What Does it Mean to Create a Trans-Affirming Practice? Part Two

Your trans clients will be navigating front desk staff, forms, intake interviews, and bathrooms. If you have office staff, they should all be trained in things such as: how to greet people without gendering them, how to speak about sensitive information without others being able to hear it in the waiting room, how to use preferred names even if the legal name is different on paperwork.

Forms should allow people to self-identify their gender, pronouns, sexual identity and relationship structures. In intake you can ask about “chosen family” versus “people who raised you” and so on. Learn who someone is “out” to and who they might not want you to use preferred names and pronouns with. This will take practice and thoughtfulness on your part. Educate yourself on types of microaggressions gender non-conforming people face on a daily basis, their emotional impact, and recognize the likelihood of trauma histories.

I decided against renting in a building once that refused to let me turn the bathrooms into all gender bathrooms. It can be hard to find a space that is perfect in all ways and sometimes you may have to make some choices about a location or building that you wouldn’t prefer, but for gender non-conforming people to feel comfortable, access to a single stall or all gender bathroom is important. If you’re in a practice, you might need to advocate with owners or admin staff about updating forms and changing bathroom signs or even building locations to accommodate trans folks.

An affirming practitioner is committed to having challenging conversations with business owners, CEOs, fellow colleagues, office suitemates, administrative employees, etc. to develop necessary changes. And lastly, a trans-affirming provider is aware of resources, community groups, processes for social and medical transition, and websites to share with their clients. These resources should be those vetted by and recommended by trans folks in the area. Clinical consultation is available for providers who have questions about these things or need guidance in a particular case with a trans person.

Also, whether you’re a solo practitioner, are in a group practice, or have office staff – all white employees need to attend anti-racism training regularly. This is because implicit (subconscious, unintentional) bias can show up and negatively affect trans and gender non-conforming clients of color in the ways they’re related to in the building, decisions made by the staff or group related to security and police involvement at the site, diagnoses given, and types of therapies offered. There are a number of groups in the area who offer these types of trainings.

What if you’re thinking: “I don’t even work with trans people, so I don’t need to worry about this”.

Well, yes you do. You work with trans people even if you don’t know it because they aren’t “out” to you yet. Maybe they aren’t “out” to anyone. But the chances of them feeling like they can talk to you about gender will be greatly increased if you take the steps mentioned here.

I recently got a letter from a former client updating me on how they’re doing now. They said that they’re now open with close people about their gender identity and that it radically changed their life in one session when I said “all parts of you are welcome here.” They said they’d never felt that kind of affirmation and will never forget hearing the words. Transitioning beyond acceptance takes work, but it could make all the difference to a trans person whose gender identity or expression is rarely affirmed.

This is part 2 of a 2 part series on developing a trans-affirming practice.

Tavi Hawn, LCSW-C is a clinical social worker licensed in NC and MD. Tavi recently re-located to Baltimore, MD where they will be teaching as adjunct faculty at UMB School of Social Work and continuing a therapy and consulting business. Tavi primarily works with transgender and gender non-conforming people of all ages and is co-founder of QORDS summer camp. www.hawntherapyandconsulting.comwww.qords.org

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