For Treatment Providers & Case Management Teams

Your transgender clients need something you can't provide (and they probably struggle to tell you).

Whether that's from getting tired of explaining, not yet having words for it, or minimizing it as important to their healing journey — the gap is real, and it's affecting your outcomes. Not because your team isn't good. Because standard clinical containers weren't built to hold the specific weight of trans experience. That gap is where this work lives — and it can plug directly into your addiction treatment, mental health, or residential program, starting this week.

Track 1
Refer a transgender client or contract direct support
Individual coaching, groups, high-touch support, companionship, case management, and front-end intake support — available during active treatment. And when discharge arrives: structured aftercare, discharge planning, and a curated referral ecosystem including trans-led clinical resources. One organization across the full care arc.
See how it works →
Track 2
Build a more TGI-competent organization
Staff training, policy review, website audit, space design — and a formal pathway to TIT-EM certification in 2027.
See training options →

Transgender and gender-diverse clients in addiction treatment, mental health programs, and residential care face a compounding problem: they are navigating recovery, identity, and often housing and relationship instability — simultaneously — inside care systems that were not designed with them in mind. Trans clients who are also navigating queer identity, racial or cultural minority stress, disability, or other layers of marginalization carry compounding load that standard programming is structurally positioned to miss. This service exists to close that gap.

A Common Misconception

"We already have TGI staff."

Many organizations assume that having one or two TGI staff members means TGI clients are covered. That assumption creates a gap — and it places unfair pressure on those staff members.

Having TGI staff is not the same as having a TGI-specific service layer. It's a meaningful start, but it's not the same thing — and it doesn't eliminate the need for outside specialist support.

RTF is not a substitute for internal TGI staff. It is a dedicated specialist layer that expands capacity, reduces overreliance on one or two people, and provides services built to hold the full range of TGI experience and disclosure your census contains.

TGI staff may not want to be "the trans provider"
Internal TGI staff are often already carrying multiple roles. Designating them as the default TGI specialist adds invisible labor — labor they may not have signed up for, and that can lead to burnout and resentment.
One or two people can't hold every TGI experience
TGI identity is not monolithic. A non-binary staff member may not be equipped — or comfortable — holding the full range of trans feminine, trans masculine, intersex, and gender-diverse experiences present across a census.
Internal staff have clinical authority — which changes the dynamic
The power differential of a clinical relationship can suppress the disclosures that most need to surface. An outside specialist with a relational and systems practice orientation — not clinical authority — changes what clients say and what teams learn.
RTF is a specialist layer, not a replacement
RTF expands your TGI-specific capacity without adding permanent overhead. Services can be activated as needed — not carried continuously as a full internal build-out — and they coordinate with your existing team rather than operating alongside it in competition.
Why lived experience changes the clinical picture

A trans specialist can go deeper, faster.

"They wouldn't understand. And if I tried to explain, I'd have to start so far back it wouldn't be worth it."

This is what your trans clients are thinking — often without fully articulating it — when they sit across from a clinician who doesn't share their reality. Even a skilled, well-meaning, affirming clinician. The issue isn't competency. It's the container.

When a client anticipates that they won't be understood, they adapt. They perform a version of themselves that fits the space. They omit. They simplify. They don't say the thing that would require too much backstory — the thing that is often the actual thing. Over time, that omission becomes structural: a practiced, felt-sense avoidance that looks like resistance or limited insight, but is rational self-protection.

There is a second, less visible layer to this. Many of the symptoms, diagnoses, relational patterns, and fears that trans clients present with in clinical settings are being interpreted through cisgender lenses — by clinicians who have no framework for understanding how trans identity reframes those presentations entirely. The clinical picture is different when identity is the ground — not a variable.

What lived experience brings that training cannot
Proprioception
The felt sense of what it is to inhabit a trans body under the specific pressures trans people face — not read about, not theorised, but known from the inside out.
Interoception
Precision in reading internal states — in oneself and reflected in a client — that have no clinical name but are immediately recognisable to someone who has lived them.
Systemic self-aware analysis
The ability to track patterns, name dynamics, and extrapolate where they lead — not from theory, but from having been inside them. This is what accelerates client growth.
Identity as reframing lens
Symptoms, diagnoses, patterns, and limiting beliefs read through frameworks that weren't built to hold trans experience misread accordingly. A relational and systems practice orientation reframes the clinical picture entirely.

