This paper focuses on the use of acting theory in a course of psychotherapy with a biological female therapist and a postoperative, female to male, transsexual client. Sex and gender issues are significant elements of the therapy and are, one would hope, applicable to other clinical situations. The paper also focuses on simulations of self, both in terms of acts of conscious portrayal and of relational movements held out of awareness. In raising awareness of such processes, a “relational theatre” is brought into the treatment room; an extension to practice that I hope will aid therapists in working with fragile clients from a range of backgrounds. An important aspect of this particular piece of work is the relationship between a man and a woman.