for Medical Professionals
Informative publications for professionals who wish to learn more about providing affirming care to their transgender, non-binary or gender non-conforming patients or clients.
See the other medical sections as well for working with transgender or non-binary patients in regards to transitioning.
INFOGRAPHIC CREDIT: Sexual orientation, gender identity & gender expression (SOGIE) safer places toolkit. AHS. 2019.
By Wendy McRoberts. March 28, 2022.
Sometimes people ask me “How are trans kids being attacked on a daily basis?”
"Well, as the Mom, let me explain.
First even though he’s 20, the “kid” doesn’t deserve the nightmare involved in Interviewing doctors.
This is what it’s like making an average appointment for an illness in a new city.
First, my son called with back pain, sore throat and congestion. I told him I’d find a doctor. I went to my resources, got a recommendation for trans friendly doctors. Yes, we’ve run into some non-friendlys. Then I checked insurance desperately hoping it would be there. Then I called and was given an immediate appointment, let them know he was trans and was asked to also schedule a follow up so he could have his first new patient check up with his new primary care. I discovered that this ONE office will treat Theo as a patient and will handle ALL of his care. No three different doctors to care for separate health needs. ONE doctor, who would treat him as a whole person. I took a screenshot of the webpage and I cried because that little flag meant that I did not need to worry that his appointment was going to be a constant barrage of judgment from ill-informed staff on top of already feeling sick, weak and vulnerable.
This is why many trans people do not try to access the healthcare they need.
Theo is going to be treated like he MATTERS, both in health and society.
I should not have to CRY when my son gets appointments for a doctor.
That is the reality."
By Meaghan Ray. Purple and Green and the Life In Between blog post. Nov 2021.
"When we hear about trans people and healthcare, we mostly hear about hormones and surgery. But trans people are way more than just hormones and surgery.
As part of my current research, I am learning about the different types of barriers that trans people experience when accessing healthcare. To my surprise, the majority of the barriers discussed were in relation to accessing transition related care – ie hormones and surgery (among other things). I had to dig significantly deeper to find anything on the barriers that trans people face in accessing regular, every day health care.
What I realized was that this was a reflection on society’s view that trans people are one-dimensional – trans. As it turns out, trans people are more than just trans. They are parents and kids and employees and students and immigrants and homeless and artists and athletes. They are just as multi-faceted as cis people – maybe more so!
This goes for their healthcare needs as well. Sure, they need access to things that are specific to medical transition, but they also need access to basic health care. They break bones, get in accidents, have chronic conditions, and get sick just like cis people.
Since this concept seems to be difficult for the medical and research communities to grasp, I thought I would break it down into three categories to make it a bit more straightforward. Here goes."
Alberta Health Services. Last revised Sept 2019.
"The Sexual Orientation, Gender Identity & Expression (SOGIE) Safer Places Toolkit is an introductory and practical tool for AHS healthcare teams including all employees and physicians, volunteers and contracted service providers. The goal is to increase awareness, encourage self-reflection and build skills to create more welcoming and safer care for LGBTQ2S+ people and their families. AHS is committed to providing a respectful environment, where staff are committed to safe, quality care. For more information, see Expectations and Responsibilities of our Healthcare Workforce, Patients and Families in Appendix B."
By Trans Equality Society of Alberta (TESA). 2020.
Guidelines for medical professionals in Alberta caring for transgender, non-binary and gender diverse patients.
Transgender health care
Alberta Health Services
TOP (Toward Optimized Practice) Resources.
“Educational resources for primary care physicians for working with transgender clients”
TOP (Toward Optimized Practice). April 2019. Booklet.
“These recommendations are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. They should be used as an adjunct to sound clinical decision making.
This practice tool is designed to be used by primary care providers who encounter an adult patient who is seeking care for gender dysphoria. It is intended as a starting point for physicians who see themselves as not expert in this area.
This tool can be similarly helpful for any physician such as psychiatrists, internists, gynecologists, surgeons, and others who may find themselves seeing transgender patients for various reasons in a range of clinical contexts.
The content is based on international standards of care and was adapted, with permission, from Canadian sources.”
