Fifteen Years of Community Gender-Affirming Psychosocial Care in Greece: A Cultural Case Study (2010–2025)

This cultural case study examines a community-based, trans-led psychosocial support service provided by the Greek Transgender Support Association (GTSA) between 2010 and 2025. Operating within a context of limited public provision of gender-affirming mental health services, the GTSA Psychotherapy and Gender-Affirming Care Team supported 380 transgender and gender-diverse individuals through more than 3,567 hours of individual psychotherapy and at least 620 hours of group-based interventions. Most service users sought support in relation to social, legal, and medical aspects of gender transition, while approximately one-third presented with suicidal ideation during intake or follow-up. Only one case of detransition was documented, followed by a later retransition, and no suicides occurred among individuals engaged in continuous care. Key features of the service included continuity of care, explicitly depathologizing clinical practices, and the integration of psychosocial support with practical and advocacy-oriented interventions. Drawing on aggregated service records and situating the analysis within Greece’s socio-cultural and institutional landscape, this case study illustrates how accessible, affirming community-based care can function as a protective mechanism in contexts of institutional absence. It contributes to cultural psychiatry by highlighting how community responses emerge in relation to systemic exclusion and by outlining implications for the development of gender-affirming mental health services in comparable settings. Clinical trial number: not applicable.