Graciela Pacheco, MFT is a dual state Licensed psychotherapist in California and Nevada, operating out of Las Vegas. She is a member of the queer community and identifies as pansexual. She works frequently with gender diverse folks and those “transitioning” genders— whom Graciela prefers to refer to as the process of revealing oneself. You’ve been in there this whole time.

At her clinic, she has published, clear, and strict rules about how clients interact with other clients. If ANY client says or does a behavior that is threatening to the dignity or safety of our LGBTQ+ family, they will be discharged from services immediately and provided with referrals because the therapy office has to remain a sanctuary. We have a zero tolerate policy for xenophobia.

All administrative assistants or any employees have very clear personalized one-on-one training with Graciela to personally drill into new hires about the appropriate way to address
queer clients, to ask for preferred names, ask for pronouns, treat everyone with dignity and respect, and make sure they know that there is a single stall restroom available and unlimited complimentary chilled refreshments available.

COMING OUT: CHRISTIAN FAMILIES
She has a niche service of assisting and aiding persons come out of the closet [sexual orientation and/or gender identity] to conservative and/or highly religious family members. She has specific experience with supporting black American clients with coming out to their friends and families— noting experience specifically with African Methodist Episcopalians (AME’s) and Baptist Christians.

Not only has she studied the Bible to utilize the text to assist in smoothing out the coming out experience with religious relatives and friends, but provides personally written educational materials about moral ways to treat marginalized persons in congruence with Christian religious beliefs. Given that Jesus Christ sought out to heal the sick with leperacy who were shunned from society, and communicated in a friendship with Mary Magdalene (a sex worker), we can examine how to model our lives after Jesus. After all, Jesus said follow me, not follow Christians. Jesus Christ shares the experience of being bullied, harassed, and eventually murdered in a form of a hate crime for his identity— can we see some commonalities with how trans people are treated? Don’t forget— he rose again!

Graciela has created her own family therapy exercises that incorporate scriptures to guide and explore the values of love, acceptance, respect, and non-violence towards people of marginalized communities. She has successfully helped those who have been “excommunicated” from their families repair and rebuild relationships.

STRENGTH: TRAUMA TREATMENT
Her clinical specialization for individual psychotherapy is in the diagnostic and comprehensive treatment of Posttraumatic Stress Disorder (PTSD), which often includes co-ocurring depressed mood, addiction, and dissociation. She works with victims of psychological abuse and manipulation, physical violence, hate crime victims, sexual abuse and rape in childhood and adulthood, economic abuse, and spiritual abuse.

She is trained by UCSF and other experts in psychological assessment of LGBTQ refugees who have been victims of torture, hate crimes, gruesome violence, and offers Spanish as her other fluent language.

TRANSGENDER RIGHTS & SAFETY VALUES
Graciela is a full professional member of the World Professional Association of Transgender Professionals (WPATH) and has trained with The Trevor Project.

TRANSGENDER MEN: HER VIBE APPROACH
She has a niche strength in assisting those who were assigned female at birth examine the myriad of ways to express and embody masculinity in a way that does not subscribe, participate, or reinforce misogynistic gender oppression of women.

DIVERSE WAYS TO EXPRESS MASCULINITY
Graciela believes strongly in helping those AFAB become rock solid, unshakable, sturdy and rooted in their masculinity to work towards self-love, confidence as a man [or transman] and no longer wonder if they fit in the male community— but champions her transmale clients to simply issue their very own membership cards to the male community and own it. No transman need an invitation because they already have a seat in the male community because her clients are aware of their incredible power through psychotherapy.

GENDER SOCIALIZATION:
ASSERTIVE COMMUNICATION SKILLS
She teaches assertive communication to those AFAB and delves into how the socialization for female presenting persons have prevented them from owning their power within then. Ranging from people pleasing, being quiet because it’s polite, or not speaking up can become a barrier to achieve congruence. Misogyny and oppression of the female sex makes provokes a sense that one could be easily sexually harassed, creates limiting beliefs about career choice, how much income I can earn and limitations and inhabiting positions of authority and leadership.

DATING AND SEX FOR TRANSMEN
Graciela always addresses the serious problem of transphobia within the LGBTQ+ dating community. She discusses prior sexual trauma, sexual partners, how to embody masculinity in an affirming way, supporting those AFAB in initiating asking someone out, initiating intimacy, and the right timing and wording when revealing transgender identity.

TRANSWOMEN: TAKE ME SERIOUSLY!
EXOTIFICATION AS A FANTASY
She delves into issues of cisgender men and cis women (or cid-hetero couples) EXOTIFYING transgender folks in the dating world, particularly prominent for transwomen who frequently complain of being someone’s adrenoline-fueled daring fantasy, rather than taken seriously as a woman of calibur and worth, deserving dignified and respectful courting— and being CHERISHED.

WE ARE LADIES, WOMEN, AND SHARE THE SISTERHOOD
Graciela interacts with her transgender female clients AMAB in ways that are Affirming and promote a sense of belonging in the female community. Of course, she will always inquire about how her clients prefer to be addressed. Graciela carefully chooses language that reinforce and re-affirm.

Meeting for a therapy session might sound like:
“Hey lady, what are the thoughts swirling around in your head this week?”

“As women, we need to stick together in making sure we back each other up.”

“What is it like interacting with cis women.
What is a big barrier with making cis female friends? How emotionally safe do you feel?”

