Psychotherapy with gender diverse people will proceed much as with cisgender people and for the same range of issues – be it bereavement, job issues, childhood trauma, relationship issues, mood disorders, psychosis, personality difficulties, and so on – although with the usual mannered inflection1 one would expect for any form of diversity. The usual principles of establishing good rapport and then utilising the appropriate modality with the client to address the presenting issue as well as any intersecting issues will apply. Naturally this will be the case whether one is a psychiatrist undertaking psychotherapy, a medical psychotherapist, a counselling psychologist, a clinical psychologist, or a psychotherapist. Given most readers will be entirely competent with such things, we will not needlessly detain ourselves here with a recap, but instead will move directly to a consideration of those matters which arise in psychotherapy which directly pertain to gender diverse people, before considering how gender diversity might be approached from the position of the more common psychotherapeutic modalities.