TORONTO — Psychologists who work with transgender or gender nonconforming people should seek to provide acceptance, support and understanding without making assumptions about their clients’ gender identities or gender expressions, according to practice guidelines adopted during the American Psychological Association’s 123rd Annual Convention.
The “Guidelines for Psychological Practice with Transgender and Gender Nonconforming People” were adopted by APA’s Council of Representatives at its meeting Aug. 5. They were drafted by an APA task force in the wake of an APA survey in 2009 that found less than 30 percent of psychologist and graduate student respondents were familiar with the issues that transgender and gender nonconforming people face.
“These guidelines are especially timely in light of the media coverage of recent completed suicides by transgender teens and murders across the country of transgender people, especially people of color. In contrast, we have also seen coverage of high-profile transitions, including Caitlyn Jenner and Laverne Cox of ‘Orange is the New Black,’” said lore m. dickey, PhD, task force co-chair. “While these guidelines are aimed at psychologists who provide care, conduct research or engage in education or training focused on transgender and gender nonconforming people, we believe they will also be useful to any psychologist or educator.”
The document lays out 16 guidelines aimed at helping professionals better understand the lifespan development, stigma, discrimination and barriers to care faced by this population, as well as the state of research surrounding transgender and gender nonconforming people.
“We hope that these guidelines provide useful information that will enable psychologists to provide competent, sensitive and well-informed care and research,” said Anneliese A. Singh, PhD, the task force’s other co-chair. “Additionally, they are written in everyday language so they may be helpful to virtually anyone seeking a deeper understanding of transgender and gender nonconforming people. It is critically important that psychologists are informed about how to not only work with transgender people across the lifespan, but also understand that transgender people have existed in multiple cultures and countries around the world for hundreds of years.”
One of the guidelines explains that the concept of gender goes beyond male and female, and that people may experience a range of gender identities that don’t align with their sex assigned at birth. Another guideline explains that gender identity and sexual orientation are “distinct but interrelated constructs.”
“For most people, gender identity develops earlier than sexual orientation,” it says. “Gender identity is often established in young toddlerhood, in comparison to awareness of sexual orientation, which often emerges in early adolescence. … Just as some people experience their sexual orientation as being fluid or variable, some people also experience their gender identity as fluid.”
Other guidelines address the developmental needs of gender-questioning youth and encourage psychologists to work with other health care providers to coordinate the care of transgender and gender nonconforming clients.
APA practice guidelines are aspirational; in other words, they set ideals to which APA encourages psychologists to aspire. The new guidelines encourage psychologists to use them in tandem with APA’s Ethical Principles of Psychologists and Code of Conduct and with treatment guidelines, such as those set forth by the World Professional Association for Transgender Health Standards of Care and the Endocrine Society.
Members of the APA Task Force on Guidelines for Psychological Practice with Transgender and Gender Nonconforming People were:
- lore m. dickey, PhD, Louisiana Tech University, co-chair
- Anneliese A. Singh, PhD, University of Georgia, co-chair
- Walter O. Bockting, PhD, Columbia University
- Sand Chang, PhD, independent practice
- Kelly Ducheny, PsyD, Howard Brown Health Center
- Laura Edwards-Leeper, PhD, Pacific University
- Randall D. Ehrbar, PsyD, Whitman-Walker Health
- Max Fuentes Fuhrmann, PhD, independent practice
- Michael L. Hendricks, PhD, Washington Psychological Center, P.C.
- Ellen Magalhaes, PhD, Nova Southeastern University and Alliant International University
A copy of the guidelines can be found online (PDF, 617KB).
The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. APA's membership includes more than 122,500 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives.