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Abstract
Counselors who work with transgender clients in rural areas may have insufficient access to information about rural transgender populations. The American Counseling Association (ACA) Competencies for Counseling with Transgender Clients serve to help fill a knowledge gap related to working with transgender clients. Yet without formal guidelines for working with rural clients, practitioners and scientists alike may be compelled to rely on educated speculation. This article discusses the results of a grounded theory exploration of well-being among members of a rural transgender support group and the resulting model, the rural transgender multi-level model of well-being. Four themes were identified: (a) vocational experiences in which work experiences impacted perceptions of well-being, (b) personal growth and coming out in which participants described choices related to coming out in relation to well-being, (c) acceptance was discussed in terms of how well-being was influenced by internal acceptance of self and acceptance from others, and (d) identity in which participants shared thoughts on gender identity and its impact on relationships and community. The ACA competencies are applied to the model. Suggestions are made for how the competencies can be applied with rural transgender populations.