Transgender clients frequently experience multiple types of violence (Mizock & Lewis, 2008), including interpersonal (violence that occurs between, at least, two people), self-directed (violence that is self-inflicted), and collective (violence that is inflicted by larger groups of people/institutions; Krug et al., 2002). Transgender clients who experience any of these types of violence are at a higher risk for developing psychiatric symptoms that may require the attention of a mental health care provider (Mizock & Lewis, 2008). Thus, it is crucial that clinicians understand how transgender clients respond to such violence and how these reactions relate to the clinical needs of transgender clients (Lev, 2004). In this article, we will summarize and cluster the types of violence that have been documented in the transgender literature. We will then highlight PTSD and complex PTSD as conceptual frameworks for working with transgender clients. Furthermore, we will examine how the binary notion of gender ignores ways in which race, class, and other identities interact with gender and make recommendations for how clinicians can affirm multiple identities as a way to minimize psychological distress following a traumatic event (Roen, 2006). We will also highlight clinical guidelines and provide feminist and multicultural recommendations for working with transgender clients.