The Gender Affirmative Model

This book provides mental health professionals with a guide to the Gender Affirmative Model, the leading approach to providing culturally competent care to transgender and gender expansive children and their families.

In recent years, there has been an explosion in the number of children and young people who diagnose themselves as gender dysphoric, or trans. In the UK, and worldwide, there is a growing tendency to refer them on to 'specialist' gender services almost as soon as they express any confusion or distress about their biological sex or gender identity. Due to the rapidly rising numbers and various pressures on the system, patients are increasingly likely to be offered life-altering medication and/or surgical treatments, often with little exploration of their emotional world. As so little is yet known or understood regarding this increase in gender incongruent patients, it seems precipitous to proceed onto physical treatments before any assessment work is undertaken. Many who present as gender dysphoric have complex needs with comorbid problems such as autism, histories of abuse or trauma, social phobias, depression, eating disorders, and other mental health symptoms. Therefore, all aspects of the individual's life deserve thorough assessment and therapeutic work. This book is aimed primarily at clinicians working in the field to provide a model for understanding, assessing, and treating gender dysphoria. The model uses a psychoanalytic framework to help explain disturbed states of mind and how psychic defences can be enlisted unconsciously to avoid overwhelming psychic pain. This offers professionals a way of trying to think with, and offer understanding to, their trans-identifying clients. Clinical examples are given to illustrate these processes and promote the understanding of transgender children, adolescents, and young people and their internal worlds, their thinking, and their interpersonal relationships. As well as clinical exploration and understanding, the book includes an overview of the current political, social, and clinical environments which have all impacted on the clinical care of trans-identifying individuals. As well as professional and trainee clinicians, this book might also prove useful to parents, other professionals, and possibly the gender dysphoric person too.

A how-to guide to affirmative counseling with transgender clients Presents the best evidence-based care Instructions for strategies to improve inclusivity Illustrated with case studies Printable tools for clinical use Expert guidance on how to provide competent gender-affirming care to trans people This volume provides fundamental and evidence-based information on working with transgender and gender diverse people in mental health settings. It provides background information on the historical context of care with transgender clients, clarifying terminology, and helping the reader understand diverse experiences of gender. The expert authors outline the key qualities of competent practice with trans clients, such as the use of affirming language and providing a safe environment, and strategies for improving inclusivity and evidence-based care. dickey and Puckett provide insight into current topics, such as the proper use of pronouns, working with youth, suicide and self-injury, and problematic approaches such as conversion therapy and rapid onset gender dysphoria. Practitioners will find the printable resources invaluable for their clinical practice, including sample letters of support for trans clients who are seeking gender-affirming medical care.

This unique resource offers an in-depth, comprehensive look at different types of mental health needs of transgender and gender diverse youth, how these intersect with gender identity, gender expression, and sexual orientation, and provides practical information on how to ethically, responsibly, and sensitively care for these patients. Affirmative Mental Health Care for Transgender and Gender Diverse Youth: A Clinical Guide begins with three introductory chapters which contain practical information regarding assessment, psychological interventions, and the potential medical and surgical interventions that are indicated for youth with gender identity concerns. The remaining chapters are illustrated by multiple cases build around overarching chapter themes. Each case chapter opens with broad questions applicable to clinical practices, while the cases themselves focus on a particular co-occuring mental health condition. The case chapters are structured with intersectionality in mind, including elements of ethnic, racial, and cultural diversity, and the patients range over the full developmental spectrum, from pre-pubertal children to older adolescents. Chapter cases range in complexity as well, to provide readers with the tools they need to evaluate patients, and to assist in the decision of which presenting factors to prioritize in treatment at which time. Ending each chapter are clinical take-home messages, closing with additional practical knowledge that can be applied to other cases providers may see in their own practices. Written by expert clinicians in the field, Affirmative Mental Health Care for Transgender and Gender Diverse Youth: A Clinical Guide is an ideal resource not only for child and adolescent psychiatrists, but for clinicians across all mental health disciplines working with gender non-conforming youth, and who are interested in providing informed, affirmative, and intersectional care.

