Competent Care for Transgender and Gender Nonconforming People

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With attempted suicide rates on the rise, it’s imperative to spotlight the transgender and gender nonconforming (TGNC) community. Prejudice against TGNC people often manifests in forms of denial (in health-care services), harassment, bullying and physical assault. TGNC people may be further marginalized by other microaggressions, such as racial and ethnic identity, socio-economic status, and age. Individuals’ external reactions towards TGNC people may be aggressive as the result of explicit and/or covert fears about what it means to deviate from gender norms. TGNC people are often perceived as “Other,” not “fitting” into a particular box. By challenging constructs, clinicians can provide and advocate for the TGNC population.

Challenging Constructs

Gender has been perceived as a binary construct with mutually exclusive groupings of male or female. Blue or pink. Trucks or dolls. These groupings create an assumption that gender identity is always in alignment with sex assigned at birth. However, for TGNC people, gender identity differs from sex assigned at birth to varying degrees. Gender identity is defined as “a person’s deeply felt, inherent sense of being a girl, woman, or female; a boy, a man, or male; a blend of male or female; or an alternative gender.” To provide the most affirmative care, a non-binary understanding of gender is essential. Whenever I am greeting a client, I always ask them, “How would you like to be addressed? Do you have preferred pronouns you’d like me to use?” Simple, but by using their preferred identification, their self-identity and sense of self-worth is validated.

Trans-Affirmative Care

I wanted to provide the following list that offers a very general overview of language used within the TGNC+ community, and it’s important to emphasis that these terms are constantly evolving. Language is powerful. Staying updated and informed as a clinician will nurture open and collaborative discussions around experience through the lens of the TGNC person. It will also support the TGNC person in the least confusing and dishonorable way. Modelling an “acceptance of ambiguity” may be helpful as TGNC people develop and discover aspects of their gender expression, especially in adolescence and early adulthood. TGNC identities include but are not limited to: transgender (TG), female-to-male (FTM), male-to-female (MTF), transgirl or transboy, they/them, bigender, gender fluid(ity), drag queen or king, gender queer, transqueer, queer, cross-dresser, androgynous.

Research in the Field

It’s important to highlight the progressive work being done by Dr. Diane Ehrensaft and her colleagues at the Child and Adolescent Gender Center in San Francisco, California. They are utilizing what is called the “Gender Affirmative Model” which encourages clinicians against labeling TGNC individuals as “dysphoric” and instead view their varying gender expressions as “fluid.” This deconstructs the concept of gender being binary and stagnant. The ability to respectfully interact in a trans-affirmative manner can help improve TGNC people’s quality of life and experience in therapy overall. By supporting TGNC people to articulate their authentic truth, clinicians can strengthen the therapeutic alliance and cultivate a safe environment to explore gender identity and  gender expression.

 

References

American Psychological Association. (2015). Guidelines for Psychological Practice with Transgender and Gender Nonconforming People. American Psychologist, 70(9), 832-864.

 

Cassy is a Licensed Clinical Social Worker-Associate who is passionate about transformative justice and advocacy for contemporary social issues. In addition to providing individual counseling, Cassy also enjoys facilitating groups. She currently provides group support for patients who have recently undergone bariatric and weight-loss surgery and a group for young women called SOAR (Staying Open about Recovery), who are making strides to positively stay on track in eating disorder recovery.

 

 

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