Transgender and gender nonconforming individuals experience severe discrimination that has a significant effect on mental health leading to high rates of depression and suicide. Unfortunately, people in the trans community are sometimes denied necessary mental and physical health care due to their gender identity. Advocacy from the trans community has increased development of more trans-affirmative (care that is respectful, understanding and aware of the identities of the trans community) mental health care initiatives. The American Psychological Association (APA) in 2009 discovered through a survey that less than 30% of psychologists and graduate students had familiarity with the experiences of the transgender and gender nonconforming community. Those mental health professionals with limited experience and training in trans-affirmative care could unintentionally harm their clients. Based on the results of the survey and the discrimination experienced by the trans-community, the APA recommended that specific guidelines needed to be created to help mental health professionals better serve and reduce harm to the trans community.
The guidelines created by the APA for “Psychological Practice with Transgender and Gender Nonconforming People” explain in depth, the different aspects of knowledge, assessment, and training that mental health professionals should have when treating trans clients. They advise that psychologists should understand that gender is a social construct and is nonbinary, an umbrella term used for all genders other than woman/man and female/male. The guidelines discuss that psychologists should know the difference between biological sex, gender identity, gender expression and sexual orientation. A person’s sex assigned at birth is their biological sex otherwise known as their physical anatomy at birth. Gender identity is the individual feeling and identity of a person’s own gender on the spectrum between male and female. Gender expression is how someone chooses to show their gender identity. Sexual orientation is the gender to which an individual is attracted to either romantically or sexually.
The guidelines encourage mental health professionals to work on understanding the cultural identities, institutional barriers that the trans-community faces as well as strive to promote social change. It is important to recognize how gender identity and gender expression affect families, romantic relationships, and to understand the difference when mental health concerns are or are not related to gender identity. The guidelines emphasize the importance of acknowledging that when transgender and gender nonconforming people receive trans-affirmative care they are more likely to live and experience positive life outcomes. Psychologists are advised to utilize interdisciplinary care, involving health professionals from varied disciplines, when working with the trans community. The guidelines also strive for all trainees in psychology and mental health professions to be well-versed and trained in working with trans clients. There is still more research needed to continue to effectively treat trans clients, but the guidelines created by the APA for practice with the transgender and gender nonconforming community is a step in the right direction.