TRANSlations: Navigating HRT access in Alberta
Pivot Edmonton 2020 Cohort Zine.
Created through a collaboration between the Edmonton Men’s Health Collective (EMHC), CBRC, the Edmonton Pivot 2020 cohort, and the Albertan 2SLGBTQ+ community, TRANSlations is an original zine (online magazine of writings) made up of a collection of community testimonials and works of poetry that illuminate the diverse experiences of twelve 2SLGBTQ+ community members as they navigate Hormone Replacement Therapy (HRT) access in Alberta. TRANSlations was created to provide a basic overview of what the path to HRT might look like from a community, self-advocacy, and resiliency perspective.”
OTHER PROVINCES AND NATIONALLY
INFOGRAPHIC CREDIT: A recipe for respectful care: Working with the LGBTQ2S+ community. Family & Community Medicine, University of Toronto. Mar 23, 2021.
2SLGBTQI Inclusion for mental health and social service providers (WEBINAR)
Join us for a free ‘Inclusion 101’ webinar!
EGALE Canada Human Rights Trust. Toronto-based but serves Canada-wide community .
"2SLGBTQI people are falling through the gaps in the Canadian mental health system. 2SLGBTQI people are especially vulnerable both amid the COVID-19 pandemic and beyond. Exclusion, discrimination and a lack of cultural competence in mental health systems prevent vulnerable 2SLGBTQI people from accessing the inclusive services and care they need to manage mental health. As an immediate response, we have developed a training for mental health and social service providers."
"This 90-minute, interactive webinar will introduce participants to identities captured by the 2SLGBTQI acronym and how they relate to four components of identity. Participants will consider structural and cultural biases in Canada and its mental health system and their impacts on 2SLGBTQI mental health and well-being. They will also learn evidence-based strategies that can be implemented immediately in their practice. Participants will leave the session equipped to continue this important work in their workplace and with further learning resources to support their effort. This webinar is designed with the following practitioners in mind: psychiatrists, psychologists, counsellors, social workers, personal support workers, palliative and long-term care workers, and professionals in educational and social services settings."
2022 Webinar Dates:
EGALE MISSION: "To improve the lives of 2SLGBTQI people in Canada and to enhance the global response to 2SLGBTQI issues. Egale will achieve this by informing public policy, inspiring cultural change, and promoting human rights and inclusion through research, education, awareness and legal advocacy."
Edited by Zena Sharman. Oct 5, 2021. (CANADA)
What if you could trust in getting the health care you need in ways that felt good and helped you thrive? What if the health system honoured and valued queer and trans people's lives, bodies, and expertise? What if LGBTQ+ communities led and organized our own health care as a form of mutual aid? What if every aspect of our health care was rooted in a commitment to our healing, pleasure, and liberation?
LGBTQ+ health care doesn't look like this today, but it could. This is the care we dream of.
The Care We Dream Of is not quite an essay collection, and not quite an anthology. Instead, it's a hybrid kind of book that weaves together the author's essays on topics like queering health and healing, transforming the health system, kinship, aging, and death, alongside stories, poetry and non-fiction pieces by Alexander McClelland and Zoe Dodd, Blyth Barnow, Carly Boyce, jaye simpson, Jillian Christmas, Joshua Wales, Kai Cheng Thom, Leah Lakshmi Piepzna-Samarasinha, and Sand C. Chang. The book also includes interviews with activists, health care workers and researchers whose work offers insights into what liberatory and transformative approaches to LGBTQ+ health can look like in practice. Interviewees include Anita 'Durt' O'Shea (of St. James Infirmary), Dawn Serra, Hannah Kia, Ronica Mukerjee, and Sean Saifa Wall.
The Care We Dream Of offers possibilities - grounded in historical examples, present-day experiments, and dreams of the future - for more liberatory and transformative approaches to LGBTQ+ health and healing. It challenges readers to think differently about LGBTQ+ health and asks what it would look like if our health care were rooted in a commitment to the flourishing and liberation of all LGBTQ+ people. This book is a calling out, a out, a calling in, and a call to action. It is a spell of healing and transformation, rooted in love."
