, consultation may also resemble mentorship. I believe that the mentor relationship is a lost art worth reviving if we want to build a world in which people invest in bringing out the best in one another.I remain open to various types of inquiries from those who are interested in partnering with me.If you think you might be interested in therapy, consulting, mentorship, podcasting, or another type of collaboration with me, I invite you to schedule a free discovery call. I have also created a “priority scheduling” option for consulting clients who are especially eager to talk to me and for whom finances are not a concern.

Therapy

(for Oregon residents)

my therapy practice is currently on pause

As of February 2024, I am not accepting new therapy patients due to the need to focus on my health while recovering from long covid (PASC).

What is therapy with me like?

My foundation as a therapist is relational-psychodynamic. I take time to get to know you, valuing the process as much as the content. I learn about you not only through what you say, but how you say it, and how previous experiences in significant relationships shape your expectations of the therapeutic relationship. The process of building rapport, trust, and resonance is an important part of the therapy itself.Upon that relational-psychodynamic foundation, I've gathered an eclectic mix of tools influenced by a variety of theories and modalities, including attachment, mindfulness, CBT, narrative, and trauma-informed approaches.Although my approach and style vary from one individual to another, I tend to be down-to-earth, warm, direct, spontaneous, and intuitive. After 10 years of providing therapy, I've grown accustomed to following hunches, sharing whatever imagery or associations come to mind as I listen, and exploring what these bring up for my patients.With couples, my work is also eclectic but primarily relational, influenced by interpersonal neurobiology (PACT), Gottman, Emotion Focused Therapy, and Nonviolent Communication.

Some issues I frequently provide counseling for include:

Anxiety, especially in relationships, in the workplace, or due to past trauma
Depression, sadness, or grief, especially in the wake of a breakup, divorce, death, or other loss
Marital problems, such as increased strain on marriages following the birth of children, or conflict-avoidance in long-term relationships resulting in emotional distance and declining intimacy
Counseling for premarital couples, or those who are considering whether to commit to a relationship or move on
Major life changes such as shifts in employment, location, household members, health status, or the vision you had for your life
Post-traumatic stress in those who have experienced acute (single incident) or complex (eg. developmental/environmental) trauma
Trauma related to detransition and desistence as well as the untreated issues that the former trans identity was masking
Complex grief over the sense of having lost a loved one to a cult-like ideology

Consulting

Although my consulting services are influenced by what I've learned in 10 years of working in the mental health field, there are considerable differences. Consulting is not therapy. Depending on the nature of our work together, it may resemble coaching, mentorship, or hiring a specialist to inform your decision-making on a particular topic.

The most common stories I hear from people seeking consultation

"My child has suddenly declared a 'trans' identity. What do I make of this? Where is my child getting these ideas? Is my child at risk of lifelong damage if those around us "affirm" the new identity? How can I help important people in my life understand what our family is going through?"
"My views have changed considerably since I met my current friends/partner/employer. I'm afraid I'll be cancelled if people know what I really think. How can I express myself while keeping the relationships that matter most to me?"
"I'm a therapist and I share your concerns, but I'm afraid I'll lose my job or even license if I say anything. How can I shift my practice to reflect my values without living in fear?"
"We are working on an initiative to change legal or institutional policies. We need expert guidance from a professional to inform our goals, strategies, framing of the issue, and choice of language."
"I want to start a blog/podcast/social media presence. Can you help me figure out how to start and what to focus on?"

Consulting may be right for you if:

You are not at risk of suicide, self-harm, psychosis, addiction, abuse, unemployment, or crisis
You have a therapist already, or you don't need therapy
You are looking for help with matters of self-expression or self-actualization, and ready to work toward your goals
Your primary concern has to do with people you care about; you are looking for my help understanding and communicating with them better
You are seeking specific knowledge that I have; you want to pick my brain on an area of my expertise
You want to be able to ask freely what I think of your situation, and receive an honest answer, not be met with a reflection of therapeutic curiosity as to why my thoughts matter to you
You are a therapist seeking consultation on a clinical matter, such as how to help detransitioners or ROGD parents

