Counseling Support for the Forgotten Transgender Community

The needs of people with nonconforming gender behavior are not homogeneous, for people who self-identify as transgender are not and should not be considered the same as individuals who self-identify as transsexual. Limited counseling resources are available for clinicians working with individuals who self-identify as transgender but have no desire to proceed to sexual reassignment surgery (SRS). Though it appears many of the recommendations for transsexuals are relevant for the broader range of transgender individuals, significant differences exist between them, warranting further investigation. This article presents a summary of approaches for gender-variant clients not matching the transsexual paradigm.     

Transition,Connection, Disconnection,and Social Media: Examining the Digital Lived Experiences of Transgender Individuals

In light of persistent discrimination, many individuals who are transgender lack a safe space to connect with others. Social media has become a platform for establishing social ties, receiving education, and sharing of resources that may not otherwise be available to individuals on the margins of society. Yet little is understood about the role of social media in the lives of individuals who are transgender. In this qualitative study, the researchers examined the experiences of adults who are transgender (N = 5) who use social media. The current study also explored possible benefits and hindrances of social media for individuals who are transgender. Two main themes emerged: social media as a resource and a path to self and authenticity. The researchers encourage counselors to become familiar with various social networking sites and their privacy settings, and propose using a theoretical framework to guide counseling work with individuals who are transgender to reflect on social media connections and disconnections.     

Building Community for Toronto's Lesbian,Gay, Bisexual,Transsexual and Transgender Youth

SUMMARY

This paper describes the development of Supporting Our Youth, an innovative grassroots program that builds community for lesbian, gay, bisexual, transsexual and transgender youth in Toronto. Hundreds of adults and youth have worked together to develop a broad range of arts, cultural, recreational, and employment training activities, as well as a very popular mentoring and housing program. Initiated in 1997, Supporting Our Youth has been developed according to underlying principles of community development and community building which value broad participation, diverse skills, partnerships, coalition building, and grassroots ownership and direction. As a model, it is transferable to other queer and trans communities, as well as to other marginalized populations.     

Intersectional Identities and Conceptions of the Self: The Experience of Transgender People

Transgender people in the United States change genders in relation to androcentric, heterocentric, and middle‐class whitenormative cultural narratives. Drawing on ethnographic data primarily with transgender people of color, I analyze the ways in which gender, race, social class, and sexuality all combine to create specific background identities – intersected identity frames – which others attribute in interaction. We can better understand these intersected identity frames through the experiences of transgender people, who actively engage in identity management. The meanings others attach to specific combinations are foregrounded in the context of transitioning; some audiences employ dominant, white cultural narratives, while others draw upon ethnic cultural narratives. In all cases, transitioning throws the multi‐dimensionality of intersected identity frames into sharp relief against the background of intersecting social and cultural structural arrangements.     

Staff Development as a School Climate Intervention to Support Transgender and Gender Nonconforming Students: An Integrated Research Partnership Model for School Counselors and Counselor Educators

ABSTRACT

This article posits that an integrative research partnership model can assist school counselors in addressing the marginalization of transgender students in schools through staff development. A methodological integration of action research and program evaluation through quantitative and qualitative data collection is explained, and a collaborative process is highlighted. A case example is provided to demonstrate the use of the design.     

The Social Costs of Gender Nonconformity for Transgender Adults: Implications for Discrimination and Health

Research suggests that transgender people face high levels of discrimination in society, which may contribute to their disproportionate risk for poor health. However, little is known about whether gender nonconformity, as a visible marker of one's stigmatized status as a transgender individual, heightens trans people's experiences with discrimination and, in turn, their health. Using data from the largest survey of transgender adults in the United States, the National Transgender Discrimination Survey (N = 4,115), we examine the associations among gender nonconformity, transphobic discrimination, and health‐harming behaviors (i.e., attempted suicide, drug/alcohol abuse, and smoking). The results suggest that gender nonconforming trans people face more discrimination and, in turn, are more likely to engage in health‐harming behaviors than trans people who are gender conforming. Our findings highlight the important role of gender nonconformity in the social experiences and well‐being of transgender people.     