"Zena Sharman is a writer, speaker, strategist and LGBTQ+ health advocate. She’s the author of three books, including The Care We Dream of: Liberatory and Transformative Approaches to LGBTQ+ Health (published by Arsenal Pulp Press in the fall of 2021). Zena edited the Lambda Literary award-winning anthology, The remedy: Queer and Trans Voices on Health and Health Care, and co-edited the Lambda award-nominated anthology Persistence: All Ways Butch and Femme, which was named a Stonewall Honor Book by the American Library Association.
Zena is an engaging speaker who brings her passion for LGBTQ+ health to audiences of health care providers, students and community members at universities and conferences across North America. She’s worked in strategic leadership roles in the health research sector for over a decade, including as the assistant director of Canada’s national gender and health research funding institute where she worked to embed gender and LGBTQ+ health into research policy and practice. Zena co-chairs the board of the Catherine White Holman Wellness Centre, a holistic health center for transgender and gender-diverse communities, and is a former board member of the Canadian Professional Association for Transgender Health (CPATH).
A PhD-trained health researcher, Zena’s graduate research focused on the intersections of gender, power and care work in the health system."
"...anthology, edited by Sharman, brings marginalized voices together to discuss their need for empathetic and dependable doctors, nurses and therapists"
By Wency Leung, Health Reporter. The Globe & Mail, Nov 15, 2016. (CANADA)
Interview with Dr Sharman regarding her 2016 book, The Remedy: Queer and trans voices on health and health care.
By the Get REAL Movement. London, Ontario. Film. (ONT)
“The Clinic is a short film and digital resource to highlight the need for more inclusive healthcare in Canada, and provide resources and tips for medical professionals seeking to make their offices and clinics more inclusive for 2SLGBTQ+ patients."
Clinical settings with new clients
Trans Care BC, Provincial Health Services Authority. (BC)
"terms you can use when providing care for gender diverse people.
Once you know the words a person uses to describe their body, use their words in a respectful & professional manner.
By Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC). Vancouver BC. May 2021.
"Gender-Diverse: A Spotlight on the Health of Trans and Non-Binary Young People in B.C. provides a profile of the health of gender-diverse youth in British Columbia (BC). The report is a collaboration between researchers at SARAVYC and the McCreary Centre Society and uses data from the 2018 BC Adolescent Health Survey (BC AHS), which is one of the most reliable, comprehensive health surveys of adolescents ages 12–19 in public schools in BC. Repeated every five years since 1992, the survey involves a large-scale population-based sample. In 2018, over 38,000 young people in 58 of BC’s 60 school districts completed the survey, the largest cohort that has participated so far.
This report focuses on the 2018 BC AHS responses of trans, non-binary, and questioning youth, reported separately, so that their experiences and voices are visible. There are also a few comparisons to cis girls and cis boys, where this is relevant to understanding the health picture of gender-diverse youth."
Download report. SARAVYC is an international, multi-disciplinary, award-winning team that studies how resilience, stigma, discrimination, violence, and trauma affect young people’s health.
Produced by Rainbow Health Ontario (RHO), a program of Sherbourne Health. (ONT)
"This Health in Focus educational resource was created to highlight the post-surgical care needs of trans and non-binary clients accessing Transition-Related Surgery (TRS). This document will help you to identify barriers to post-surgical care for trans and non-binary clients who are recovering from TRS and strategies that can be used to improve post-surgical experiences."
[RHO thanks the 15 trans and non-binary community members and the seven service providers, our reviewers and authors for this product, including Hwihyon Kwon and Kirstin Loates.]
Joint Statement on the Affirmation of Gender Diverse Children and Youth (CANADA)
The following joint statement by the Canadian Association for Social Work Education (CASWE-ACFTS) and the Canadian Association of Social Workers (CASW) clarifies our position on issues of social work education and social service provision with respect to gender diverse children and youth.
My guide to caring for trans and gender-diverse patients
By Rainbow Health Ontario. Trans Primary Care. 2020. (ONT)
Guide for medical personnel caring for gender-diverse patients.