This clinical guide reviews theory-based strategies for affirmative, competent practice with transgender and gender nonconforming clients of different ages, ethnicities, sexual orientations, and religious backgrounds. Readers will learn how to develop collaborative, client-driven partnerships to ensure optimal therapeutic outcomes. Less than 30% of psychologists report familiarity with transgender and gender nonconforming (TGNC) clients' needs. The clients, in turn, report a lack of support in their gender journeys. There is clearly a large gap in knowledge, skill, and competence in this area of practice. This clinical guide aims to fill that gap by providing mental health practitioners with an affirmative approach that emphasizes a collaborative partnership guided by client-driven goals. An expert panel of contributors teaches readers strategies for working with a diverse array of TGNC clients, including adolescents, older adults, parents, and people of color. Client factors, including sexual orientation, religious and spiritual beliefs, and traumatic experiences, are also given special attention. Readers will learn how to address the impact of the injustices TGNC people face in everyday life, work with clients' strengths to enhance their resilience and coping skills, and advocate for their rights to obtain mental and physical health services. Readers will also learn how to negotiate complex issues, such as interdisciplinary care, ethical and legal obligations, and gender-affirming surgeries and medications. Contributors draw from evidence-based theories and APA's Guidelines for Psychological Practice With Transgender and Gender Nonconforming People to help readers meet the latest standards of care.

From a leading US authority on a subject more timely than ever—an up-to-date, all-in-one resource on gender-nonconforming children and adolescents In her groundbreaking first book, Gender Born, Gender Made, Dr. Diane Ehrensaft coined the term gender creative to describe children whose unique gender expression or sense of identity is not defined by a checkbox on their birth certificate. Now, with The Gender Creative Child, she returns to guide parents and professionals through the rapidly changing cultural, medical, and legal landscape of gender and identity. In this up-to-date, comprehensive resource, Dr. Ehrensaft explains the interconnected effects of biology, nurture, and culture to explore why gender can be fluid, rather than binary. As an advocate for the gender affirmative model and with the expertise she has gained over three decades of pioneering work with children and families, she encourages caregivers to listen to each child, learn their particular needs, and support their quest for a true gender self. The Gender Creative Child unlocks the door to a gender-expansive world, revealing pathways for positive change in our schools, our communities, and the world.

Transgender and gender nonconforming (TNGC) clients have complex mental health concerns, and are more likely than ever to seek out treatment. This comprehensive resource outlines the latest research and recommendations to provide you with the requisite knowledge, skills, and awareness to treat TNGC clients with competent and affirming care. As you know, TNGC clients have different needs based on who they are in relation to the world. Written by three psychologists who specialize in working with the TGNC population, this important book draws on the perspective that there is no one-size-fits-all approach for working with TNGC clients. It offers interventions tailored to developmental stages and situational factors—for example, cultural intersections such as race, class, and religion. This book provides up-to-date information on language, etiquette, and appropriate communication and conduct in treating TGNC clients, and discusses the history, cultural context, and ethical and legal issues that can arise in working with gender-diverse individuals in a clinical setting. You’ll also find information about informed consent approaches that call for a shift in the role of the mental health provider in the position of assessment and referral for the purposes of gender-affirming medical care (such as hormones, surgery, and other procedures). As changes in recent transgender health care and insurance coverage have provided increased access for a broader range of consumers, it is essential to understand transgender and gender nonconforming clients’ different needs. This book provides practical exercises and skills you can use to help TNGC clients thrive.

First-hand accounts of how parents support their transgender children There is a new generation of parents and families who are identifying, supporting, and raising transgender children. In Trans-Affirmative Parenting, Elizabeth Rahilly presents their fascinating stories, interviewing parents of children who identify across the gender spectrum, as well as the doctors, mental health practitioners, educators, and advocates who support their journeys. Rahilly provides a window into parents' experiences, exploring how they come to terms with new ideas about gender, sexuality, identity, and the body, as well as examining their complex deliberations about nonbinary possibilities and medical interventions. Ultimately, Rahilly compassionately shows how parents can best advocate for transgender awareness and move beyond traditional gendered expectations. She also shows that child-centered, child-driven parenting is as central to this new trans-affirmative paradigm as growing LGBTQ awareness. In an era that is increasingly trans-aware, Trans-Affirmative Parenting offers provocative new insights into transgender children and the parents who raise them.