Clinical Practice With Transgender and Gender Diverse Clients: Setting Up an Inclusive Practice and Training Considerations

摘要

Transgender and gender diverse (TGD) people experience various minority stressors that drive health disparities. In the face of this marginalization, therapy may be helpful to manage these stressors and promote well-being. For some TGD people, they also may need to interact with mental health providers in order to gain access to gender-affirming medical procedures. As such, it is not unusual for mental health providers to have TGD clients at some point in their careers. Even so, there is little graduate training about working with TGD clients, which can result in providers being underprepared to work with TGD communities in affirming ways. Many TGD people report experiencing microaggressions or worse on the part of providers and even those who claim to be affirming may not be taking the steps needed to create a safe clinical context for care. This presents an important training point for graduate programs as well given that many of the professors or clinic staff may not have received the necessary training either. In this manuscript, we detail a summary of existing best practices for affirming mental health services with TGD clients that were informed by existing literature, community input, and clinical practice. These specific actions span from paperwork, to the clinical space, and specifics of interactions with clients. By carrying out these actions, providers will be able to live out their commitment to affirmation of TGD people. We also provide guidance for graduate programs to ensure that future generations of therapists are better trained in these areas.Clinical Impact Statement:Although many therapists strive to be affirming of transgender clients, they often fall short. This manuscript provides specific actions and steps that therapists can take to improve their practices, as well as guidance for graduate programs to improve their training.