The author is an open transperson, a medical doctor, a family therapist and a sexologist, who has worked personally and professionally with issues of gender identity for decades. Through media exposures insights have been shared with the public. The quality of being an open transperson has inspired clients to include information they otherwise would have believed contrary to their goals in therapy. Clients’ frankness has influenced the insights of this paper. Gender therapy does not aim at changing the clients’ perception of self, but at changing the clients’ surroundings perception of the client. This is accomplished both through a strengthening of the individual’s self-confidence, and through education of significant people in the individuals’ networks. Gender therapy is seen as an assisted process where one moves from an unsatisfying to a more satisfying state of living. The optimal endpoint does not have to lie within the gender majorities. Since culture and society have a foul tendency to sanction negatively gendered expressions that do not conform to the binary, all therapeutic work focused only on the individual may be futile, because the individual will not be gender affirmed by the surroundings. The optimal therapeutic approach to individuals of unusual gendered or non-gendered talents must address and assist both the inner and the outer world in order for the individual to be able to present an egosyntonic perception of self to society, and for society to be able to affirm. When congruence exists between the individual’s sense of gendered or non-gendered self, and the surroundings perception of it, the state of gender or non-gender belonging arises. The combined individual and cultural endeavor will reach different endpoints as both the client’s and the networks needs and capacities are different. This paper offers some clues as to how positive gender belonging can be established.