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    There is a common misconception that science does not support the transgender community. This is a collection of official guidelines, policies, and positions from major medical, mental health, and educational associations stating their support for transgender and gender nonconforming individuals. These associations are in agreeance transgender people deserve equal treatment, the ability to socially, legally, and medically transition, identifying as transgender is not a mental illness, and one’s gender identity cannot be changed. 

    American Academy of Child and Adolescent Psychiatry

    “The American Academy of Child & Adolescent Psychiatry rejects all public and private discrimination based on sexual orientation or gender identity of persons of any age particularly in the areas of employment, military service, housing, public accommodations, membership, licensing, promotion or assignment, education, training, marriage, adoption, parenting, foster care, or qualification as an expert in a court of law. The AACAP affirms the right of all people to their orientation and identity without interference or coercive interventions attempting to change sexual orientation or gender identity. Further, the AACAP condemns any restriction on employment or service based on sexual orientation or gender identity in positions involving the delivery of services or treatments to children and adolescents.” “Children and adolescents who are gay, lesbian, or bisexual, and those with gender nonconformity or gender discordance may be affected by negative attitudes, putting them at risk of certain mental health conditions. The American Academy of Child and Adolescent Psychiatry (AACAP) has released practice principles to consider when caring for these patients.”

    American Academy of Child and Adolescent Psychiatry. “Sexual Orientation, Gender Identity, and Civil Rights.” Sexual Orientation, Gender Identity, and Civil Rights. American Academy of Child and Adolescent Psychiatry, 2009. Web. 29 Oct. 2016. <http://www.aacap.org/AACAP/Policy_Statements/2009/Sexual_Orientation_Gender_Identity_and_Civil_Rights.aspx>

    Randel, Amber. “AACAP Releases Practice Parameter on Sexual Orientation, Gender Nonconformity, and Gender Identity Issues in Children and Adolescents.” Practice Guidelines: AACAP Releases Practice Parameter on Sexual Orientation, Gender Nonconformity, and Gender Identity Issues in Children and Adolescents – American Family Physician. American Academy of Child and Adolescent Psychiatry, Aug. 2013. Web. 23 Dec. 2016. <http://www.aafp.org/afp/2013/0801/p202.html>.

    American Academy of Family Physicians

    “Cross-sex hormone therapy appears to improve mental health outcomes and quality of life for transgender persons”

    “The American Academy of Family Physicians today reaffirmed its policies against discrimination by approving a resolution that specifically opposes state and federal laws that compromise the safety and health of transgender people. The action, which opposes laws prohibiting transgender people from using public facilities that match their identity, adds to the AAFP’s long-standing policy against discrimination. AAFP’s policy opposes “all discrimination in any form, including but not limited to, that on the basis of actual or perceived race, color, religion, gender, sexual orientation, gender identity, ethnic affiliation, health, age, disability, economic status, body habitus or national origin.”

    Champlin, Leslie, Senior Public Relations Strategist. “AAFP Reaffirms Antidiscrimination Policy with Vote on Transgender Equality.” AAFP Reaffirms Antidiscrimination Policy with Vote on Transgender Equality. American Academy of Family Physicians, 20 Sept. 2016. Web. 28 Oct. 2016. <http://www.aafp.org/media-center/releases-statements/all/2016/transgender-equality.html>.

    American Academy of Pediatrics

    “The American Academy of Pediatrics (AAP), a nonprofit organization representing 64,000 pediatricians dedicated to the health, safety and well-being of all infants, children, adolescents and young adults, and its North Carolina chapter, representing 2,000 pediatric care professionals serving children in the state, join in calling for the repeal of HB2, legislation recently signed into law by North Carolina governor Pat McCrory.”All gender nonconforming children (regardless of whether they later identify as straight, gay, lesbian, bisexual, or transgender), are at risk for bullying and mental health problems.

    “A large proportion of teenage suicide attempts are linked to issues of gender and sexuality, and many gay, lesbian, bisexual, and transgender youth attempt suicide. As a parent, your most important role is to offer understanding, respect, and support to your child. A non-judgemental approach will gain your child’s trust and put you in a better position to help him or her through difficult times. You need to be supportive and helpful, no matter what your child’s gender identity or sexual orientation may be. Research has shown that supportive families greatly reduce a teen’s risk of suicide.”

    “Researchers found that children allowed to exhibit their gender, by changing their names, clothing, pronoun use, and hairstyles, had normal levels of depression, and anxiety levels only slightly above their peers.”

    American Academy of Pediatrics Opposes Legislation That Discriminates Against Transgender Children.” American Academy of Pediatrics Opposes Legislation That Discriminates Against Transgender Children. The American Academy of Pediatrics, n.d. Web. 18 Oct. 2016. https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAPOpposesLegislationAgainstTransgenderChildren.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3A%2BNo%2Blocal%2Btoken 

    American Academy of Pediatrics. “Gender Non-Conforming & Transgender Children.” HealthyChildren.org. American Academy of Pediatrics, 21 Nov. 2015. Web. 28 Oct. 2016.  https://healthychildren.org/English/ages-stages/gradeschool/Pages/Gender-Non-Conforming-Transgender-Children.aspx

    American Academy of Pediatrics. “Transgender Preadolescents Have Good Mental Health Outcomes after Transitioning Gender Identities.” HealthyChildren.org. American Academy of Pediatrics, 26 Feb. 2016. Web. 28 Oct. 2016. https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Transgender-Preadolescents-Have-Good-Mental-Health-Outcomes-After-Transitioning-Gender-Identities.aspx ttps://healthychildren.org/English/news/Pages/Transgender-Preadolescents-Have-Good-Mental-Health-Outcomes.aspx 

    American Association for Marriage and Family Therapy

    “Due to societal and cultural stigma and oppression that trans clients still face in the United States, they need social support. This support may come from inside and/or outside the family system. When adequate support is not found within the family, therapists can assist clients in finding alternative support systems, such as continued therapy, connections with other trans people, friendships, and online support. When working with minors, it is also important for family therapists to highlight to families how their support is a protective key factor for their children.”

