Therapy First was founded in 2021 by Lisa Marchiano, Chairman of the Board of Directors, along with a group of clinicians concerned that young people experiencing gender dysphoria were not receiving adequate mental health care. From the beginning, the organization has been dedicated to improving the quality of mental health care for children, adolescents, and young adults navigating gender-related distress.

In 2023, under the leadership of Paul Garcia-Ryan, Therapy First strengthened its operational capacity, developed a strategic roadmap for growth, and underwent a rebranding to better convey and advance its mission. Since that time, the organization’s visibility and impact have expanded. Members of Therapy First regularly present at professional conferences, publish original research, and contribute to national conversations on youth mental health, and our work has been featured in major media outlets, including The New York Times and The Washington Post.

Therapy First has trained mental health professionals across the United States and beyond and offers accredited continuing education through the American Psychological Association and the National Board of Certified Counselors. Our programming has featured leading experts in youth gender dysphoria, including members of the World Professional Association for Transgender Health, and equips clinicians to provide care in accordance with the established standard of care endorsed by major mental health associations, whose guidelines support therapy first for gender diverse youth.