THe Use of Hormone Therapy in the Male-to-Female Transgender Population: Issues for Consideration in Thailand

ABSTRACT

Objectives: Prejudice against transgender people is evident around the world with discrimination in many aspects of life, including access to health care. Even in Thailand, where male-to-female (MTF) transgender people are particularly visible and society is reputedly accepting, barriers to attaining appropriate health care still exist. The vast majority of MTF transgender people in Thailand are reported to be taking hormone therapy; however, most do not seek medical advice regarding these regimens, with the initiation and tailoring of medication often being guided by sympathetic peers instead. The objectives of this review are to consider hormone therapy in the context of the Thai population and provide recommendations regarding ways to improve practice and reduce health risks. Methods: The data analysis in this article represents a comprehensive literature review regarding hormone therapy for MTF transgender people including the guidelines for initiation, prescribing, and monitoring of hormone therapy, risks for serious adverse events and reported hormone use by the MTF transgender population in Thailand. Results: There is a notable lack of published research regarding hormone therapy in the transgender population. Guidelines, whilst relying considerably on expert opinion, do provide clear recommendations on the initiation, maintenance and monitoring of hormone therapy. Comparison of endocrine guidelines with reported practice in Thailand reveals significant opportunities for improvement in MTF transgender hormone therapy. Conclusions: The incautious use of hormone therapy may represent a considerable health risk behavior undoubtedly contributing to the morbidity and mortality in MTF transgender people. Although there is currently considerable focus on sexually transmitted infections in the MTF transgender population, a more comprehensive approach to health care is required, including education for transgender people and the health professionals who attend to them regarding appropriate hormone therapy.     

INCOME: A Culturally Inclusive and Disability‐Sensitive Framework for Organizing Career Development Concepts and Interventions

This article demonstrates how the INCOME model (S. Beveridge, S. Heller Craddock, J. Liesener, M. Stapleton, & D. Hershenson, 2002; D. Hershenson & J. Liesener, 2003), developed with special reference to persons with disabilities and from diverse backgrounds, provides a framework for organizing, selecting, and implementing concepts from career theories and career intervention practices. Rather than using stages or processes typical of existing career development theories, this framework uses J. E. Helms's (1995) multicultural construct of statuses, which may occur or recur in any order or combination. The 6 career statuses in the INCOME framework, which occur across demographic and cultural groups, are Imagining, iNforming, Choosing, Obtaining, Maintaining, and Exiting.     

Bathrooms,Boundaries, and Emotional Burdens: Cisgendering Interactions Through the Interpretation of Transgender Experience

Building on findings demonstrating that social institutions may cisgender realities by creating and enforcing binary notions of gender rooted in cisgender experience, this study examines the ways cisgender people reinforce cisnormative gender binaries in their ongoing interactions. Utilizing interviews with 99 cisgender people, I show how respondents react to a vignette about a gender nonconforming person seeking to use a public bathroom by “cisgendering interactions,” which I define as the process whereby people reassert binary understandings of gender to make sense of transgender experience while placing an unequal emotional burden on transgender and gender nonconforming people to mend the interactional disruption of the gender panic. Additionally, my analysis extends transgender scholarship by demonstrating some ways cisgender people make sense of transgender people in public spaces. In conclusion, I draw out insights for understanding (1) the ways people cisgender their realities in the face of conflicting stimuli, (2) the ways in which emotions are a mechanism of inequality reproduction, and (3) the consequences these actions have for the perpetuation of gender inequality.     

A Re-Conceptualization of the Working Alliance in Cross-Cultural Practice with Non-Western Clients: Integrating Relational Perspectives and Multicultural Theories

This article will addresses a gap in the literature regarding the working alliance in cross-cultural treatment. The paper draws on references from current relational theories and multicultural conceptual and empirical sources to re-conceptualize the definition of the working alliance to include cross-cultural dynamics between Asian clients and European-American therapists as a case in point. The paper includes an overview of the working alliance, and a proposal for the inclusion of specific relational domains that this author has found to be important for the definition of the working alliance. These domains are empathy, mutuality, the dynamics of power and authority, the use of self, and the process of communication. A case vignette is included to illustrate these discrete domains. The paper opens new directions for clinical practice and research in the area of the working alliance in cross-cultural counseling.     