    American Association for Marriage and Family Therapy. “Gender Identity.” Gender Identity. American Association for Marriage and Family Therapy, n.d. Web. 18 Oct. 2016.  https://www.aamft.org/Consumer_Updates/Gender_Identity.aspx

    American College of Nurse-Midwives

    “The American College of Nurse-Midwives (ACNM) supports efforts to provide transgender, transsexual, and gender variant individuals with access to safe, comprehensive, culturally competent health care and therefore endorses the 2011 World Professional Association for Transgender Health (WPATH) Standards of Care.

    It is the position of ACNM that midwives Exhibit respect for patients with nonconforming gender identities and do not pathologize differences in gender identity or expression; Provide care in a manner that affirms patients’ gender identities and reduces the distress of gender dysphoria or refer to knowledgeable colleagues;

    Become knowledgeable about the health care needs of transsexual, transgender, and gender nonconforming people, including the benefits and risks of gender affirming treatment options;

    Match treatment approaches to the specific needs of patients, particularly their goals for gender expression and need for relief from gender dysphoria; Have resources available to support and advocate for patients within their families and communities (schools, workplaces, and other settings).”

    The American College of Nurse-Midwives. “Position Statement: Transgender/Transsexual/Gender Variant Health Care.”Transgender/Transsexual/Gender Variant Health Care (2012): 1-4.Http://www.midwife.org/. The American College of Nurse-Midwives, Dec. 2012. http://www.midwife.org/ACNM/files/ACNMLibraryData/UPLOADFILENAME/000000000278/Transgender%20Gender%20Variant%20Position%20Statement%20December%202012.pdf 

    American College of Obstetricians and Gynecologists

    “Transgender individuals face harassment, discrimination, and rejection within our society. Lack of awareness, knowledge, and sensitivity in health care communities eventually leads to inadequate access to, underutilization of, and disparities within the health care system for this population. Although the care for these patients is often managed by a specialty team, obstetrician–gynecologists should be prepared to assist or refer transgender individuals with routine treatment and screening as well as hormonal and surgical therapies. The American College of Obstetricians and Gynecologists opposes discrimination on the basis of gender identity and urges public and private health insurance plans to cover the treatment of gender identity disorder.”

    Obstetrician–gynecologists should be prepared to assist or refer transgender individuals. Physicians are urged to eliminate barriers to access to care for this population through their own individual efforts. An important step is to identify the sexual orientation and gender identity status of all patients as a routine part of clinical encounters and recognize that many transgender individuals may not identify themselves. The American College of Obstetricians and Gynecologists urges health care providers to foster nondiscriminatory practices and policies to increase identification and to facilitate quality health care for transgender individuals, both in assisting with the transition if desired as well as providing long-term preventive health care”

    American College of Obstetricians and Gynecologists. “Health Care for Transgender Individuals.” ACOG, Dec. 2011, www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2011/12/health-care-for-transgender-individuals 

    American College of Physicians

    “The American College of Physicians recommends that public and private health benefit plans include comprehensive transgender health care services and provide all covered services to transgender persons as they would all other beneficiaries.”

    Daniel, Hilary, BS, Renee Butkus, BA, and Health and Public Policy Committee of the American College of Physicians. “Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians Free.” LGBT Health Disparities. American College of Physicians, 21 July 2015. <http://annals.org/aim/article/2292051/lesbian-gay-bisexual-transgender-health-disparities-executive-summary-policy-position>.

    American Counseling Association

    Regardless of the stage of life in which individuals with gender identity disorder find themselves, the key root of their cross-identification behavior is the conflict over their biological sex role and their perceived sexual identity . The acting out of cross-dressing; cross-identification; and active pursuit of hormonal, social, and medical approaches to alter their appearance are all conducted by these individuals in order to ensure that their biological characteristics or appearance corresponds to their mental social identity, thereby providing relief for the internal conflict over their sex role”

    American Counseling Association. “The Latest News from ACA.” Ethical Issues Related to Conversion or Reparative Therapy. American Counseling Association, 16 Jan. 2015.  <http://www.counseling.org/news/updates/2013/01/16/ethical-issues-related-to-conversion-or-reparative-therapy>.

    Kirk, James, and Robert Belovics. “Understanding and Counseling Transgender Clients.” Http://onlinelibrary.wiley.com/. Journal of Employment Counseling, Mar. 2008.  <http://onlinelibrary.wiley.com/doi/10.1002/j.2161-1920.2008.tb00042.x/epdf>.

