The National Transsexual Counseling Unit (NTCU)

Before there was “Google it,” there was the National Transsexual Counseling Unit — the world’s first peer-run trans support organization, founded in San Francisco in 1968.

The NTCU was the brainchild of activists like April Ashley and Reed Erickson, backed by a small but determined group of trans women who wanted to create a safe place to find resources, medical referrals, and community. At the time, finding a doctor willing to provide gender-affirming care was like searching for a unicorn in a snowstorm.

Operating out of a modest storefront, the NTCU offered counseling, legal advice, and connections to sympathetic medical providers. It was also a hub for building community resilience, especially as many members faced police harassment, job loss, and family rejection.

At a time when being openly trans was socially and legally dangerous, the NTCU worked directly with hospitals and clinics to develop respectful treatment protocols — a radical move that influenced later LGBTQ+ health organizations. The NTCU showed the power of peer-led services, especially for marginalized groups whose needs were ignored or misunderstood by mainstream systems. It’s part of the lineage of today’s trans resource centers and health nonprofits.

The group ran a “buddy system” so no trans person had to go to a doctor’s appointment or court appearance alone. Think of it as early community escort service, but for survival, not romance. At Big Gay Smiles, we believe peer support is priceless — whether it’s calming dental anxiety or affirming someone’s gender identity. Sometimes the most healing thing is someone who’s walked your path smiling back at you.

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