August 17, 2008

APA Resolves to Play Leading Role in Improving Treatment for Gender-Variant People

Gender identity task force calls for nondiscriminatory guidelines, better research and training

BOSTON—The American Psychological Association urged psychologists today to take a leading role in ending discrimination based on gender identity, calling upon the profession to provide "appropriate, nondiscriminatory treatment to all transgender and gender-variant individuals" and encouraging more research into all aspects of gender identity and expression.

The action came at APA's Annual Convention when the association's governing Council of Representatives adopted a resolution supporting full equality for transgender and gender-variant people. The resolution also calls on APA to:

  • support legal and social recognition of transgender individuals consistent with their gender identity and expression;
  • support the provision of adequate and medically necessary treatment for transgender and gender-variant people;
  • recognize the benefit and necessity of gender transition treatments for appropriately evaluated individuals;
  • call on public and private insurers to cover these treatments.

In addition to adopting the wide-ranging resolution, the Council of Representatives received a report by APA's Task Force on Gender Identity and Gender Variance. The six-member task force spent more than two years reviewing the scientific literature, as well as APA policies regarding transgender issues. It was also charged with developing recommendations for education, professional training and further research into transgenderism, and proposing how APA can best meet the needs of psychologists and students who identify as transgender or gender-variant.

Noting that transgender people, their families, friends and employers are increasingly turning to psychologists for help, "this trend underscores the need for psychologists to acquire greater knowledge and competence in addressing transgender issues," the report states.

Among the report's recommendations:

  • APA should encourage training programs and graduate internships to welcome and support transgender and gender-variant people;
  • APA should develop separate practice guidelines for transgender clients;
  • APA should encourage more research into gender identity and expression, including the reliability and validity of diagnostic criteria for gender identity disorders;
  • APA should advocate for antidiscrimination protection for transgender people in jurisdictions that lack such laws.

With regard to research, the task force listed a series of recommended areas of focus, including social stigma and public attitudes toward gender identity; identity development, including prospective studies of children and adolescents; the process and outcome of transgender-specific health care; and the variables associated with the efficacy of sex reassignment.

As a direct result of the task force's work, APA added gender identity to its nondiscrimination policy earlier this year. This builds upon prior adoption of gender identity nondiscrimination language in APA's bylaws, Code of Ethics and its Guidelines and Principles for Accreditation of Professional Programs in Psychology.

In addition, the task force developed a brochure, Answers to Your Questions about Transgender Individuals and Gender Identity, which APA published in 2006 and has made available on its Web site.

The task force recommended that APA take no position with respect to the diagnosis of gender identity disorder, which is sometimes required for transgender clients to obtain needed care. "Psychologists who work with clients with gender identity issues are not of one mind on this issue," task force members wrote. They noted that the psychiatric profession publishes the Diagnostic and Statistical Manual, which contains GID, "and thus revision is their responsibility."

The report noted that APA has previously adopted resolutions discouraging psychologists from using diagnoses that are potentially harmful or discriminatory. "Accordingly, if there were evidence showing the GID diagnosis to be similarly harmful and discriminatory against gender-variant, transgender or transsexual people, there would be a precedent for a resolution discouraging psychologists from using this diagnosis," the task force wrote. "However … there is a great deal of disagreement about the GID diagnosis and whether it is helpful or harmful; therefore, the Task Force does not recommend that APA take a position on GID at this time."

It is APA's position that no psychological disorder should be stigmatized or used as the basis for discrimination.

Task force members:
Chair: Margaret Schneider, PhD, University of Toronto, Canada;
Walter O. Bockting, PhD, University of Minnesota Medical School;
Randall D. Ehrbar, PsyD; New Leaf Services Our Community, San Francisco;
Anne A. Lawrence, MD, PhD, Seattle; Katherine Rachlin, PhD, New York;
Kenneth J. Zucker, PhD, Centre for Addiction and Mental Health, Toronto, Canada

For more information/interview contact Margaret Schneider, PhD, at (416) 978-0684 or by e-mail.

The American Psychological Association (APA), based in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 148,000 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 psychology as a science, as a profession and as a means of promoting human welfare.