    American Educational Research Association

    “Beginning in 2017, AERA members will have the option to select from an expanded list of gender categories when renewing their membership or joining the Association. Recognizing that the traditional gender category options of “female,” “male,” and “other gender” fail to capture the full spectrum of gender identities and expressions, AERA Council approved the use of a new gender identity question and an expanded set of gender categories at its February 2016 meeting. AERA’s demographic data collection will now include five gender categories”

    American Educational Research Association. “AERA Expands Gender Category Options for Member.” AERA Expands Gender Category Options for Member. AERA, Apr. 2016. http://www.aera.net/Newsroom/AERA-Highlights-E-newsletter/AERA-Highlights-April-2016/AERA-Expands-Gender-Category-Options-for-Member

    American Educational Research Association. “LGBTQ Issues in Education.” LGBTQ Issues in Education. AREA, 9 July 2015.  http://www.aera.net/Education-Research/Issues-and-Initiatives/LGBTQ-Issues-in-Education

    American Hospital Associations

    “Similarly, behavioral health group therapy sessions may be organized for groups of individuals facing similar concerns so that they might better support each other in recovery. That might mean that groups formed as part of a treatment for female rape victims may need to exclude males to promote a more open dialogue, or groups formed to help transgender individuals deal with the prejudices they face would only include transgender individuals”

    “As hospitals expand their focus on providing equitable care, attention on those who are lesbian, gay, bisexual, transgender and intersex (LGBTI) is critically important. Dr. Makadon, director of the National LGBTI Health Education Center at The Fenway Institute at Fenway Health, works with organizations across the country to create more affirming and inclusive care environments for LGBTI people through research and evaluation, education and training, and public health advocacy. Their mission is to ensure access to high quality, culturally competent medical and mental health care for traditionally undeserved communities.”

    Thompson, Ashley. “Re: NPRM on Nondiscrimination in Health Programs and Activities.” November 5, 2015 American Hospital Association, 15 Nov. 2015. http://www.aha.org/advocacy-issues/letter/2015/151105-cl-nprm-nondis.pdf

    Hospitals In Pursuit of Excellence. “Ensuring Access and High-Quality Care for LGBT Patients.” HPOE.org. American Hospital Association, n.d. Web. 18 Oct. 2016. <http://www.hpoe.org/resources/hpoe-live-webinars/2634>.

    American Medical Association

    The American Medical Association (AMA) and 15 additional medical, mental health, nursing and other health care organizations filed a joint friend-of-the-court brief urging the Supreme Court of the United States to rule in favor of protecting transgender individuals from employment discrimination to ensure their physical and mental health.

    The brief was submitted in the cases of Bostock v. Clayton County, Georgia, Altitude Express Inc. v. Zarda and R.G. & G.R. Harris Funeral Homes Inc. v. Equal Employment Opportunity Commission, which consider whether Title VII of the Civil Rights Act of 1964 protections against discrimination on the basis of “sex” include sexual orientation and gender identity.

    The AMA-led brief cites more than four dozen studies and papers demonstrating the consensus among health care professionals regarding: what it means to be transgender; the protocols for the treatment of gender dysphoria, which include living in accordance with one’s gender identity in all aspects of life; and the predictable harms discrimination poses to the health and well-being of transgender individuals.

    The brief, intended to inform the high court, maintains that “being transgender implies no impairment in a person’s judgment, stability, or general social or vocational capabilities.” Despite this medical consensus, there is evidence of widespread employment discrimination against transgender people that exacerbates gender dysphoria, frustrates medical treatment, and impedes access to health care when such discrimination results in a person losing income or health insurance.

    Many transgender individuals are diagnosed with gender dysphoria, a condition that is characterized by clinically-significant distress and anxiety resulting from the incongruence between an individual’s gender identity and birth-assigned sex. Medical treatments are effective in alleviating gender dysphoria. But according to the brief, “employment discrimination against transgender people frustrates the treatment of gender dysphoria by preventing transgender individuals from living openly in accordance with their true gender identity and impeding access to needed medical care.”

    “AMA: Leading Medical Organizations Fight for Transgender Americans.” American Medical Association, 10 July 2019, www.ama-assn.org/press-center/press-releases/ama-leading-medical-organizations-fight-transgender-americans 

    American Medical Student Association

    “Transgender is an umbrella term for a diverse group of people—such as trans women (male-to-female) and trans men (female-to-male), genderqueer individuals, and many others—whose gender identity or expression differs from societal expectations of how they should look, act, or identify based on the sex they were assigned at birth. Transgender and other gender minority people are often the targets of discrimination and harassment that can lead to negative health outcomes.

    Transgender people face numerous health disparities as well as stigma, discrimination, and lack of access to quality care. Some health disparities include an increased risk of HIV infection, especially among transgender women of color, and lower likelihood of preventive cancer screenings in transgender men. See the graphic below for more information.

    There is much controversy surrounding transgender identity and the field of mental health. At the moment, transgender people often receive medical care under the diagnosis of ‘Gender Dysphoria’ found in the Diagnostic and Statistical Manual of Mental Disorders V, while in the past being diagnosed with ‘Gender Identity Disorder,’ now considered an outdated and incorrect term. Many people believe that transgender identity is NOT a mental disorder and should be a medical, rather than psychiatric, diagnosis. Some physicians use the diagnosis, ‘endocrine disorder otherwise unspecified,’ to avoid using a psychiatric diagnosis altogether. Most people recognize that even though transgender identity is truly a medical issue, the social stigma associated with the identity can create a difficult situation for those who identify as transgender. Therefore, many physicians recommend consultation with a mental health care professional if the patient so desires.”