“Girl, there are so many ways to express femininity but you don’t seek it outside of yourself. You must turn inward to reveal who’ve you always been. There’s no transition— just an unmasking. Who knows who we will find within you:
— A modest cardigan-wearing intellectual who enjoys reading and gardening
— A bad bitch who speaks up and owns her sexuality and insists upon partners meeting her needs and accepts nothing less
— A health-conscious lady who is spends time in meditation practice and yoga
— A business woman who has no time for bullshit
— A wash and go lady who wears minimal makeup
— A glamorous lady who is always well styled and enjoys experimenting with different makeup, ranging from cat eye liner to a soft taupe sultry, smokey look

THERE IS NO ONE RIGHT WAY TO BE A [TRANS] WOMAN
Seek your identity within yourself, listen closely, and notice your authentic feminine divine self unmask as you feel emotionally and physically safer— and more connected to yourself. DONT HUNT FOR YOURSELF OUTSIDE OF YOURSELF. SHE’S ALREADY WITHIN. You will find her within. Opinions of others about how you are supposed to look are irrelevant about how to be a woman— you’ve been a woman this entire time! Don’t pressure or rush her as she slowly reveals herself, develops herself, and begins a self-loving and self-honoring journey. Gender congruence and self-love are one hell of a high!

DATING: TRANSWOMEN
She supports her transwomen clients in how to assess intentions of dating partners they meet, set boundaries, develop a set of “non-negotiables” of what transwomen clients will not tolerate in their dating lives to preserve their self-respect and dignity. Graciela and her transwomen clients — who she refers to as fellow ladies in the female sisterhood— works with them one-on-one with discussing EXOTIFICATION and how to tell if they are truly experiencing an authentic and genuine romantic connection.

SEX & INTIMACY ISSUES FOR TRANSMEN
In exploration of gender affirming sex and intimacy, transmen work with Graciela how to connect intimately — to both give and receive sexual pleasure and satisfying experiences that are gender congruent.

She coaches and makes plenty of room for the awkward feelings of dating when new to coming out, how to relate with a person of interest from a gender affirming place that feels right for them, acknowledging that gender affirming dating support is customized for how one embodies their own unique expression of gender.

For some AFAB transmen who believe in a traditional gender roles in accordance with American society, it can feel pretty foreign to take the initiative, ask someone out, initiate intimacy, and engage in gender affirming intimacy and sex in a dominant, connected, and respectful way to their partner. Dysphoria crops up throughout this process and Graciela is here to help and provide practical support.

POWER EXCHANGE
There are many power dynamics at play in sex and intimacy and it’s important to communicate with ones partner about positions that increase dysphoria (for example, laying down on ones back and being penetrated can feel very “female,” trigger disturbing dysphoria, and feel disempowering for some ).

We develop boundaries and new ways to have more satisfying sex lives as men. I always ask and utilize how folks want to be referred to, such as a transman, transmasculine person, or simply— a man.

Another matter that comes up in sex for transgender men is about how one prefers to physically present, for example, if a client has not had top surgery, it’s importance that he wears garments that affirm him and let his partner know which areas of his body are off limits, for example touching breasts.

There are so many nuances to nudity, partial clothing, using bras and binders (and the dysphoria around those), and menswear to explore. You take control and are truly the architect of your own gender congruence, presentation, and style. Graciela has found several products that her clients have recommended and keeps a running list. She’s also aware of advantages and disadvantages of using some products designed to be affirming, such as STPs (Stand-to-Pee devices), packers, and others. She shares information and encourages open reflection on whether gender congruence products are appropriate and beneficial.

LESBIAN PARTNERS FACING GENDER TRANSITION
There can be some serious challenges when we have been in a “same-sex” relationship and are transitioning genders.
— Will my girlfriend still want me or take off?
— Will she lose attraction because of my gender?
— How may we have satisfying sex that affirms my gender if she doesn’t want penetrative sex?
— What do I need from my girlfriend to feel affirmed in my masculinity?
— Does my girlfriend grieve the old me who she first fell in love with?
— Will she want to be with a cis man after experiencing this? How will I measure up?

PREPARING FOR TRANSPHOBIC BULLSHIT
Graciela enjoys role playing and practicing uncomfortable yet realistic conversations that her transmale and transmasculine clients may face inside a men’s restroom, when shopping for clothing, when misgendered by friends or family, and when clocked by transphobics — and how to navigate these conversations while conserving ones emotional energy and protecting the self from trauma. She does bring up issues of self-defense and firearms when addressing the realities of hate crimes and hate-based violence. Transgender safety is a top priority.

HUMANITARIAN WORK: LGBTQ REFUGEES
Graciela has served gay, lesbian, and transgender asylum seekers from Russia, Chechnya, Mexico, Uganda, and Central America by helping them gain protection from deportation back to a country without minimal rights nor basic protections for LGBTQ safety. She conducts psychological evaluations documenting their suffering and experiences, assigns clinical diagnoses as applicable, and provides clinical recommendations. This service is in high demand by immigration attorneys since it speaks to the credibility of their immigration case and verifies that their application is valid — and is more likely to be accepted. She is listed in the directory in the UC Hastings Center for Gender and Refugee Studies.

She works with interpreters and arranges interpreters for those who speak indigenous languages as needed, and is well connected and knowledgeable about the specific dialects of languages so that she can arrange the appropriate interpreter.

She is well trained and experienced in serving gay, lesbian, pansexual, asexual, non-binary, fluid, and other persons with variations of romantic and sexual orientation. She works frequently with gender diverse folks and those “transitioning,” who Graciela prefers to refer to as the process of revealing oneself.