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Fees, Policies, and Other Fine Print

february 2024 update

As of February 2024, I am taking a partial medical leave. I will not be seeing therapy patients for the foreseeable future. However, I will be seeing consulting clients. Why, you may ask?I have been suffering from symptoms of long haul covid since February, 2022. In January, 2024 I was reinfected with acute covid. In the weeks following, my condition worsened significantly. I am now partially disabled on a daily basis by symptoms including severe fatigue, post-exertional malaise, tachycardia, hypotension, dysautonomia, and shortness of breath. My health is unpredictable and unstable, potentially impacting my patients. My symptoms are worst prior to noon and after 8pm, limiting the hours I have available for work while increasing my need for stress management and a daily commitment to lifestyle interventions. Since I need to cut back on work, but cannot afford to stop working entirely, I have come to the difficult decision to no longer see therapy patients. I take seriously the commitment and responsibility of being someone's mental health provider, and do not want to take the risk that my health instability could send a vulnerable person into further distress.In contrast, I am very clear that consultation is not a mental health service. My consulting clients are not in treatment with me. If they need therapy, I ensure they have a qualified provider who is local to them. I am not responsible for the status of my consulting clients' psychological wellbeing. And because consulting clients are hiring me for my expertise, knowledge, and skills pertaining to a specialized topic, rather than as a therapeutic mirror for their own psyche, there is more room in the consulting relationship for me to be transparent and up-front about my health limitations, whereas I feel the need to protect therapy patients from this information, given the uniquely sensitive nature of the therapeutic relationship. Therefore, working as a consultant only is a more responsible and sustainable choice for me at this time.With this notice being provided, consulting clients should be aware of my health status and the fact that it may impact my availability.

fees, insurance, and coverage

Rates: I charge $250 per 50-minute consulting appointment. Longer or shorter appointments are available at pro-rated fees. Services can also be customized according to your needs. I am open to designing packages that suit the needs of my clients. This rate reflects my specialized subject matter expertise, which is in high demand, combined with my limited ability to work, and the extra burden of my healthcare expenses. Those who wish to work with me but cannot afford my rate on a regular basis are welcome to book a one-time appointment to discuss other resources and referrals.Insurance: I am presently in network with Aetna and PacificSource for therapy for Oregon residents. Insurance does not cover consulting, which is not a medical service for the treatment of a mental health condition. However, as of February 2024, I am not taking new therapy patients, due to a need to prioritize my health.Detransitioners: Genspect’s Beyond Transition program can help cover the cost of therapy. The first step is to apply here.Cancellation policy: I request 48 hours notice when cancelling appointments. Under 48 hours, I charge the late cancellation fee of half the normal appointment costs. I will typically waive this fee as a courtesy one time per party because life happens to all of us. For no-shows without communication, I charge the full rate. Cancellation fees are not coverable by insurance.

client communication policy

Established clients will be connected with a portal with its own secure means of messaging and the ability to request appointments. This is to be used for any information that needs to be exchanged between sessions. That being said, if what you need to communicate would require more than a 1-2 sentence response, it is best to schedule an appointment. I use a secure telehealth platform for all appointments.I do not provide any type of service via email or text. I do not use any written methods to conduct therapy, evaluate information, counsel, advise, consult, or mentor.I cannot guarantee the confidentiality of email, text, or other written means of electronic communication besides the secure, HIPAA-compliant platform I use for established clients.I cannot guarantee a rapid response to emails, nor to texts sent outside of working hours.I cannot promise to read or respond to every email, as I receive too many emails to keep up with while also maintaining my primary responsibilities to established clients during scheduled appointments.I ask all parties I work with to keep email and text communication to a minimum. Text is to be used only for last minute scheduling issues, such as letting me know you are running late.In the spirit of reducing email overload, I do not provide an email address or contact form on this website. The best way to inquire about my services or ask a quick question is to book a free discovery call.