    American Medical Student Association. “Transgender Health – AMSA.”Http://www.amsa.org. American Medical Student Association, 2015.<http://www.amsa.org/advocacy/action-committees/gender-sexuality/transgender-health/>.

    American Mental Health Counselors Association

    “These important pieces of legislation would prohibit persons who are licensed to provide professional counseling and various health practitioners from engaging in conversion therapy with person who is younger than 18 years of age. The bill These bills specifically affect professionals licensed under FS 491 including (2) (a) Licensed Mental Health Counselors (LMHC), Licensed Marriage and Family Therapists (LMFT) and Licensed Clinical Social Workers as well as other specified professionals licensed in the State of Florida under other chapters.
    Conversion Therapy or Reparative Therapy consists of clinical efforts to change an individual’s sexual orientation, gender identity, or gender expression (SAMHSA, 2015). This type of therapy has been controversial and finds little support in the mental health community and the general public.
    The American Mental Health Counselors Association and The American Counselors Association have both taken strong positions in respect to sexual orientation and mental health. Both national organizations affirm the potential for great psychological harm and take the position that therapeutic interventions around sexual orientation or gender identity follow the framework of self- affirming outcomes

    Sutherland-Hoyt , Louise. “Florida Mental Health Counselors Association Strongly Supports House Bill 273 (Richardson) and Senate Bill 258 (Clemens).” FMHCA’s Government Relations Committee, 20 Mar. 2017, http://connections.amhca.org/blogs/louise-sutherland-hoyt/2017/03/20/florida-mental-health-counselors-association-supports-legislation-banning-conversion-therapy 

    American Psychiatric Association

    “Treatment options for gender dysphoria include counseling, cross-sex hormones, puberty suppression and gender reassignment surgery. Some adults may have a strong desire to be of a different gender and to be treated as a different gender without seeking medical treatment or altering their body. They may only want support to feel comfortable in their gender identity. Others may want more extensive treatment including hormone treatment and gender reassignment surgery leading to a transition to the opposite sex. Some may choose hormone treatment or surgery alone.

    Individual therapy can help a person understand and explore his/her/their feelings and cope with the distress and conflict. Couples therapy or family therapy may be helpful to improve understanding and to create a supportive environment. Parents of children with gender dysphoria may also benefit from counseling. Peer support groups for adolescents and adults and parent/family support groups can also be helpful.


    A child’s treatment typically involves a multi-disciplinary team of health care professionals, which may include a pediatrician, a psychiatrist, other mental health professionals, a pediatric endocrinologist (specialists in hormone conditions in children) and an advocate. Treatment may focus primarily on affirming psychological support, understanding feelings and coping with distress, and giving children a safe space to articulate their feelings. For many children the feelings do not continue into adolescence and adulthood. A person may also address social and legal transition to the desired gender.”

    “Gender dysphoria is not the same as gender nonconformity, which refers to behaviors not matching the gender norms or stereotypes of the gender assigned at birth. Examples of gender nonconformity (also referred to as gender expansiveness or gender creativity) include girls behaving and dressing in ways more socially expected of boys or occasional cross-dressing in adult men.

    Gender nonconformity is not a mental disorder. Gender dysphoria is also not the same being gay/lesbian.”

    Parekh, Ranna, M.D., M.P.H. “What Is Gender Dysphoria?” What Is Gender Dysphoria? American Psychiatric Association, Feb. 2016. Web. 16 Oct. 2016. <https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria>.


    Drescher, Jack, MD, Jack Pula, MD, and Ranna Parekh, M.D., M.P.H. “Help With Gender Dysphoria.” Gender Dysphoria. American Psychiatric Association, Feb. 2016. Web. 16 Oct. 2016. <https://www.psychiatry.org/patients-families/gender-dysphoria>.

    American Psychoanalytic Association

    The American Psychoanalytic Association affirms the right of all people to their sexual orientation, gender identity and gender expression without interference or coercive interventions attempting to change sexual orientation, gender identity or gender expression.
    As with any societal prejudice, bias against individuals based on actual or perceived sexual orientation, gender identity or gender expression negatively affects mental health, contributing to an enduring sense of stigma and pervasive self-criticism through the internalization of such prejudice.
    Psychoanalytic technique does not encompass purposeful attempts to “convert,” “repair,” change or shift an individual’s sexual orientation, gender identity or gender expression. Such directed efforts are against fundamental principles of psychoanalytic treatment and often result in substantial psychological pain by reinforcing damaging internalized attitudes.

    American Psychoanalytic Association. “2012 – Position Statement on Attempts to Change Sexual Orientation, Gender Identity, or Gender Expression.” 2012 – Position Statement on Attempts to Change Sexual Orientation, Gender Identity, or Gender Expression | APsaA, 2012, apsa.org/content/2012-position-statement-attempts-change-sexual-orientation-gender-identity-or-gender.

