Report of the APA Task Force on Gender Identity and Gender Variance

In recent years, transgender people have increasingly been willing to identify themselves openly. Public awareness of transgender issues has increased dramatically, in part because of an increasing number of books, motion pictures and television programs featuring transgender characters and addressing transgender issues. As a result, not only transgender people themselves but also their families and friends, employers, schools and government agencies are increasingly turning to psychologists for help in addressing these issues on individual and community levels. At the same time, changes in service delivery systems related to transgender issues have resulted in transsexuals and other people with gender identity concerns more frequently turning to community mental health professionals for assessment and treatment.

Consequently, it has become increasingly likely that psychologists will encounter people needing assistance with gender identity concerns. This trend underscores the need for psychologists to acquire greater knowledge and competence in addressing transgender issues.

In February 2005, the Council of Representatives of the American Psychological Association (APA) authorized the appointment of a Task Force on Gender Identity and Gender Variance. The task force was charged with the following:

• Review extant APA policies regarding these issues and affected populations and recommend any indicated changes.

• Develop recommendations for education, training, and further research into these topics.

• Propose how APA can best meet the needs of psychologists and students who identify as transgender or gender variant.

• Recommend appropriate collaboration with other professional organizations concerning these issues.

The task force reviewed APA policy documents,including bylaws, association rules, policies and procedures, the Ethical Principles of Psychologists and Code of Conduct (APA, 2002), practice guidelines, criteria for continuing education content and sponsorship, resolutions, and the Guidelines and Principles for Accreditation of Programs in Professional Psychology (APA Committee on Accreditation, 2006). On the basis of this review, the task force made specific policy recommendations in a number of areas.

They proposed, among other things, the development of practice guidelines for transgender and gender variant clients. Although there may not be sufficient research concerning many transgender issues to develop empirically based guidelines related to all important areas of practice, the task force agreed that there was adequate research concerning discrimination and stereotyping to support the development of clinical guidelines addressing these issues specifically.

The task force noted that APA is in a position to advocate on behalf of transgender people in the same way it advocates on behalf of many other disadvantaged groups: through activities such as lobbying and filing amicus briefs. Specific policy areas that would appropriately be a focus of such advocacy include access to transition-related health care, appropriate placement and treatment within sex-segregated facilities, and access to appropriate legal documents.

APA sponsors a variety of education and training activities and services for members, including hosting conventions, providing continuing education opportunities, publishing books and journals, and accrediting training sites. To meet its public education mandate, APA also publishes brochures, reports, periodicals, and Internet materials designed for laypersons. Accordingly, we believe that APA is well positioned to address the educational needs of its members and the general public regarding issues of transgender and gender variance.

To address the needs of psychologists, students, and interested members of the public, we outlined three levels of information, including specific products that should be available at these levels:

• Basic information on transgender issues would be readily available to all psychologists and students of psychology as an element of cultural competence and would also be available to interested members of the public.

• Intermediate-level information concerning transgender issues is important for psychologists who work with transgender clients and for interested members of the public; such information would address clinical presentations, prevalence, etiology, life span development, assessment and treatment, comorbidity, and aspects of
  cultural competency.

• Advanced or specialized information concerning transgender issues would include a more in-depth consideration of the topics listed under intermediate-level resources; this information would be most relevant to clinicians working intensively with transgender clients and to students with particular interests in transgender issues.

In support of these aims, the task force created an educational brochure concerning transgender issues, intended for APA members and the general public.

The task force surveyed transgender psychologists and students and identified several broad categories of needs related to their status as transgender persons. These included more education, training, and research devoted to transgender issues; greater protection from discrimination; greater acceptance, mentoring, advocacy, and demonstration of ally status by colleagues; and increased recognition that transgender persons are experts regarding their own issues.

We identified a variety of specific needs related to educational and workplace settings. These included promotion of education regarding transgender issues in accredited training programs and internships sites; access to facilities that are typically segregated by sex, such as restrooms; confidential document management that reflects
the individual’s gender identity; and access to appropriate medical care and health insurance.

Within APA itself, specific needs included collection of demographic information regarding transgender status in relevant surveys of APA members; review of existing APA employment policies to ensure that they support equal employment opportunities for transgender people; and review of health insurance programs offered to APA members to ensure that they include transgender-related health care.

The task force identified six professional organizations with substantial expertise in transgender issues and with which APA should consider collaboration:

HBIGDA, now known as The World Association for Transgender Health,

The Society for the Scientific Study of Sexuality,

The Council on Sexual Orientation and Gender Expression of the Council on Social Work Education,

The American Psychiatric Association,

The International Association for Social Work Research and

The American Public Health Association.

They also identified several other professional organizations and community-based organizations that have an interest in these issues and that could be considered for collaboration.

Members
Margaret S. Schneider, PhD, Chair
Walter O. Bockting, PhD
Randall D. Ehrbar, PsyD
Anne A. Lawrence, MD, PhD
Katherine Rachlin, PhD
Kenneth J. Zucker, PhD

APA Public Interest Directorate Staff
Clinton W. Anderson, Director, Lesbian, Gay, Bisexual, and Transgender Concerns Office
Charlene DeLong, Administrative Coordinator