Therapy for trans and nonbinary adults

Find stillness in the current of life.

A calm place to talk about your life, your name and your body, at your own pace. Sessions in San Francisco and by video in California.

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Meet Dr. Kylie Pierce

I work with trans and nonbinary adults, one on one. You can use whatever name and pronouns are yours, and you do not have to explain or defend them.

I explain each method before I use it, and you can say no to any of it. I want therapy to feel like a conversation, and you set the pace.

Licensed clinical psychologist (PsyD)
Adults, individually and as couples
In person in San Francisco
Video for clients in California, where I am licensed

Dr. Kylie Pierce

Licensed clinical psychologist

A smiling woman in a navy dress holds a folder in a white office

You might be here if

These are some of the questions and changes that bring people to my office.

You are working out what to call yourself and want a place to say it out loud.
You are thinking about coming out, and about how, to whom and when.
A change at home, at work or in a relationship is asking a lot of you.
You are tired of explaining yourself and want to be understood the first time.
A past therapist made the hour about their questions and not yours.
You know something needs attention and are not sure where to begin.

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How I can help

Every person's path is different. Here is what we can work on together.

Individual therapy
One-on-one sessions to talk through what is on your mind, at your pace, with your name and pronouns used as you ask.
Couples and partners
Sessions for you and a partner or partners, with room for both of your stories and no assumption about how a relationship looks.
Identity and coming out
A place to think aloud about names, pronouns, family and work, without being asked to justify who you are.
Life transitions
Moves, job changes, loss and other turning points, and what they ask of you.

50 min
Individual sessions
80 min
Couples sessions
Video
Or in person
Written
Fee estimate before you start

Your path forward

No waitlist talk and no long intake forms. A clear, gentle way in.

Reach out
Use the form or call. Share as much or as little as you like.
A reply
I write back with times, and a written fee estimate if you pay yourself.
First session
We talk about what you want from the time, at your pace.
Ongoing support
Regular sessions at a rhythm that suits you.

My Approach

Good therapy leaves room to move between feeling safe and being challenged. I aim for a relationship where you feel seen and understood, and where growth is yours to pace.

Safety First
Every session starts with respect. You set the pace, and I follow your lead.
Whole-Person Care
Mind, body and the people around you are connected, and we can talk about all of it.
Methods explained
Acceptance and Commitment Therapy, cognitive behavioral therapy and body-based awareness. I explain each one first.

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What clients say

What it felt like to be in the room.

“I did not have to explain my name or my pronouns even once. She just used them.”

Valentino S.

“The pace was mine. Some weeks we talked about work, and nobody acted as if that was a detour.”

Maggie O.

“It is a quiet room and an unhurried hour. I looked forward to it.”

Riku N.

“She asked what I wanted from the time, and then she listened to the answer.”

Braxton L.

“I was nervous before the first session, and the first ten minutes took care of that.”

Aryan P.

“Nobody rushed me toward a label or away from one. I could just think out loud.”

Chau T.

Sample reviews.

Common questions

Honest answers to help you feel prepared before you write.

What should I expect in the first session?

We talk about what you want from the time, and you can use whatever name and pronouns are yours. There is no pressure to say more than you want to. We move at your pace.

How long does therapy typically last?

It varies by person. Some people come for a few months and some for longer. We check in regularly, and you can change the pace or stop whenever you choose.

Do you offer video sessions?

Yes. I offer in-person sessions in San Francisco and secure video sessions in states where I am licensed, which is California, for clients who are there at the time of the session.

What are your fees and do you accept insurance?

I am out of network, so I do not bill insurance. I can provide a superbill for reimbursement, and you get a written fee estimate before the first session. How fees work has the details.

How do I know if we are a good fit?

Fit matters in therapy. The first session is a chance to see whether you feel comfortable, understood and respected. If I am not the right match, I will help you find someone who is.