    American Psychological Association

    “A psychological state is considered a mental disorder only if it causes significant distress or disability. Many transgender people do not experience their gender as distressing or disabling, which implies that identifying as transgender does not constitute a mental disorder. For these individuals, the significant problem is finding affordable resources, such as counseling, hormone therapy, medical procedures and the social support necessary to freely express their gender identity and minimize discrimination. Many other obstacles may lead to distress, including a lack of acceptance within society, direct or indirect experiences with discrimination, or assault. These experiences may lead many transgender people to suffer with anxiety, depression or related disorders at higher rates than non-transgender persons.”
    “According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people who experience intense, persistent gender incongruence can be given the diagnosis of “gender dysphoria.” Some contend that the diagnosis inappropriately pathologizes gender non-congruence and should be eliminated. Others argue that it is essential to retain the diagnosis to ensure access to care. The International Classification of Diseases (ICD) is under revision and there may be changes to its current classification of intense persistent gender incongruence as “gender identity disorder.”

    American Psychological Association, Margaret Schneider, PhD, Walter O. Bockting, PhD, Randall D. Ehrbar, PsyD, Anne A. Lawrence, MD, PhD, and Kenneth J. Zucker, PhD. “APA Resolves to Play Leading Role in Improving Treatment for Gender-Variant People.” Http://www.apa.org/. American Psychological Association, 18 Aug. 2008. Web. 17 Oct. 2016. <http://www.apa.org/news/press/releases/2008/08/gender-variant.aspx>

    American Public Health Association

    “Policies and practices that exclude transgender and gender-nonconforming people have a negative impact on gender minority health by permitting discrimination and reinforcing stigma. APHA advocates for the adoption and application of inclusive policies and practices that recognize and address the needs of people and communities identifying as transgender or gender nonconforming. Inclusive policies and practices are those that recognize transgender and gender-nonconforming identities as valid and deserving of equal consideration and treatment. Inclusive policies and practices are critical to reduce health inequities experienced by transgender and gender-nonconforming people. Transgender is an umbrella term that refers to individuals who do not conform to binary gender norms that correspond with their assigned sex at birth. This term includes a wide spectrum of individuals, including but not limited to people whose gender identity differs from the gender typically associated with the sex they were assigned at birth, those who embrace gender fluidity, and those who do not identify as either men or women. The term gender nonconforming is also used in this policy statement to describe those with nonbinary gender identities. Although transgender and gender-nonconforming people may experience similar gender-related bias and discrimination, they are diverse in terms of factors such as age, race, ethnicity, ability, income, sexual orientation, socioeconomic status, and immigration status. APHA urges Congress, state legislatures, and other public and private entities to ensure that policies and practices across all sectors are explicitly inclusive of transgender and gender-nonconforming people.”

    “Namely, APHA:

    • Urges Congress and state legislatures to enact legislation to protect the rights, legal benefits, and access to services of people of all gender identities and expressions.
    • Urges Congress and state legislatures to incorporate into legislation language that is clearly inclusive of transgender and gender-nonconforming people, that does not interpret gender as a binary, and that protects the right of transgender and gender-nonconforming people to use facilities that match their gender identity.
    • Urges Congress and state legislatures to fund research to better understand and promote transgender and gender minority health, including research that monitors the effects of policies and practices on health.
    • Urges public and private workplaces to institute nondiscriminatory policies and practices inclusive of transgender and gender-nonconforming people.
    • Encourages public and private research entities to actively include transgender and gender-nonconforming people in research studies, including clinical trials and observational studies, in order to build a stronger evidence base for transgender and gender minority health.
    • Encourages public and private education systems to foster academic cultures grounded in nondiscrimination policies and practices inclusive of transgender and gender-nonconforming people.
    • Encourages juvenile justice and criminal justice policies and practices inclusive of transgender and gender-nonconforming people.
    • Encourages public health and health care practices that are inclusive of transgender and gender-nonconforming people.
    • Encourages public and private entities to adopt policies and practices inclusive of transgender and gender-nonconforming people in different settings and across all sectors.

    American Public Health Association. Promoting Transgender and Gender Minority Health through Inclusive Policies and Practices. 1 Nov. 2016, www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2017/01/26/promoting-transgender-and-gender-minority-health-through-inclusive-policies-and-practices.

    American Sexual Health Associations

    “Transgender individuals are those who identify with a gender other than the one society expects of them based on their genitalia and physical appearance, and may display characteristics (manner of dress, for example) of either gender. One also does not have to have had body-altering surgery to be considered transgender. Some transgender individuals never pursue hormone therapies or surgery due to the expense and difficulty or they feel comfortable in their body as it is”

    American Sexual Health Associations. “LGBTQ – American Sexual Health Association.” Http://www.ashasexualhealth.org/. American Sexual Health Associations, n.d. Web. 29 Oct. 2016. <http://www.ashasexualhealth.org/sexual-health/lgbtq/>.

