By John L. Singleton, CEO Whetstone Academy
Over the past decade, the number of individuals who identify as transgender, transsexual, or gender nonconforming has increased dramatically. Independent educational consultants (IECs), both traditional and therapeutic, are now finding themselves in a dilemma when recommending an appropriate placement for these clients. In response to that increase, however, we are also seeing more discussions and support that are based on the best available research and professional consensus to assist in appropriate placement of those clients.
Recognizing that no two people are identical, being well-informed and ready to ask the right questions before placement provide insight and help IECs make appropriate recommendations for placement, maximizing the chance for improved general health, psychological well-being, and self-fulfillment for the client. The following considerations emphasize six areas: standards of care and best practices, treatment of cooccurring issues, boarding environment, social transitioning, supportive interventions and practices, and family support.
Standards of care. Verify that any school or program under consideration understands and embraces the World Professional Association for Transgender Health’s (WPATH) Standards of Care and staff training based on those standards. “WPATH recognizes that health is dependent upon not only good clinical care but also social and political climates that provide and ensure social tolerance, equality, and the full rights of citizenship” (WPATH 2011). It is essential to verify that a school or program ensures the promotion of tolerance for gender and sexual diversity, which can eliminate prejudice, discrimination, and stigmatization of students.
Cooccurring conditions. Ensure that the organization does not attempt to treat the idea of being transgender but rather addresses the coexisting issues, such as anxiety and depression, by making informed choices and recognizes the value of harm reduction approaches. Harm reduction refers to policies, programs, and practices that aim to reduce the harms associated with identifying as transgender, transsexual, or gender nonconforming.
Boarding environment. Look for a school or program that does not isolate the student in the boarding portion of the program according to the gender assigned at birth. Placing a child with roommates that are the same gender as the identified student’s gender is essential to the positive mental health of the child. In general, it’s recommended that “housing and shower/bathroom facilities for transsexual, transgender, and gender nonconforming people living in institutions should consider their gender identity and role, physical status, dignity, and personal safety. Placement in a single-sex housing unit, ward, or pod on the sole basis of the appearance of the external genitalia may not be appropriate and may place the individual at risk for victimization” (Brown 2009). Schools and programs that accept transsexual, transgender, and gender nonconforming clients should train and monitor for a tolerant and positive climate that ensures that individuals are not under attack by staff or other residents.
Social transitioning. Determine how well the school welcomes discussions about and supports a child’s social transition. Program and school professionals can help families make decisions regarding the timing and process of any gender role changes for their children. They should provide information and help parents weigh the potential benefits and challenges of particular choices. School or program professionals should be willing to counsel and support the student and family as they work through the options and consequences of social transitioning. Families may also need assistance in using correct pronouns, maintaining a safe and supportive environment, and collaborating with other individuals in their child’s life; consequently, the organization must have comprehensive knowledge of social transitioning.
Supportive interventions and practices. Ask about the school’s support for both fully and partially reversible interventions, such as puberty suppressant hormones and hormone therapy. According to WPATH, “Refusing timely medical interventions for adolescents might prolong gender dysphoria and contribute to an appearance that could provoke abuse and stigmatization. As the level of gender-related abuse is strongly associated with the degree of psychiatric distress during adolescence (Nuttbrock et al. 2010), refusing puberty suppression and the ensuing hormone therapy is not a neutral option for adolescents, it can be damaging.”
Family support. Look for a program that has services to support the family of the transgender student. In addition to prejudice and discrimination in society at large, stigmatization can contribute to abuse and neglect in a student’s relationships with peers and family members, which in turn can lead to psychological distress. WPATH states: “Families should be supported in managing uncertainty and anxiety about their child’s or adolescent’s psychosexual outcomes and in helping youth to develop a positive self-concept” and “Clients [students] and their families should be supported in making difficult decisions regarding the extent to which clients [students] are allowed to express a gender role that is consistent with their gender identity, as well as the timing of changes in gender role and possible social transition.”
Seeking knowledge about these important considerations and asking informed questions before making placement recommendations will provide IECs with valuable insight and help ensure an educated and appropriate placement of the transsexual, transgender, or gender nonconforming student.
Brown, G. R. 2009. “Recommended Revisions to the World Professional Association for Transgender Health’s Standards of Care Section on Medical Care for Incarcerated Persons With Gender Identity Disorder.” International Journal of Transgenderism, 11(2), 133–139.
Nuttbrock, L., S. Hwahng, W. Bockting, A. Rosenblum, M. Mason, M. Macri, and J. Becker. 2010. “Psychiatric Impact of Gender-Related Abuse Across the Life Course of Male-to-Female Transgender Persons.” Journal of Sex Research, 47(1), 12–23.
WPATH (World Professional Association for Transgender Health). 2011. Standards of Care, 7. WPATH.
John L. Singleton can be reached at [email protected]