“The content of this illustrated guide is based on Sherbourne’s Guidelines for gender-affirming primary care with trans and non-binary patients authored by Dr. Amy Bourns, a family physician on Sherbourne’s LGBT2SQ Health Team.”
Family & Community Medicine, University of Toronto. Mar 23, 2021.
See infographic above.
"Historically, patients identifying as sexual or gender minorities (SGM) have faced healthcare inequity and discrimination. Although the LGBTQ2S+ (lesbian, gay, bisexual, trans, queer, two-spirit and other SGMs) community have made great strides toward achieving the rights and freedoms they deserve in Canada, this community is underserved and experience health disparities.
This is in part due to experiences of discrimination. Many care providers lack the skills and knowledge needed to provide safe, inclusive and affirming care. Although Canadian medical schools are constantly improving their sexual health curriculum, issues surrounding SGM health are as diverse and complex as the LGBTQ2S+ community.
When LGBTQ2S+ student leaders expressed concern that the University of Toronto undergraduate medical curriculum did not teach the knowledge, skills and attitudes needed to address their future SGM patient needs, Dr. Laurence Biro’s team responded.
To address this gap, Dr. Biro, an Assistant Professor at U of T’s Department of Family and Community Medicine (DFCM), worked collaboratively with community, faculty and student partners to develop a clinical skills seminar for first-year undergraduate medical students. During the four-hour seminar, students answer discussion questions, participate in peer role-plays and interview two standardized patients. Students leave the seminar with an appreciation of SGM health and associated clinical communication skills."
Edited by Zena Sharman. Book. 2016. (CANADA)
"Lambda Literary Award winner
To remedy means to heal, to cure, to set right, to make reparations.
The Remedy invites writers and readers to imagine what we need to create healthy, resilient, and thriving LGBTQ communities. This anthology is a diverse collection of real-life stories from queer and trans people on their own health-care experiences and challenges, from gay men living with HIV who remember the systemic resistance to their health-care needs, to a lesbian couple dealing with the experience of cancer, to young trans people who struggle to find health-care providers who treat them with dignity and respect. The book also includes essays by health-care providers, activists, and leaders, with something to say about the challenges, politics, and opportunities surrounding LGBTQ health issues.
Both exceptionally moving and an incendiary call-to-arms, The Remedy is a must-read for anyone--gay, straight, trans, and otherwise--passionately concerned about the right to proper health care for all.
Contributors include Amber Dawn, Sinclair Sexsmith, Francisco Ibanez-Carrasco, Cooper Lee Bombardier, Kara Sievewright, Kelli Dunham, Vivek Shraya, and many more."
A resource guide on gender-affirming primary care
Every journey is unique; understand your patient's
Oakmed (multidisciplinary health clinic). Oakville, Ontario. Brochure. (ONT)
"This resource guide is intended to help you provide trans and gender-diverse primary care to patients in the Mississauga Halton LHN."
Sherbourne’s Guidelines for gender-affirming primary care with trans and non-binary patients: 4th edition
Authored by Dr. Amy Bourns, family physician on Sherbourne’s LGBT2SQ Health Team. 2019. (ONT)
“In addition to incorporating recently available evidence in both general primary care and trans health, the 2019 edition features revisions and expansions in several areas, including: expanded discussion of considerations for non-binary patients; unique considerations for older trans patients; subtle language changes that reflect the rapid pace of cultural change; an expanded discussion of fertility considerations for trans people; discussion of alternate routes of hormone administration; an overview of the role of PCPs in supporting patients with transition-related surgeries; and The Trans Primary Care Guide, the online interactive tool based on the Guidelines, has also been updated… You may also want to access the Quick Reference Guide that was created to accompany the full Guidelines.”
Fact Sheet for health and social service providers
By Rainbow Health Ontario. 2012. (ONT)
“The purpose of this fact sheet is to share information with health and social service providers in Ontario regarding evidence-based best practices for working with and supporting gender independent children and their families.”
Shelbourne Health. 2016. (ONT)
Ontario-based, but has good information regarding care.