Elder Transgender Lesbians: Exploring the Intersection of Age,Lesbian Sexual Identity,and Transgender Identity

This study is the first to examine the experiences and needs of an international sample of current, English-speaking, lesbian, transgender-identified (trans-lesbian) adults around a number of later life and end-of-life perceptions, preparations, and concerns. I analyzed a subset (n = 276) of the cross-sectional data collected from the online Trans MetLife Survey on Later-Life Preparedness and Perceptions in Transgender-Identified Individuals (N = 1,963). I assessed perceptions and fears around aging, preparation for later life, and end-of-life as well as numerous demographic and psycho-social variables. Despite the overall feeling that they have aged successfully, the respondent trans-lesbian population harbors significant fears about later life. I found that this population, while better-prepared than the overall respondent trans-identified population, is still ill-prepared for the major legalities and events that occur in the later to end-of-life time periods.     

The Cat and the Cloud: ACT for LGBT Locus of Control,Responsibility, and Acceptance

Advocating acceptance, committed action, and value-guided behavior over experiential avoidance, Acceptance and Commitment Therapy (ACT) may aid lesbian, gay, bisexual and transgender (LGBT) clients affected by hetero/homonormative social pressure. By conceptualizing LGBT paradigms of internal/external control/responsibility (IC-IR; EC-IR; IC-ER; EC-IR), ACT may be adapted to a myriad of multicultural worldviews. This article presents locus of acceptance as the attributed worth of internal/external cues perceived necessary by the client to achieve self-acceptance. Recognizing visibility and isolation as recurrent LGBT issues, locus of acceptances balances identity as individual (internal acceptance) with identity as community (external acceptance).     

Traversing the Margins: Intersectionalities in the Bullying of Lesbian,Gay, Bisexual and Transgender Youth

SUMMARY

This study explores the perspectives of service providers and youth advocates on bullying of lesbian, gay, bisexual and transgender (LGBT) youth and intersectionalities in LGBT peer victimization. In depth, semi-structured interviews were conducted with nine key informants (4 male, 4 female, 1 transgender male; 4 gay, 3 lesbian, 2 non-identified; 6 white, 1 South Asian, 2 Middle Eastern) recruited using purposive sampling from diverse education and social service settings. Narrative thematic analysis and a constant comparative method were used to identify themes. Five themes emerged from the data: (1) “transgressing gender norm boundaries”; (2) homophobic sexism vs. sexist homophobia; (3) “you choose sexuality or you choose race”; (4) newcomer youth and citizenship; and (5) “multiple wires together … create the cage.” Findings suggest the importance of an intersectional approach to conceptualizing and addressing LGBT bullying and to uncovering the differential experiences of bullying among LGBT youth. Bullying related to sexual orientation should not be assumed to be the only or primary form of violence shaping the lives of LGBT youth.     

Identification and Integration of Career Theory: Students’ Perspectives on the Process

In many counseling programs, while students are learning about career theory, they may be tasked in a separate course with identifying a theoretical approach to counseling. This may result in a dichotomous situation in which students lack an understanding of the relationship between career theory and counseling theory. Career counselors have long recognized the artificial distinction between career counseling and general counseling. However, counselor education programs generally lag, and there is a dearth of literature regarding the process of identifying and integrating career theory and counseling theory. This phenomenological study examined 6 students’ perceptions of the process of career theory identification and integration. Analysis of in‐depth interviews yielded 5 major themes: theory identification and integration, perceptions of career counseling, resources, personal dimensions, and application across the life span. Findings of this study have the potential to inform counselor education pedagogy regarding career theory identification and its application to the counseling context.     

Patching Holes and Integrating Community: A Strengths-Based Continuum of Care for Lesbian,Gay, Bisexual,Transgender and Questioning Youth

This article describes an integrated model of service provision called a continuum of care (CoC), and illustrates the application of this approach to working with lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth through a case example. The CoC described in this article includes provision of individual and group counseling, case management, housing/family supports, socialization events, and prevention workshops, along with relevant outcomes. The relevance of a CoC model for LGBTQ youth due to the inclusion of community context and potential to empower service users is explored. Key recommendations for CoC models with LGBTQ youth include a focus on collaboration, provider education, and affirmative practice, and incorporating service user feedback.