    Emergency Nurses Association

    “Every patient presenting to the emergency care setting has the right to be provided with a safe, equitable, knowledgeable, culturally sensitive, and accepting environment, free from discrimination. No one should have to worry about receiving substandard or inequitable care specifically because of their gender identity status. However, many gender‐expansive and transgender patients have these apprehensions, which are only intensified when health concerns force them to seek emergency care. Healthcare facilities and providers may be uncertain how to go about protecting gender‐expansive and transgender patients from discrimination, and may also be unfamiliar with the healthcare disparities that this unique patient population may experience. The purpose of this topic brief is to provide an overview of the gender‐expansive and transgender patient population, describe methods for creating gender‐affirming and supportive environments, discuss some barriers to healthcare, and provide recommendations for caring for gender‐expansive and transgender patients in the emergency care setting”


    “There are various misconceptions about what it means to be transgender. Some believe being transgender is about sexual orientation or how someone dresses, when in fact it is about how individuals feel internally about their own gender. Another misconception some may have is that being transgender is a mental illness. In 2012, the American Psychological Association (APA) amended the diagnosis “gender identity disorder” (GID) to “gender dysphoria” in The Diagnostic and Statistical Manual of Mental Disorders (DSM)–5th edition. Gender dysphoria is described as a condition in which an individual is overwhelmingly distressed or uncomfortable with his or her biological sex and strongly identifies with and desires to be the opposite. This new terminology focuses on the emotional distress one may experience and shifts away from the stigma associated with mental illness. Some gender‐expansive or transgender individuals are very comfortable dressing and acting according to their gender identity, while others may experience difficulties throughout their lives.”

    Escalante Kolbuk, Monica. Care of the GenderExpansive and Transgender Patient in the Emergency Care Setting . Emergency Nurses Association, June 2016, www.ena.org/docs/default-source/resource-library/practice-resources/topic-briefs/non-member/care-of-gender-expansive-and-transgender-patients.

    National Association of School Psychologists

    “The National Association of School Psychologists (NASP) is dismayed by recent media reports that the Trump Administration is considering a proposal to roll back civil rights for transgender people by redefining sex under Title IX as solely and irrevocably male or female at birth. Such a change would be detrimental to the 2 million individuals who identify as transgender or gender diverse in our nation.
    NASP affirms our long-standing position on necessary policies and practices to support the safety and well-being of all students, including those who are transgender and gender diverse. We believe that the civil rights of transgender students are protected as part of U.S. public schools’ obligations under Title IX of the Education Amendments of 1972. This includes respecting a person’s right to express gender identity, and the right to modify gender expression when necessary, and to have their gender identify affirmed and acknowledged. Our position is consistent with all major medical, mental health, and education organizations.


    NASP has developed resources for school psychologists, other school leaders, and public officials to aid them in developing and implementing policies and practices that respect the rights of transgender and gender diverse students. Resources to help in this effort are available below.”

    “It is best to use the pronouns that the student prefers, so asking the student what their preferred gender pronouns (PGPs) are is the best place to start. Many schools and some states now have policies regarding use of pronouns that correspond to students’ gender identity. Washington’s State Office of the Superintendent of Public Instruction addresses this in its transgender student procedure policy:


    A student is not required to change their official records or obtain a court-ordered name and/or gender change as a prerequisite to being addressed by the name and pronoun that corresponds to their gender identity. When communicating with transgender or gender nonconforming students regarding particular issues such as conduct, discipline, grades, attendance or health, school employees will focus on the conduct or particular issues rather than making assumptions regarding the student’s actual or perceived gender identity . . .The district will not condone the intentional and persistent refusal to respect a student’s gender identity, or inappropriate release of information regarding a student’s transgender status. 
    Some students who do not identify as male or female, may ask to be referred to with pronouns such as ze and they. While this new language and usage may initially be difficult to incorporate, with practice they will become more natural in their use.”

    National Association of Social Workers

    “Research shows how parents and caregivers should respond to having a transgender child. The most important thing parents can do to promote their child’s well-being and to reduce their risk is to love and accept them. This means allowing them to live in ways that make them happy — just as you would with any child. For example, let your transgender child play with the toys they enjoy. Let your transgender child dress and wear their hair in the way that is most comfortable for them.
    Supporting your child’s transgender behavior is not easy. But research shows that by loving and accepting your children as they are, you can help them lead happier, healthier lives – and literally save their lives.
    In families where parents highly pressured their children to conform to gender expectations, young people were five times more likely to report symptoms of depression, nearly four times as likely to attempt suicide and to use illegal drugs, and twice as likely to be at high risk for HIV infection, compared with those who parents did not pressure them to conform.”

    Ryan, Caitlin, and Stephanie Brill. How Do I Know If My Child Is Transgender? National Association of Social Workers, www.helpstartshere.org/?p=1114.

    National Commission on Correctional Health Care

    “Transgender people face an array of risks to their health and well-being during incarceration, and are often targets of physical assault and emotional abuse. They are commonly placed in correctional facilities according to their genitals and/or sex assigned at birth, regardless of their gender presentation. The health risks of overlooking the particular needs of transgender inmates are so severe that acknowledgment of the problem and policies that assure appropriate and responsible provision of health care are needed. Sex refers to the biological and physiological characteristics that define males and females. Gender refers to the socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for men and women. Transgender is an umbrella term used to describe people with gender identities and/or expressions not traditionally associated with the sex that they were assigned at birth. Transgender women are individuals whose birth sex was male but who understand themselves to be, and desire to live their lives as, women. Transgender men are individuals whose birth sex was female but who understand themselves to be, and desire to live their lives as, men. Transgender people may identify as men, women, neither, both, or another gender. They can be of any race, sexual orientation, age, religion, body type, socioeconomic background, or national origin. Transgender does not imply any specific form of sexual orientation; transgender persons display a range of sexual orientations similar to those who are not transgender. Individuals may identify their gender in different ways over the course of a lifetime.”

