Clinician's Digest: Clinically Oriented Article Summaries for Volume 7, Issue 4

摘要

Tatum and colleagues remind clinicians to be aware of the foundational assumptions of their theoretical models to truly understand the uniqueness of the transgender clients they are working with. Using data from the 2015 U.S. Transgender Survey, the authors examined differences in reported developmental milestones for trans men, trans women, assigned male at birth genderqueer individuals, and assigned female at birth genderqueer individuals. Analyses revealed differences across all groups in timing of milestones, including age of first feeling they were transgender, age of coming out, and age of beginning hormones. This work is an important reminder that stage models of development appear linear and unidirectional (even if they are not meant to be applied as such) and relying on them to make clinical decisions can sometimes lead well-meaning clinicians to unintentionally invalidate their client. Although such models describe general developmental trajectories, they do not capture experiential nuance and individual difference; the transgender population is not homogenous. Clinicians' relying on a transnormative theoretical framework that assumes a gender binary risks marginalizing the experiences of genderqueer nonbinary (GQNB) clients. For example, a transnormative model suggests medical interventions are integral to transition. Not only may this not be a goal for some GQNB clients, but making such an assumption may inadvertently communicate that their experiences are somehow less legitimate. Beyond individual clinicians' checking their own theoretical assumptions, this research also speaks to the need for broader adjustments in the WPATH Standards of Care, because these standards may encourage a transnormative approach by providers.