Psychological sessions may be needed to define which gender affirming pathway to follow and/or for support. Furthemore, they may be useful to better understand one's sexual identity in case a person feels confused.
Transgender people have individualized needs that differ from person to person. For example, not all transgender people request a medical gender-affirming path (formerly also know as transition). Some transgender people undertake a social gender affirming path; such as when a person presents accordingly to their gender identity (for example, a person who identifies as a woman and wears women's clothing) and/or changes gender and name on legal documents. A gender affirming path becomes medical when a transgender person starts hormone therapy and/or decides to undergo gender affirming surgery. This requires signing an informed consent and it is recommended that a person refers to a specialized transgender health care center. Italian transgender healthcare centers are listed in the website Infotrans.it in the section "Map of services". Usually, the first professional that a transgender person meets is a psychologist or a psychiatrist.
The reason for this is not because transgender people have a mental illness. A mental health professional may be useful for various reasons: a person may feel confused about sexual identity and therefore need psychological interviews to better understand how they feel; some people may struggle in accepting their gender identity, or in opening up to family, friends or at work (the so-called coming out). In general, a transgender person may need psychological support to define which gender affiming path is best to reach wellbeing. This includes acquiring correct knowledge and realistic expectations about every gender affirming step.
Psychological interviews in fact allow to reach awareness about the limits and benefits of each choice and to make informed decisions. The psychologist works within a multidisciplinary team (psychiatrists, endocrinologists, gynecologists, surgeons). In case a person suffers from depression, anxiety, eating disorders or is at risk of suicide, the need for a psychiatrich consultation may arise.
Coleman E, Bockting W, Botzer M, et al. Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. International Journal of Transgenderism. 2011; 13:165-232.