"The Guide provides an introduction to trans care issues, addresses common fears around providing hormone therapy, and maps out guidelines and protocols for caring for trans patients. This inventive tool is based on Sherbourne’s globally-used Guidelines and Protocols for Trans Clients handbook, which was first published in 2009 and revised in 2015. The Guide was developed in partnership with Kelly Speck, a student of the University of Toronto (U of T)’s Biomedical Communications program."
Sherbourne Health / Rainbow Health Ontario. (ONT)
"Intended for use by primary care providers, these summary sheets about transition-related surgeries (TRS) provide information to facilitate discussion of TRS between primary care providers and patients. Please note that they are not exhaustive and do not replace the informed consent process between surgeon and patient.
Sheets are available about the following procedures:
Breast augmentation; Chest reconstruction; Clitoral release; Hysterectomy and BSO; Metoidioplasty; Orchiectomy; Phalloplasty; Vaginoplasty
ACKNOWLEDGMENT: These documents were created by clinicians at Sherbourne Health using information adapted from the Transgender Health Information Program of British Columbia, the GRS Montreal Clinic, and the Gender Identity Clinic at the Centre for Addiction and Mental Health."
Areas to consider when assessing a paediatric transgender or gender diverse patient. WPATH, World Professional Association for Transgender Health.
US & INTERNATIONAL SOURCES
Not necessarily applicable to Albertans, but interesting information
for medical professionals.
Inclusive Guide to Medical and Surgical Transition
By Sidhbh Gallagher, MD. Nov 2020. (US)
"Finding accurate information to help along the path to medical and surgical transition can be challenging. There is still a lack of competent providers in this field and though the internet is a wonderful resource while transitioning, there is just too much myth and inaccuracy out there. This book was conceived in response to just that.
Written by Dr. Gallagher and a group of dedicated colleagues who serve the transgender and non-binary community, it is designed to be a solid resource when it comes to transgender health care. It is primarily designed to deliver information to patients in a way that’s straight forward and jargon free. These concepts can be difficult enough to understand without reading a medical dictionary at the same time! Transitioning is such a complex process and the physical aspect of it is just one part of the puzzle. Our hope is that this guide will help de-mystify the process."
This book by Dr. Sidhbh Gallagher of Gallagher Plastic Surgery in Miami takes a very complex topic (medical and surgical affirmation of transgender persons) and breaks it down in an informative and easy to read book. This book may be the first comprehensive 'manual' to describe the latest up to date procedures available to the person undergoing transition. Included are descriptions of procedures, the expected results, potential complications, as well as pros and cons to many options. In areas where Dr. Gallagher is not an expert on, she invites those with expertise in those areas to contribute to the book (e.g. facial feminization and voice feminization). Providing a well rounded overview of the medical side of transition.
I highly recommend this book to those not only in the early stages of planning their transition, but also those in the process of transitioning. ---- MR
A clinician’s guide to gender-affirming care: Working with transgender or gender nonconforming clients
by Sand C. Chang, Anneliese A. Singh, Lore M. Dickey. 2018. (US)
“Transgender and gender nonconforming (TNGC) clients have complex mental health concerns, and are more likely than ever to seek out treatment. This comprehensive resource outlines the latest research and recommendations to provide you with the requisite knowledge, skills, and awareness to treat TNGC clients with competent and affirming care. As you know, TNGC clients have different needs based on who they are in relation to the world. Written by three psychologists who specialize in working with the TGNC population, this important book draws on the perspective that there is no one-size-fits-all approach for working with TNGC clients. It offers interventions tailored to developmental stages and situational factors-for example, cultural intersections such as race, class, and religion.
This book provides up-to-date information on language, etiquette, and appropriate communication and conduct in treating TGNC clients, and discusses the history, cultural context, and ethical and legal issues that can arise in working with gender diverse individuals in a clinical setting. You’ll also find information about informed consent approaches that call for a shift in the role of the mental health provider in the position of assessment and referral for the purposes of gender-affirming medical care (such as hormones, surgery, and other procedures).