dual relationships & professional boundaries

To protect the sanctity of the therapeutic relationship, I avoid "dual relationships" with psychotherapy patients to the fullest extent possible. This applies to our relationship before, during, and after therapy; once a client, always a client. Psychotherapy patients cannot be former or future friends, business associates, podcasting partners, social media buddies*, or other acquaintances unless external circumstances render the situation unavoidable.Consulting is different. Although I respect my clients' privacy, the boundaries are not as strict. Acquaintances from various contexts have hired me for consultations. Consulting clients are free to ask me for introductions to other people I know, or invite me to connect in different settings.If you think we may cross paths outside of our work together, have mutual friends, or wish to collaborate in any way in the future, and you are considering choosing between hiring me as your therapist and as your consultant, consulting is likely to be the more suitable option.*I do not assume responsibility for ascertaining whether psychotherapy patients choose to follow me on public social media accounts. I have large followings and cannot pay attention to every follower. Some people may use anonymous accounts to follow me, in which case I would have no idea that the follower is a client. If I am aware that a social media account is used by a current or former psychotherapy patient, I do my best to avoid interacting with that account, out of respect for the therapeutic relationship. I do not encourage patients to follow me on social media, but I also recognize there are limits to the extent to which I can effectively discourage it.

limitations

I only provide therapy to Oregon residents. Consultations are available worldwide, but are not a substitute for mental health treatment.I only work with adults. This includes couples and families.I only work with people who want my services of their own free will. I do not counsel, consult or advise under duress or court order. Likewise, I do not provide couples counseling when any physical or sexual abuse, or threats thereof, have occurred within the present relationship.Location: I provide services online only. My business address is for administrative purposes only; the office belongs to an acquaintance. Materials should not be sent to this address as they may not be received.Limits to consulting: Consulting is not a mental health service. Consulting clients who need therapy will be referred to therapists either in lieu of consulting or in addition to it. I do not diagnose or treat mental health conditions as part of consulting, nor do I write assessments, treatment plans, or letters. I do not provide consulting if I believe my client is in need of mental health treatment for suicidal ideation, psychosis, or an acute trauma state.All services are mutually contractual and at-will: Although anyone is welcome to book a discovery call, this in and of itself does not constitute a contract for me to provide therapy, consulting, or any other type of service. We are not in a committed professional relationship until we have both verbally agreed, I have sent you intake documents, and you have completed those documents. I reserve the right to turn down prospective clients if I feel we are not a match. I reserve the right to terminate services if I believe it is not beneficial or if a client is verbally abusive toward me. Likewise, clients are free to terminate services at any time. I do request communication in advance as a courtesy so that we can plan to spend our last appointment together wrapping up and so that I may address any concerns, provide referrals, or take any other appropriate steps to ensure you receive the best care. However, I do not abandon therapy patients. If a patient is in need of therapy that I cannot provide, I will refer them out.

client responsibilities

Client responsibility for tracking information: Established clients will receive appointment reminders but should assume full responsibility for tracking appointments, attending, or canceling with at least 48 hours notice. Clients should also be prepared to take notes should they wish to keep track of any ideas that come up during appointments, and are welcome to pause our session at any time to write something down. I do not offer the service of sending clients written messages to remind them of what we discussed.Client responsibility for personal safety and privacy: I conduct all appointments from a private location using a secure platform. I respect patients’ privacy to the full extent of laws and regulations governing the practice of psychotherapy. I apply similar considerations to consulting clients, but exercise freedom when appropriate and mutually negotiated. For example, if a consulting client would like me to introduce them to an acquaintance, I would do that for them, whereas I would not do that for a therapy patient. That being said, clients and patients also bear the responsibility of ensuring privacy on their end. I enter appointments trusting that clients and patients have ensured they are in a safe and private location. I do not bear responsibility for any failure of clients or patients to safeguard their own privacy. I do not talk to patients or clients while they are driving a moving vehicle. If on the road, I request they pull over. Any therapy patients struggling with their personal safety, such as thoughts of suicide, will be given my phone number as well as referrals for crisis calls and centers; will be involved in safety planning; and will be asked to notify me if in crisis, while availing themselves of all other resources. Any consulting clients struggling with personal safety will be referred to therapists who are licensed in their state. Consulting services may be terminated if these are contraindicated with clients' mental health needs.

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Stephanie Winn, LMFT