What takes months to surface in a clinical container — or never surfaces at all — can emerge in the first session. Not because the technique is different. Because the client already knows they don't have to justify the existence of their experience before exploring it.

And when it does surface, it arrives in its full identity context — not flattened into diagnostic categories that were built without trans lives in mind. That reframing changes the clinical picture. It changes what your team is working with.

Identity work isn't what comes after stabilization

It's present from day one.
It just changes form.

The instinct is understandable: stabilize the nervous system first, then — when the client has some ground under them — explore identity. Style, embodiment, self-expression. The deeper stuff. Once they're ready.

The problem is that for trans clients, identity isn't downstream of dysregulation. It's often the source of it. The sympathetic activation, the dorsal shutdown, the hypervigilance in group — these responses aren't floating free. They're organized around something. Usually something gendered. Usually something that has been running for years without a name.

At minimum, what RTF provides is this: a container in which a client's identity is held, seen, and doesn't need to be justified before the session can start. That alone changes the nervous system's relationship to treatment. It's not a small thing. It's often the thing that makes everything else land.

And it can go further — as capacity builds, so does the work.

Where most clients start · Nervous system activation
Identity as context for dysregulation
Not self-exploration — orientation. Getting curious about the gendered and dysphoric origins of what's firing. Placing sympathetic activation and dorsal shutdown in minority stress context so the client stops reading their own nervous system as evidence of failure. The stabilization work becomes more accurate when identity is the frame, not an afterthought.
As capacity builds · Window of tolerance expanding
Limiting beliefs organized around gender
As the window of tolerance expands, the work moves into the stories the body has been running as protection — what it means to be seen, to take up space, to be gendered correctly or incorrectly. These aren't abstract. They're specific, felt, and directly relevant to what's happening in your clinical programming.
Higher window · Prefrontal online
The generative, embodied work of becoming
Style, gesture, community, embodiment — the self that exists before and beneath any particular story. This is the territory that requires enough safety and cognitive flexibility to actually be inhabited. It becomes accessible as the treatment episode progresses. The arc is available. How far it goes depends on where the client is.

Most providers are already doing the right things — somatic stabilization, window of tolerance work, trauma-informed approaches. What they're missing is the substrate that explains why their trans clients' nervous systems are organized the way they are.

Evidence-based tools applied to misread presentations produce weaker outcomes. The identity layer isn't added on after the clinical work. It's what makes the clinical work accurate.

After 30 days to six months of structured treatment, clinical programming has become the texture of daily life — and then it ends all at once. What most trans clients need at that moment is not more groups. It's a different kind of holding entirely.

Post-Discharge · Aftercare · The Highest-Risk Window

Clinical saturation is real. RTF is built for what comes after.

The post-discharge window is documented as the highest-risk period for relapse — and it arrives at exactly the moment when a client is most saturated with clinical structure. Groups feel like more of the same. Processing feels like re-entering a room they just escaped. The container that held them has done its job, and what's needed now is categorically different.

For trans clients specifically, this is also the moment when the identity work that couldn't fully happen inside treatment becomes urgent. Who am I outside the program? What does my life look like now — as myself, on my terms? These aren't questions therapy is wrong to hold. They're questions that land differently in a coaching relationship that isn't organized around diagnosis, symptom management, or clinical goals.

RTF is built for this moment. Not as a lighter version of clinical care. As a genuinely different container — identity-forward, relational, and structured around becoming rather than stabilizing.

