Scope of Competence in Working With Transgender and Gender Nonconforming Clients

As psychotherapists we all are concerned with working within our scope of clinical and cultural competence as clinicians. Increasingly, professional organizations whose members provide services to the LGBTQI populations we serve have recognized the need to define standards of care. These standards enable us to determine our level of professional expertise to serve the needs of members of our communities.

One important group served by members of Gaylesta are transgender and gender nonconforming persons. While we anticipate that our members would describe themselves as transgender/gender-affirming clinicians, there is a considerable difference between that, having a defined competence in working with transgender/gender nonconforming persons, and being a gender specialist. Among our members, we have a number of clinicians who are gender specialists, as well as a number who have a great deal of experience in working with transgender and gender nonbinary persons. With their aid, the Board felt it was important to create an online resource for our members to both help them identify their levels of competence in working with this population, and providing resources for those who wish to further their clinical training and ability to work with these clients.

We have created a series of webpages for our members. Lisette Lahana, LCSW has kindly shared a document that she has written that covers the following topics:

We have created links in these webpages to many of the resources mentioned. Members can also download a PDF of Lisette Lahana’s full write-up here.

In addition, we encourage our members to review other resources available online, including the American Psychological Association’s Guidelines for Psychological Practice with Transgender and Gender Nonconforming People, The World Professional Association for Transgender Health’s (WPATH’s) Standards of Care for the Health of Transsexual, Transgender and Gender Nonconforming People, Version 7, and the UCSF Center of Excellence for Transgender Health’s Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, Members may also be interested in an article co-authored by Gaylesta member Sand Chang, PhD, Providing competent and affirming services for transgender and gender nonconforming older adults in Clinical Gerontologist, an article in Lancet, Serving transgender people: Clinical care considerations and service delivery models in transgender health (free to download if one registers at this site — see upper right corner of this webpage). There are also useful write-ups (and potential client handouts) on the FORGE website.

Of course, there are also many professional journal articles and books that can be found in libraries or available for purchase as well. One of note is the June 2016 issue of Psychology of Sexual Orientation & Gender Diversity (vol. 3, no. 2), with a special section, Transgender and Gender Nonconforming Guidelines. Among the nine papers in this section are: "Affirming psychological practice with transgender and gender nonconforming people of color" (co-authored by Sand Chang and Anneliese Singh); "Missteps in psychotherapy with transgender clients: Promoting gender sensitivity in counseling and psychological practice;" "Affirmative practice with transgender and gender nonconforming youth: Expanding the model;" "Family creation options for transgender and gender nonconforming people;" "Experiences of older transgender and gender nonconforming adults in psychotherapy: A qualitative study."

We have also created a public webpage that we hope will help transgender and gender nonconforming persons seeking psychotherapy to identify the level of expertise potential psychotherapists have in this area. For helping with that, we must thank another Gaylesta member who is a gender specialist, Koen Baum, LMFT, for both drafting this document and helping to initiate this project.