As changes in recent transgender health care and insurance coverage have provided increased access for a broader range of consumers, it is essential to understand transgender and gender nonconforming clients’ different needs. This book provides practical exercises and skills you can use to help TNGC clients thrive.”
By Irwin Krieger. 2017. (US)
“There are growing numbers of youth who identify as transgender, and as a result, clinicians and counselors are in need of an informed resource that covers the basics of gender identity and expression. This book responds to that need by setting out clear advice and support on working with transgender and non-binary youth with regard to their identity, mental health, personal and family life and their medical and social transition as well as offering additional resources and reading lists.
Along with the basic information needed to understand transgender clients, Irwin Krieger applies this general knowledge to work with transgender teens at what can be the most critical and problematic stage in a trans person's life. Specifically, issues of gender identity awareness and expression for youth along with the mental and physical challenges that puberty presents are discussed. This guide will inform counselors and therapists to support transgender teens in their practice, while providing the necessary tools for opening up the conversation on transgender issues in families and schools.”
Irwin Krieger, LCSW is a clinical social worker who provided psychotherapy in a private practice setting for LGBT individuals, couples and families for over 30 years. Irwin has worked extensively with transgender teens and adults and their families. Irwin has presented at the World Professional Assn for Transgender Health Symposium in Atlanta, the US Professional Assn for Transgender Health Symposium in Los Angeles, the Philadelphia Trans-Health Conference, and the Maine Academy of Family Physicians. University presentations include Yale, Quinnipiac, Ursinus, University of Hartford and UConn. Irwin was the keynote speaker at the GSA Summit at Eastern CT State University in the fall of 2011, the CT School Counselors Conference in 2017, the GeMS Conferences at Boston Children’s Hospital in 2013 and 2015, and Transgender Family Day at Dartmouth-Hitchcock Hospital in 2017. From 2012 to 2016 he was a consultant for the Transgender Care Team at Yale Health Plan.
By Jason Rafferty, MD, MPH, EdM, FAAP, Committee on Psychosocial Aspects of Child and Family Health. Committee on Adolescence, Section on Lesbian, Gay, Bisexual, and Transgender Health and Wellness. Published in Pediatrics October 2018, 142 (4) e20182162; DOI: https://doi.org/10.1542/peds 2018-2162
“Abstract: As a traditionally underserved population that faces numerous health disparities, youth who identify as transgender and gender diverse (TGD) and their families are increasingly presenting to pediatric providers for education, care, and referrals. The need for more formal training, standardized treatment, and research on safety and medical outcomes often leaves providers feeling ill equipped to support and care for patients that identify as TGD and families. In this policy statement, we review relevant concepts and challenges and provide suggestions for pediatric providers that are focused on promoting the health and positive development of youth that identify as TGD while eliminating discrimination and stigma.”
Establishing trust with youth seeking gender affirmative medical care
Gender Spectrum website. “Medical Resources”. (US)
“Your most important skill in your work with transgender, nonbinary and gender expansive youth is your ability to listen. Remember: the young person (and their caregiver) has a gender history when they come to their appointment. This history may create a barrier to their feeling safe with you, and could compromise your ability to provide informed and affirmative care.”
Everything you ever wanted to know about trans* (but were afraid to ask)
By Brynn Tannehill. 2018. (US)
“Leading activist and essayist Brynn Tannehill tells you everything you ever wanted to know about transgender issues but were afraid to ask. The book aims to break down deeply held misconceptions about trans people across all aspects of life, from politics, law and culture, through to science, religion and mental health, to provide readers with a deeper understanding of what it means to be trans. The book walks the reader through transgender issues, starting with 'What does transgender mean?' before moving on to more complex topics including growing up trans, dating and sex, medical and mental health, and debates around gender and feminism. Brynn also challenges deliberately deceptive information about transgender people being put out into the public sphere. Transphobic myths are debunked and biased research, bad statistics and bad science are carefully and clearly refuted. This important and engaging book enables any reader to become informed the most critical public conversations around transgender people, and become a better ally as a result.”