What RTF provides post-discharge
Individual Coaching
Relational, identity-forward, not organized around a clinical goal. For clients who are done with the clinical arc for now and need a different kind of presence — one that meets them in who they're becoming, not where they've been.
What RTF provides post-discharge
High-Touch Support & Companionship
For clients in the densest part of the transition — when the structure of a program disappears and daily life hasn't yet found its shape. High-touch check-ins and companionship fill the gap between "discharged" and "stable."
What RTF provides post-discharge
Discharge Planning & Aftercare Case Management
Starting before the discharge date — not after. Building the next layer before the previous one closes: housing, benefits, routine, appointments, the practical ecosystem. For treatment centers, this means a warm handoff to a structured aftercare plan rather than a referral into the void.
Trans-led clinical resources — curated referral network

Where clinical support is needed post-discharge — therapy, psychiatry, specialist care — RTF maintains a curated referral network of trans-led and trans-affirming clinical providers. Treatment centers referring to RTF at discharge aren't sending their clients to find their own way. They're handing off to an organization that can hold the full post-discharge picture and connect to clinical resources when and where they're needed. One organization. The full arc.

How this fits with your team
What this is
✓ Peer support — non-clinical, grounded in shared lived TGI experience
✓ A specialist layer alongside therapy, psychiatry, and case management
✓ Trans-led, relational and systems practice orientation
✓ Focused on stabilization, embodiment, relational repair, and real-world navigation
✓ Available for clinical all-hands and team meetings
✓ Can provide session summaries and suggested entry points for your clinical team
✓ ROI process is flexible — we fit your existing system
✓ Post-discharge aftercare and curated trans-led clinical referral network
What this is not
✕ A therapist, licensed clinician, or certified SUD provider
✕ A replacement for your clinical team or case management staff
✕ Operating under clinical supervision of your program
✕ Providing clinical assessment, diagnosis, treatment planning, or therapy
✕ A substitute for internal TGI staff — a specialist layer alongside them
On the "just a coach" question

It comes up. Here's the honest answer.

The value here isn't clinical authority. It's vantage point, remit, and what happens to your cases when this layer is present.

Clinicians work within a single episode of care, a defined scope, a diagnosis frame, a documentation burden. That's not a criticism — it's the structure of the role. What it means is that there are things clinical roles structurally cannot see: what clients say outside the 50-minute session, what happens in the gaps between programs, what gets withheld because the container doesn't signal safety.

That's the dataset this work operates from. Not instead of clinical work — alongside it, feeding back what's useful.

When Hana is in the room — or in the ROI, or in the case conference — clinicians regularly encounter information that changes how they're reading a client. This is coaching and specialist support, not therapy. What it produces is a different dataset: the layer of identity, embodiment, and continuous threat that clinical roles weren't built to track, brought back in a form that makes clinical work more accurate.

Vantage point
Sitting in the seams — before, during, and after treatment; inside and outside programs; with clients and with teams. That's a different dataset than a single episode of care, and it's not available from inside a clinical role.
Remit
Able to hold things that are clinically relevant but not easily billable — identity, embodiment, housing, systems navigation, the stuff that falls between therapy and case management. No diagnosis frame required. No modality constraints.
Impact on your work
Surfacing undisclosed identity and safety material. Reframing behaviors through embodiment and continuous threat rather than personality. Pointing out where the system, not the client, is breaking down. When that layer is present, clinical work gets more accurate.

"I'm not here to replace clinical work or argue with your modalities. I'm here because there is a layer of identity, embodiment, and continuous threat that your systems were never built to hold — and that layer is affecting your clients' engagement, their safety, and your outcomes."

The question isn't whether this is clinical.
It's whether your trans clients' outcomes improve when this layer is present.

They do.

For clinical directors & compliance teams

Hana Leyland operates as a non-clinical specialist — not as a therapist, counselor, psychologist, or licensed clinical social worker. She does not provide clinical assessment, diagnosis, treatment planning, or therapeutic intervention of any kind.

Her work is supplemental and coordinating — designed to operate alongside your existing clinical and case management programming, not to replace or duplicate it. She works within appropriate professional boundaries, coordinates actively with your clinical team, and fits whatever release of information process your organization uses.

This is a peer support, coaching, and specialist support relationship. It carries no clinical liability and does not require clinical supervision by your team. RTF does not hold a DHCS SUD facility license, clinical certification, or operate as a licensed treatment provider of any kind. RTF's services are explicitly peer support — supportive and ancillary to clinical care, not primary treatment. It is structured to reduce your team's load, not add to it.

