The emergent consciousness and political activism within the transgender community has important implications for the field of counseling. In the current paradigm, the focus has shifted from using surgical and hormonal interventions and thereby enabling transgendered persons to "pass" within the traditional gender binary of society to affirming the unique identities of transgendered persons. To prepare counselors, counselor educators, and counseling supervisors for this important challenge, the authors describe the evolving nature of the transgender community, discuss mental health issues and counseling interventions for use with transgendered clients, and present a case study detailing the progression of counseling with 1 transgendered client.