    National Commission on Correctional Health Care. “POSITION STATEMENT Transgender, Transsexual, and Gender Nonconforming Health Care in Correctional Settings.” PsycEXTRA Dataset (2009): 1-3. Http://www.ncchc.org/. National Commission on Correctional Health Care, Apr. 2015. <http://www.ncchc.org/filebin/Positions/Transgender-Transsexual-and-Gender-Nonconforming-Health-Care.pdf>.

    National Health Service

    If the results of an assessment suggest that you or your child have gender dysphoria, staff at the GIC will work with you to come up with an individual treatment plan. This will include any psychological support you may need. Treatment for gender dysphoria aims to help reduce or remove the distressing feelings of a mismatch between biological sex and gender identity. This can mean different things for different people. For some people, it can mean dressing and living as their preferred gender. For others, it can mean taking hormones or also having surgery to change their physical appearance.
    Many trans people have treatment to change their body permanently, so they’re more consistent with their gender identity, and the vast majority are satisfied with the eventual results.”

    National Health Service. “Overview -Gender Dysphoria.” NHS Choices, NHS, 1 Apr. 2019, www.nhs.uk/conditions/gender-dysphoria/.

    Pan American Health Organization

    “The ICD still regards transgender people as “patients” because their identity does not conform to the sex assigned to them at birth. Although experts say that this designation does not mean that they have a psychopathological condition, it has given rise to requests to review the classification. Mazin notes that when transgender people receive support and are treated with respect, consideration, and solidarity, “they are as well-adapted, productive, and as happy as anyone else.”

    Mitchell, Cristina. “Stigma and Discrimination Jeopardize the Health of Lesbians, Gays, Bisexuals, and Transgender People.” Pan American Health Organization / World Health Organization. Pan American Health Organization, 17 May 2013. Web. 15 Nov. 2016. <http://www.paho.org/hq/index.php?option=com_content&view=article&id=8670%3A2013-stigma-discrimination-jeopardize-health-lesbians-gays-bisexuals-transgender-people&Itemid=1926&lang=en>.

    Royal College of Psychiatrists

    “The term ‘conversion therapy’ has also been used to describe treatments for transgender people that aim to suppress or divert their gender identity – i.e. to make them cisgender – that is exclusively identified with the sex assigned to them at birth. Conversion therapies may draw from treatment principles established for other purposes, for example psychoanalytic or behaviour therapy. They may include barriers to gender-affirming medical and psychological treatments. There is no scientific support for use of treatments in such a way and such applications are widely regarded as unacceptable.”

    “There is evidence that this increased rate of psychiatric disorders can, in part, be explained by societal responses to transgender people. For example, pupils who present as transgender or gender-diverse are also disproportionately affected by bullying in schools (Bradlow et al. 2017) and are therefore at higher risk of experiencing poor mental health, particularly self-harm and suicide attempts. Regardless of cause, it is essential that transgender people can seek help in
    confidence for such psychological distress or illness. ”

    “The College is committed to working with people who seek help in the context of gender diversity. It considers that interventions that claim to convert transgender and gender-diverse people into cisgender people are without scientific foundation and thus both unethical and unacceptable. Thus, the College concurs with the views of many international professional organisations, such as the World Professional Association for Transgender Health (WPATH), the American Academy of Child & Adolescent Psychiatry, and the American Psychological Association, that psychological treatments to suppress or ‘revert’ gender-diverse behaviours are unscientific and unethical.
    The Royal College of Psychiatrists considers that use of conversion therapy with transgender and gender diverse (or lesbian, gay or bisexual) people may be an act of discrimination under the Equality Act (2010)”

    Royal College of Psychiatrists. Supporting Transgender and Gender-Diverse People . Mar. 2018, www.rcpsych.ac.uk/pdf/PS02_18.pdf.

    Substance Abuse and Mental Health Administration

    “Working With Youth Who Are Transgender: Provide training for staff who work with youth who self-identify as transgender, particularly regarding health and medical issues. These youth should not have to educate agency staff about their needs, preferences, and issues to receive effective therapeutic services. Therapeutic gains may be compromised if these youth function in a teaching role, rather than receive the help they need. Design or revise agency forms with gender neutral language, and allow youth to identify gender as “other” if they wish. Requiring youth who are transgender or non-gender to identify their sex or a male-female gender identity is especially problematic when youth are in crisis.” “Have safe, non-gendered bathrooms for youth who are transgender or do not identify as male or female.”

    Poirier, J. M., K. B. Francis, S. K. Fisher, K. Williams-Washington, T. D. Goode, and V. H. Jackson. “Providing Services and Supports for Youth Who Are Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex or Two-Spirit.” Providing Services and Supports for Youth Who Are Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex or Two-Spirit (2008): 1-8. Http://www.samhsa.gov/. The National Center for Cultural Competence, Spring 2008. Web. 15 Nov. 2016. <http://www.samhsa.gov/sites/default/files/lgbtqi2-s-practice-brief.pdf>.

    World Health Organization

    “Gender refers to the socially constructed characteristics of women and men – such as norms, roles and relationships of and between groups of women and men. It varies from society to society and can be changed. While most people are born either male or female, they are taught appropriate norms and behaviours – including how they should interact with others of the same or opposite sex within households, communities and workplaces. When individuals or groups do not “fit” established gender norms they often face stigma, discriminatory practices or social exclusion – all of which adversely affect health. It is important to be sensitive to different identities that do not necessarily fit into binary male or female sex categories.”