Active referral partnerships
Silverbell Global · Sober Escorts · Intent Clinical · Sober Companions · RightFit Consulting
Pricing — individual support, ready to implement now
Weekly Coaching · Monthly Rate
Ongoing 1:1 Support
$700/month
4 sessions per month alongside existing clinical programming. Org-funded or per client. ($200 per individual session.)
Per Session
Individual Session
$200
Single 50-minute session. Entry point or step-down check-in.
High-Touch / Companionship / Case Mgmt
Scoped Per Engagement
Contact
Pricing built around frequency, duration, and intensity. Contact to discuss.
Groups
Group Programming
Contact
Scoped per pilot or contract. See group offerings below.

Flexible billing structures available — per client, standing partnership, or incorporated into your program pricing. See funding structures below.

1
Track 1 — Client Referrals & Direct Support
How to refer a client or contract services
Group Programming

The highest-leverage service for your census.

For organizations with trans clients in their census, group programming is the most scalable, highest-impact offering RTF provides. Groups are contractable directly — structured, repeatable, and built to hold TGI-specific identity and recovery work in a peer container.

Each group runs within RTF's six-domain care approach. The domains aren't mapped rigidly onto session content — they're the underlying framework that orients every group, every facilitation decision, and every question asked in the room.

Groups can function as standalone programming, as a complement to individual coaching, or as a referral pathway that converts participants into deeper individual work where clinically and ethically appropriate.

Stabilize
Drop-In or Open Group · Nervous System & Capacity
For trans individuals in acute or subacute instability — overwhelming nervous systems, survival mode, and capacity breakdown. Drop-in format makes it accessible to clients who can't commit to a cohort. Frame: overwhelm is not failure, it's capacity. Useful at any level of care.
Function
4-Week Cohort · Daily Life & Functional Capacity
A structured four-week cohort focused on where life breaks down — routine, task overwhelm, environment, energy, and what makes daily function sustainable. Grounded in occupational therapy frameworks and RTF's relational care orientation. Designed to fit within a standard 30-day treatment stay or run as a post-discharge container.
Become
4-Week Cohort · Identity & Embodiment
Identity work in a peer container — gender, selfhood, embodiment, style, gesture, and the experience of inhabiting yourself. For trans clients who are navigating identity alongside recovery, at whatever stage of that journey they're in. Includes gendered experience layers, the felt sense of being seen accurately, and what belonging to yourself can look like.
Connect
4-Week Cohort · Community & Belonging
Peer connection, mutual recognition, and belonging — for trans clients for whom isolation is a core driver of instability. Focuses on where connection feels risky, what makes it possible, and how to build a support ecosystem that doesn't depend on any single institution.
The referral process

Simple to plug in. No new workflows.

1
Reach out
Contact via the form below or email directly. Tell us about the client — their context, presenting needs, and whether they're in active treatment or stepping down. No referral paperwork required at this stage.
2
Match the right service
Together we identify the right container based on where the client is — coaching, high-touch support, companionship, case management, front-end intake support, post-discharge aftercare, or group referral. We can also discuss a standing contract for group programming.
3
Sort the ROI & billing
We complete whatever release of information process your organization uses — we fit your system, not the other way around. Billing is structured to match your program model: per client, org-funded, or incorporated into program pricing.
4
Coordinate with your team
Available for clinical all-hands and team meetings. Can provide session summaries and suggested entry points for your clinicians. The level of coordination is up to your team.
5
Client begins
First session typically within one week of referral. For in-treatment clients, sessions run alongside existing programming. For step-down and post-discharge, we provide structured continuity through the highest-risk window — and build the aftercare ecosystem before the program door closes.
When to refer

Use cases for your program

Transgender & gender-diverse clients in active addiction or mental health treatment
Who are not receiving identity-affirming relational support alongside their clinical programming. Supplemental coaching or high-touch support runs in parallel — your team stays focused on clinical work. Trans clients who are also navigating queer identity or other layers of minority stress benefit from support that can hold that full intersectional picture.
Transgender clients approaching or past discharge — clinically saturated, highest-risk window
After 30 days to six months in treatment, clients are often saturated with clinical structure. What they need at discharge isn't more groups — it's a different kind of holding. RTF provides post-discharge coaching, high-touch support, aftercare case management, and connection to a curated network of trans-led clinical resources. One warm handoff. Full arc covered.
Trans & gender-diverse clients with high engagement barriers
Who are disengaged, dysregulated, or performing compliance in clinical sessions. A single coaching session or a front-end intake conversation often opens what the clinical work needs to access.
Programs with transgender or gender-diverse clients in census
Who would benefit from structured trans-affirming group programming — contractable as a pilot or standing offering, without permanent internal overhead.
Coordination with your team
Meetings

