This research explored how clinical psychologists talk about working with trans clients. The Introduction outlines historical and cultural institutions that have staked a claim in the conceptualisation of gender identity. I then describe a social constructionist approach and the possibilities of this framework for examining the dominant historical and cultural notions of gender identity. In detailing the current legislative and National Health Service policies I argue that certain discourses about gender identity will impact on how clinical psychologists can construct the work they do with trans clients and that this will have implications for the healthcare services that trans people receive. The aim of the research was to identify how clinical psychologists constructed gender identity when talking about working with trans clients to explore what actions and practices seemed reasonable or unreasonable. I interviewed seven participants: all qualified clinical psychologists who had had clinical contact with trans people but not through a specialist gender identity service. The Analysis explored the language that participants used to construct gender identity and their work with trans clients. Similar discourses were drawn upon by the participants but were often constructed in different ways. In the discussion I summarise the analysis and explore the implications for practice and future research. Finally I reflexively examine the research in relation to my own positioning, identity and validity of the analysis.