    “WHO works with international and country partners to address the varied health needs of transgender people, including HIV prevention, diagnosis and treatment while also supporting partners to address structural barriers which impact on service access by transgender people.
    Violence against transgender people is common (including police abuse, abuse perpetrated by clients of sex workers and intimate partner violence). Further, transgender people may experience family rejection, violation of their rights to education, employment and social protections and as such experience higher rates of unemployment, poverty, housing insecurity and marginalization.”

    Gender.” World Health Organization. World Health Organization, n.d. <http://www.who.int/gender-equity-rights/understanding/gender-definition/en/>.


    Transgender people World Health Organization. World Health Organization, n.d. https://www.who.int/hiv/topics/transgender/about/en/

    World Medical Organization

    “Although being transgender does not in itself imply any mental impairment, transgender people may require counseling to help them understand their gender and to address the complex social and relational issues that are affected by it. The Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-5) uses the term “gender dysphoria” to classify people who experience clinically significant distress resulting from gender incongruence. Evidence suggests that treatment with sex hormones or surgical interventions can be beneficial to people with pronounced and long-lasting gender dysphoria who seek gender transition. However, transgender people are often denied access to appropriate and affordable transgender healthcare (e.g. sex hormones, surgeries, mental health care) due to, among other things, the policies of health insurers and national social security benefit schemes, or to a lack of relevant clinical and cultural competence among healthcare providers. Transgender persons may be more likely to forego health care due to fear of discrimination.

    1. The WMA emphasizes that everyone has the right to determine one’s own gender and recognises the diversity of possibilities in this respect. The WMA calls for physicians to uphold each individual’s right to self-identification with regards to gender.
    2. The WMA asserts that gender incongruence is not in itself a mental disorder; however it can lead to discomfort or distress, which is referred to as gender dysphoria (DSM-5).
    3. The WMA affirms that, in general, any health-related procedure or treatment related to an individual’s transgender status, e.g. surgical interventions, hormone therapy or psychotherapy, requires the freely given informed and explicit consent of the patient.
    4. The WMA urges that every effort be made to make individualized, multi-professional, interdisciplinary and affordable transgender health care (including speech therapy, hormonal treatment, surgical interventions and mental health care) available to all people who experience gender incongruence in order to reduce or to prevent pronounced gender dysphoria.
    5. The WMA explicitly rejects any form of coercive treatment or forced behaviour modification. Transgender healthcare aims to enable transgender people to have the best possible quality of life. National Medical Associations should take action to identify and combat barriers to care.
    6. The WMA calls for the provision of appropriate expert training for physicians at all stages of their career to enable them to recognize and avoid discriminatory practices, and to provide appropriate and sensitive transgender healthcare
    7. The WMA condemns all forms of discrimination, stigmatization and violence against transgender people and calls for appropriate legal measures to protect their equal civil rights. As role models, individual physicians should use their medical knowledge to combat prejudice in this respect.
    8. The WMA reaffirms its position that no person, regardless of gender, ethnicity, socio-economic status, medical condition or disability, should be subjected to forced or coerced permanent sterilization (WMA Statement on Forced and Coerced Sterilization). This also includes sterilization as a condition for rectifying the recorded sex on official documents following gender reassignment.
    9. The WMA recommends that national governments maintain continued interest in the healthcare rights of transgender people by conducting health services research at the national level and using these results in the development of health and medical policies. The objective should be a responsive healthcare system that works with each transgender person to identify the best treatment options for that individual.”

    World Medical Association General Assembly. “WMA Statement on Transgender People.” Http://www.wma.net/. World Medical Association, Oct. 2015. Web. 20 Dec. 2016. <http://www.wma.net/en/30publications/10policies/t13/>.

    World Psychiatric Organization

    “Psychiatrists have a social responsibility to advocate for a reduction in social inequalities for all individuals, including inequalities related to gender identity and sexual orientation.
    In two major diagnostic and classification systems (International Classification of Diseases (ICD-10) and (DSM-5), same sex sexual orientation, attraction, and behaviour and gender identity are not seen as pathologies
    1. The World Psychiatric Association (WPA) holds the view that lesbian, gay, bisexual, and transgender individuals are and should be regarded as valued members of society, who have exactly the same rights and responsibilities as all other citizens. This includes equal access to healthcare and the rights and responsibilities that go along with living in a civilised society
    4. WPA acknowledges the social stigma and consequent discrimination of people with same-sex sexual orientation and transgender gender identity. It recognizes that the difficulties they face are a significant cause of their distress and calls for the provision of adequate mental health support.
    5. WPA supports the need to de-criminalize same–sex sexual orientation and behaviour and transgender gender identity, and to recognize LGBT rights to include human, civil, and political rights. It also supports anti-bullying legislation; anti-discrimination student, employment, and housing laws; immigration equality; equal age of consent laws; and hate crime laws providing enhanced criminal penalties for prejudice-motivated violence against LGBT people.”

    World Psychiatric Association. “WPA Position Statement on Gender Identity and Same-Sex Orientation, Attraction, and Behaviours.” World Psychiatric Association Advance Psychiatry and Mental Health Across The World. World Psychiatric Association, October 2017.  https://3ba346de-fde6-473f-b1da-536498661f9c.filesusr.com/ugd/e172f3_e7d4dac33acd4000921b942f7ec70df0.pdf 

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