Question: I'm transgender, I know I am, but I've only told a few friends. I know I can't tell my family because of previous conversations we've had. They just wouldn't accept it.
 My gender dysphoria is getting really difficult to deal with on my own. I need some strategies for dealing with it. What should I do?

Answer: This is a difficult situation to be in, as it sounds like you are feeling very isolated from both your family and your friends.   I don't know your age or gender so please excuse any incorrect assumptions about you being under 18 and use what is useful from the ideas if you are older.  One idea is to research online to find a therapist or a local clinic that has a therapist who is a "Gender Therapist" or a "Gender Specialist."  Most therapists who are transgender affirmative also have other specialties and do general therapy.  Though I don't think lying to your parents is a good idea, if you feel you truly can't talk to them about your gender, then perhaps you can find a therapist with a specialization in gender identity who can help you cope with your gender dysphoria.  You can let your parents know that you would like to see that particular therapist for other reasons, such as anxiety/worry, and that you researched them and liked their website.  Work to find a therapist who takes your parents insurance if you can.  You can also talk to the therapist on the phone first, before you talk to your parents about scheduling the first therapy visit. Therapists can help you learn some ways to manage feelings of worry, shame, and fear related to gender dysphoria. Depending on your family situation, many therapists will work to help you learn skills to safely communicate with your parents about what is troubling you.  Your parents may actually surprise you and be more accepting than you think.  Usually when parents learn that you are suffering, they want to be open to learning how they can help you, even if awkwardly at first.Reframing is a tool that helps you think about your situation from other perspectives.  It's kind of how you can look at the same picture with a different picture frame and it makes the same picture look a little different.   Keep in mind your situation is probably temporary and think about in the context of your whole long life (can you tolerate another 2 to 4 years living like you are if you have another X number of years to live?).  If you are living at home, you will eventually be more independent and be able to make more of your decisions about your gender expression. Keep the idea in mind the concept that is popular in mindfulness classes I teach, that "This too shall pass" or "This is only for now" when you start to feel hopeless. If you start to over focus on your gender or body issues, try to distract yourself with things that make you feel happy (your pet, music, art, sports etc) or stay busy.  If you can, find any GSA or LGBTIQQ youth group that you can attend confidentially, further away from home, to get some support.  Work to find an ally, one person, that you can talk to about what you are feeling. Making new friends online through social media can sometimes be a start in breaking down the isolation you feel. Another idea, if you are under 24 years old, there is a phone line (866-488-7386)  to call in case you are ever feeling you are in crisis.  You can also text chat! Trevor Project: http://www.thetrevorproject.org/There is also a trans teen online chat group if you are 12-19 http://www.glbthotline.org/transteens.htmlIf you are an adult you can get numbers to call in your state if you start to feel suicidal:http://www.suicidepreventionlifeline.org/Day to day, can you creatively work on your gender dysphoria?  Yes!  Are there ways you can focus on parts of your body you love?  Can you focus on that when you look in the mirror?  Are you a writer?  Can you write stories or poetry about the life you imagine for yourself in the future?  Can you do small things that help you get more in touch with your gender day to day like making small choices about your clothing, like wearing clothes that are more unisex,  that only you know are gender related but others won't notice?  You cannot force others to accept you but you can work on your self-acceptance and self-compassion. That work is something that is best done in the company of others like you as well as with at least another person who gets you and whom you can trust.  Good luck to you!