Clinical All-Hands

Available to join clinical all-hands meetings, case conferences, and team check-ins. The level of involvement is up to your team — we adapt to what's most useful for your program.
Documentation

Session Summaries

Can provide session summaries and suggested entry points for your clinicians after sessions. Formatted to your team's preference — we fit your documentation workflow.
Process

Release of Information

ROI process is simple and flexible. We use whatever system your organization already has in place — no new workflows, no extra paperwork for your team to manage.
Front-End TGI Intake Support

What standard intake misses — and how to close the gap.

Front-end TGI intake support is a specialist supplement to your existing intake, biopsychosocial, or SOP process. It is not a replacement for your evaluation process — it is an additive layer that surfaces what that process is structurally positioned to miss.

Trans clients regularly withhold disclosures in standard intake that would materially affect their treatment plan — not because they don't want to share, but because the container doesn't signal safety. Identity-specific concerns, trauma histories connected to gender, and practical needs that intersect with trans experience all surface differently when the intake conversation is held by someone with a TGI-specific relational care orientation.

What this produces for your clinical team is a clearer picture from day one — and a set of specific, actionable entry points for treatment planning that a standard biopsychosocial would not have generated.

What it does
Surfaces identity-specific disclosures that may remain hidden with cisgender providers — not through better questioning technique, but through a fundamentally different container that signals safety before a word is spoken.
What it produces
Specific, actionable entry points and treatment-plan additions for your clinical team — not a summary of the client's trans identity, but a clearer picture of the concerns, patterns, and needs that will affect their engagement with your program.
What it is not
A replacement for your intake process, your biopsychosocial evaluation, or your treatment planning. It runs alongside those processes — adding a layer, not displacing one.
When to use it
Before treatment begins, or at the start of a program episode. Can also be used to supplement treatment planning mid-episode where a trans client is disengaged or where the clinical picture feels incomplete.
Funding & Partnership Structures
Insurance-Based / Funded Programs

Org covers the cost

Costs covered directly by the organization as a supplemental service. Can be scoped per client or structured as a standing partnership — whichever makes more sense for your program and client volume.
Best for: residential programs, outpatient treatment centers, case management orgs with insurance-based clients. We'll work with your billing and intake team to make this as frictionless as possible.
Private Pay Programs

Client pays or costs roll into program pricing

Clients can pay directly, or organizations can incorporate these services into their overall program pricing as a specialist add-on. Flexible arrangements welcomed.
Best for: private pay or luxury treatment programs that already include specialist services in their program fee. No clinical overlap — this service coordinates with your team, not in competition with it.
2
Track 2 — Organizational Development
Build a more TGI-competent organization
Training & Consultation

Trans-competent isn't a workshop. It's architecture.

Most TGI-competency training layers onto systems that were never built with trans people in mind. RTF's training goes deeper — policy, procedure, environment, and staff practice — working through the structural conditions that determine whether a trans client feels safe before they ever speak to a clinician.

Staff Training: TGI-Affirming Practice

Structured training for clinical teams on TGI identity, trans experience in recovery, and the specific ways standard care containers fail trans clients. Grounded in RTF's six-domain approach and frameworks of interpersonal spatiality.

Staff better equipped to hold trans clients · reduced dysregulation and dropout · improved retention

Policy & Procedure Review

Review and update of intake forms, EHR protocols, chosen-name workflows, prescription labeling, and internal policies — ensuring the institutional architecture is affirming before a trans client ever speaks to a clinician.

Structurally affirming intake and documentation · reduced harm at first contact

Website & External Communications Audit

Review of public-facing language, imagery, and program descriptions to ensure trans clients can recognise your organization as a safe place before they make contact.

