Developing a Gender Specialization

This information is authored by Gaylesta member and Gender Specialist, Lisette Lahana, LCSW; if shared with others, please provide appropriate attribution. Her website is

  1. Receive individual consultation, which may include group consultation, over the course of 2-3 years with Senior Gender Specialist(s) who have over 5 years of experience in the field. During the time cases should include a wide range of gender-focused cases in an active practice or clinical setting.
  2. Attended a significant number of weekend-long and day-long trainings over the course of a number of years. Training must be relevant to the development of basic clinical skills, assessment and cultural competence through conferences such as: WPATH, Gender Spectrum, Gender Odyssey, National Transgender Health Summit, Philadelphia Trans-Health Conference as well as other University or continuing education courses.
  3. Consider formal certification or courses through the WPATH program, which began in 2016.
  4. Reading of professional articles and literature relevant to the field such as Trans Bodies, Trans Selves (Laura Erickson-Schroth, 2014) and the International Journal of Transgenderism.
  5. Have the ability to conduct gender-focused assessments for clients seeking to make physical, legal or other changes.
  6. Awareness of common issues in the field of transgender health, the biology of gender and common surgical options for transition.
  7. Awareness of current research in the field related to transgender health, including hormones, surgery and gender identity/expression.
  8. Develop a basic understanding of hormone treatment options including common methods of administration. Have skills to provide basic informed consent for clients to have realistic expectations of hormone treatment.
  9. Have the ability to discuss fertility and reproduction goals for all clients who are being referred for hormone treatment or surgeries that may result in the inability to have biologically-related children.
  10. Gender specialists must understand and feel comfortable discussing options beyond surgery and hormones. These options may help clients better express their gender and feel satisfied with their body such as voice coaching or the use of various prosthetics.
  11. Develop an understanding of non-binary gender identity and the level of oppression that may result for clients possessing that identity. Within this understanding therapists must work to explore personal biases around the gender binary and how this bias may manifest during clinical work.
  12. Develop an understanding of local, state and national resources relating to gender identity and expression including groups for people who enjoy dressing in clothing not typical of the sex they were assigned at birth.
  13. Ability to work with a broad spectrum of gender concerns such as people who identify as MTF, FTM, genderqueer, eunuch, agender, gender nonconforming, non binary, crossdresser, intersex as well as helping questioning clients sort through their gender and options for expression.
  14. Have an understanding of how to work with family members, children of transgender people and spouses/partners and the resources available.
  15. Possess skills to help clients create disclosure plans which take into account factors such as safety, culture, workplace, socioeconomic status, religion and region.
  16. Be aware of developmental models of gender identity in both cisgender and transgender people. In addition, understand how stages of gender identity development are impacted by culture and society, among other important factors.
  17. Understand how the field has evolved over time including definitions of terms, paradigms (binary versus spectrum), language and depathologization. Be able to discuss changes in the field such as early gatekeeping protocols, the current standards of care as well as common informed consent protocols.
  18. Knowledge of theories about minority stress, impact of stigma, intersectionality of race, ethnicity, class, gender identity, abilities, religion, and immigration status.
  19. Understand common co-occurring issues and diagnoses such as depression and rates of suicidality, anxiety disorders, substance abuse, autism spectrum diagnosis and post-traumatic stress disorder.
  20. Ability to discuss client’s sexuality and sex history in the context of their gender identity and relationship to their body. Help clients improve sexual satisfaction and comfort in their bodies related to sexuality regardless of whether a physical transition has occurred.
  21. Have a fundamental understanding of controversies in the field particularly about the treatment of children, global movement issues and WPATH policy statements.
  22. Have taken part in personal exploration related to countertransference, understanding of ethics, and how your own experiences, including various areas of privilege, may impact the work you do with clients.
  23. Read first-person accounts in the form of non-fiction literature, written by transgender, genderqueer, gender fluid, agender and people who identify outside of conventional gender norms.
  24. Attendance at events or conferences created and/or organized by people who are transgender, genderqueer, gender non conforming, intersex, or by people we may work with. These events may include Southern Comfort, Transcending Boundaries, Accord Alliance, Transgender Law Center, Gender Odyssey, Philadelphia Trans-Health Conference and events in your area including LGBT conferences. These can include events for self- expression such as dance, film, art, poetry or book readings. Note, some events may be “Closed” to outside attendees so be please be sensitive to any restrictions on participation when registering.

To go to next pages of Lisette Lahana's write-up:

Additional Skills Needed for Developing a Gender Specialization with Children and Adolescents

Recommendations for Maintaining a Gender Specialization

©2016 Lisette Lahana. The author welcomes comments on or suggested changes for future updates of this document.