Pronouns can feel like a tiny detail until you realize they are a real-time test of safety. When someone’s identity has been questioned, policed, or punished, the smallest moments in a therapy office can signal either danger or relief. I sit down with Dr. Lou Himes, a licensed psychologist and certified specialist in transgender mental health, to get concrete about what gender-affirming care looks like when trauma, dissociation, and systemic betrayal are part of the story. We talk about how ...