Improved trans client acquisition and trust · alignment with TGI-affirming communication standards

Environment & Space Design Consultation

Review of physical spaces — signage, intake areas, bathrooms, shared spaces — for affirming design. Recommendations grounded in RTF's environmental approach and occupational therapy frameworks for gender-affirming spatial design.

Reduced somatic dysregulation on arrival · improved sense of safety before care begins

Inquire about training & consultation →
Frequently Asked Questions

What clinical directors and compliance teams ask most.

What is RTF's liability exposure for our organization? ▼
None beyond a standard supplemental services relationship. Hana Leyland operates as a non-clinical specialist — not as a licensed clinician. She does not provide clinical assessment, diagnosis, treatment planning, or therapeutic intervention. This is a coaching and support relationship; it carries no clinical liability and does not require clinical supervision by your team. A standard services agreement governs the relationship.
We already have TGI staff. Why do we need outside support? ▼
Having TGI staff is meaningful — and it's not the same as having a TGI-specific service layer. Internal TGI staff are often carrying multiple roles and may not want to become "the trans provider" for every client in your census. They also carry clinical authority, which changes what clients disclose. RTF provides a specialist layer alongside your internal team — not instead of them — that expands TGI-specific capacity, reduces overreliance on one or two people, and holds a broader range of TGI experience and disclosure than any single staff member can.
Is this covered by insurance or Medi-Cal? ▼
Not directly. Coaching and non-clinical support are not currently reimbursable under standard insurance or Medi-Cal billing codes. Most organizations structure this as a supplemental service funded directly by the organization — either per client or as a standing partnership incorporated into program pricing. For private pay programs, costs can roll into overall program fees as a specialist add-on.
How does the ROI and documentation process work? ▼
We use whatever release of information process your organization already has in place — no new workflows or paperwork for your team. Session summaries and suggested entry points can be provided after sessions in whatever format your team prefers. Hana is available for clinical all-hands meetings and case conferences at whatever level of involvement is useful for your program.
How quickly can a referred client start? ▼
First session typically within one week of referral. There is no waitlist for provider-referred clients. Reach out with a brief description of your client's situation and current level of care — we'll respond within 3–5 business days to confirm fit and sort logistics.
Does the client need to identify as trans to access these services? ▼
No. RTF serves transgender, gender nonconforming, intersex, and gender-diverse people across the full spectrum. Clients are not required to use particular language about themselves or fit a particular definition of trans identity. If you have a client whose gender identity intersects with their treatment in any way — even if they're still working out that language — this service may be relevant.
What does post-discharge support actually look like? ▼
It depends on where the client is and what they need, but the core offering is: individual coaching (relational, identity-forward, not organized around clinical goals), high-touch support or companionship for the densest part of the transition, and aftercare case management that starts before discharge — building the next layer before the previous one closes. Where clinical resources are needed, RTF connects clients to a curated network of trans-led and trans-affirming therapists and providers. Treatment centers don't have to send their clients into the void at discharge. RTF can be the warm handoff that holds the full post-discharge picture.
Can we pilot with a single client before committing to a standing partnership? ▼
Yes. A single session or a short-term coaching engagement is a fully contained entry point — no ongoing commitment required from the client or the organization. Many provider relationships begin with one referral, see the impact on clinical engagement, and expand from there. There is no minimum commitment to start.
How do Track 1 (referrals) and Track 2 (training) relate to each other? ▼
They are designed to work together. Referring a client generates live, contextualised insight about a real trans client in your program — insight your clinical team can observe and learn from in real time. The organizational training formalises and completes that picture, giving your clinicians the frameworks and language to apply what they're learning not just to this client, but to every trans client who comes after. Organizations that do both get significantly more value from each track than either delivers alone.

Track 1 and Track 2 are designed to work together. Organizations that refer a client and invest in training get significantly more from each than either delivers alone — the referral generates live specialist insight; the training gives your team the framework to apply it to every trans client who comes after.

Refer a client or contract services

Tell us where your client is. We'll match the right service, sort the ROI and billing, and be ready to start within a week.

Make a referral →

Explore training & consultation

Staff training, policy review, communications audit, space design. Let's talk about what TGI-competent looks like structurally for your organization.

Inquire about training →

Looking for support for yourself or a loved one? See the Coaching & Direct Support page →