APA Adopts Guidelines for Working With Transgender, Gender Nonconforming People
The American Psychological Association (APA) took a step forward earlier this month announcing the formal introduction to “The Guidelines for Psychological Practice with Transgender and Gender Nonconforming People.” These guidelines serve as a model for what competent psychological care should look like and go beyond diagnosis to address broader psychosocial issues affecting people of Trans* experience such as stigma, rejection and bias which we know can lead to violence, homelessness, poverty and health disparities.
The APA felt compelled to develop these guidelines after learning that only about 30% of clinicians in their field had knowledge of gender identity issues. I suspect this is equally true for clinicians practicing in other related fields such as social work, counseling and psychiatry. It is easy to lose sight of this discouraging fact when your work is primarily focused on issues of gender and sexual identities, as it is for our staff at Mazzoni Center. Gender specialists and clinicians who have sought out specialized training to build competence in this area of work are vastly underrepresented among their colleagues. So all the more reason to cheer the APA’s vision to raise awareness among their ranks.
The World Professional Association for Transgender Health (WPATH) has historically been focused on developing appropriate and holistic standards of care for clinicians that have evolved with our understanding of gender and gender fluidity. However, those standards of care and other relevant literature only reach a small percentage of practicing clinicians and those in training.
Gender is very much a natural element of every individual and therefore variances in gender should be viewed as just that – and not pathologized. Unfortunately, all too often, training institutions still view gender and sexuality as specialized fields of study, and don’t incorporate enough standardized training into curriculums. This reinforces that future clinicians can compartmentalize their training and therefore avoid learning about gender and the unique aspects of working with Trans* and gender nonconforming people.
It is imperative for clinical training programs and institutions to incorporate more mandatory coursework and practice for any student embarking on a clinical career. This is a vital step in preparing new clinicians. Further, the boards that govern practicing clinicians should consider mandating, at minimum, basic training for active clinicians (many of whom were trained at a time when sexual orientation and gender identity were not even included or discussed). The licensing boards have made a priority for other important topics by mandating training for ethics and abuse reporting.
This does not mean that any clinician who has had a 3-hour course in Gender 101 should be considered competent or apt to practice with people of Trans* experience. It may help, though, to demystify and alleviate some gaping knowledge deficits, and ultimately, it may translate into better, more comfortable and affirming experiences for Trans* and gender nonconforming individuals seeking care.
After all, helping to improve the lives of those seeking mental health care is the core of the APA’s mission. By adopting these guidelines, they have taken a meaningful step in making this more realistic.