The clients’ Little Rock-based therapist, Kirsten Sowell, works primarily with LGBTQ+ clients. They’re “concerned about losing protections like access to health care, marriage equality, protection from discrimination, and … protection from violence,” Sowell said. Advocacy, which Sowell felt she owed to her clients and community, has helped Sowell cope with her own mental health, but it also has taken a toll. “When these decisions are made, it is as if no medical or mental health professional is in the room,” he said. “There are already guidelines implemented in the medical and mental health fields for gender-affirming care.