Case Study
In this unit, you read about several different approaches to the treatment process with sexuality- and gender-related issues. Adapt and apply an approach of your choice to the following case study. Be sure to focus on the treatment planning phase of the process and how that would be conceptualized and implemented from your chosen approach.

Julia (formerly John) and her wife, Allison, have been married 11 years. They were high school sweethearts and best friends who married right after college. They own a successful business. They have a nice home, two children, and what friends and family considered the perfect marriage. During most of their marriage, John and Allison had a great sex life, seemingly very satisfying for both partners, but for the past six months, they have been having sex less and less. Allison had convinced herself that it was all her fault, that she had put too much energy into her children and her work, and she had “let herself go.” At that time John assured her that was not the case. But three months ago, John came out as a transgender female and now wants to be called Julia. She says she is still in love with Allison and is still sexually attracted to her. However, Allison says she is not a lesbian. Julia is frustrated and hurt. Allison is confused and scared. The couple has always been committed and devoted to each other and to their family; however, their relationship has become strained. Julia thinks Allison should be accepting of her transition, and Allison thinks Julia should be more understanding of her perspective.

Feel free to add details as needed to convey your case conceptualization. Be sure to list which perspective you are taking and address the following questions:

How would the presenting issue be conceptualized from this perspective?
What would be the target of intervention?
What would the goals of therapy be from this perspective?
What would be your role as therapist in this case working from this perspective?