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There is a wide-ranging academic literature addressing “Otherness” from sociological, philosophical, pedagogical, psychological, and literary perspectives, but there is little work that distinguishes between kinds of Otherness, nor much systematic exploration of the intersection between the social dynamics that produce, and the psychological effects of experiencing, different kinds of Otherness. As a result, psychotherapists often lack both the vocabulary and conceptual tools they need to respond to transgender, nonbinary, or other clients whose lives and psyches have been shaped by the experience of Otherness. By reading personal experiences of Otherness as a transgender child living in hiding and an adult “othered” by gender transition through the lenses of theoretical concepts of Otherness developed by W.E.B. Du Bois, Jean-Francois Staszak, and Ralph Waldo Emerson, this essay seeks to expand our conceptual vocabulary for, and practical therapeutic understanding of, the varieties and effects of feeling and being seen as Other. This essay argues that we need to understand Otherness simultaneously as a social circumstance many of us need to cope with, a psychic wound, and a formative sense of difference which, even as it makes us feel isolated, gives each human being something in common with everyone around us. To this end, this essay delineates three distinct, interrelated forms of Otherness – Structural Otherness, Internalized Otherness, and Inherent Otherness – including their psychological effects, the social dynamics that foster them, and how each represents an effort to understand ourselves in ways that enable us to relate and attach to those to whom our difference marks us as Other.