"Brynn Tannehill is a military veteran who felt that the United States military’s discriminatory policies forced her to make a choice between continuing serving her country and living openly as a transgender woman. Brynn was born and raised as a boy, but that never felt right, and so she came out as transgender, transitioned, and now lives every day as the woman she has long known herself to be. Brynn has become a vocal advocate for the transgender community, in particular transgender soldiers, because of her own experiences and previous fears about openly serving her country."
HUman Diversity Lab, Princeton University. Research. (US)
“Our research lab is conducting several studies about gender development in childhood. The TransYouth Project (TYP) is our largest project and is the first large-scale, national, longitudinal study of socially-transitioned transgender children to date. For more about the TransYouth Project check out our Frequently Asked Questions about the TYP. We are following a cohort of about 300 children from 45 U.S. states and several Canadian provinces for 20 years.”
By Kelly Storck. Apr 2018
“The Gender Identity Workbook for Kids offers fun, age-appropriate activities to help your child explore their identity and discover unique ways to navigate gender expression at home, in school, and with friends. Transgender and gender-nonconforming (TGNC) children need validation and support on their journey toward self-discovery.
Unfortunately, due to stigma and misinformation, these kids can be especially vulnerable to bullying, discrimination, and even mental health issues such as anxiety or depression. The good news is that there are steps you can take to empower your child as they explore, understand, and affirm their gender identity. This important workbook will guide you both.
In this guide, a licensed clinical social worker who specializes in gender-nonconforming youth offers real tools to help your child thrive in all aspects of life. You and your child will discover a more expansive way of understanding gender; gain insight into gender diverse thoughts, feelings, and experiences; and find engaging activities with fun titles such as, 'Apple, Oranges, and Fruit Bowls' and 'Pronoun Town' to help your child to explore their own unique identity in a way that is age-appropriate and validating.
No child experiences gender in a vacuum, and children don’t just transition—families do. Let this workbook guide you and your child on this important journey in their lives.”
"A sensitive and empowering exploration of identity and expression that both educates and celebrates." —School Library Journal
Groundbreaking UW study: Transgender kids’ gender identity is as strong as that of cisgender children
By Kristina Olson, Psychologist. University of Washington / Association for Psychological Science. December 2019. (US)
“This research is part of the TransYouth Project, led by UW psychologist Kristina Olson, who earlier this year received the Alan T. Waterman Award, which is given to early-career scientists by the National Science Foundation, and was awarded a genius grant from the MacArthur Foundation. Olson put a $1 million grant from the Waterman award toward the TransYouth Project “
Care for transgender, nonbinary & gender nonconforming patients at a glance
University of Colorado OB/GYN. (US)
"At University of Colorado OB/GYN, we understand that transgender, nonbinary and gender-nonconforming patients face significant barriers to receiving medical care. We strive to provide open, culturally competent gynecologic care to those in need of an affirming environment regardless of gender identity. Transgender, nonbinary and gender-nonconforming patients who have retained reproductive organs such as the cervix require routine gynecological care."
Aspivix. Blog post.
" 'You can’t be modern if you are not inclusive'. In this article we talk about being inclusive in gynecology.
It was the feedback Aspivix received in social media after releasing its newly created vision statement Gynecology. Now modern which was followed by a descriptor: 'Developing modern devices in gynecology for clinicians and women.'
Using gender-balanced language is becoming non-optional in every sector, yet how do we articulate inclusiveness in a sector named ‘women’s healthcare’ ?
In obstetrics and gynecology, where women are known as the primary patients, where do transgender and non-binary patients fit?
Such reflections made us stop and recognize the pivotal role of companies in the field of Obstetrics and Gynecology, so we asked ourselves:
How to be inclusive in gynecology?
How to approach the special needs of transgender people from a medical perspective?"
By Alex Iantaffi and Meg-John Barker. Sept 2017. (UK)
”Have you ever questioned your own gender identity? Do you know somebody who is transgender or who identifies as non-binary? Do you ever feel confused when people talk about gender diversity?
This down-to-earth guide is for anybody who wants to know more about gender, from its biology, history and sociology, to how it plays a role in our relationships and interactions with family, friends, partners and strangers. It looks at practical ways people can express their own gender, and will help you to understand people whose gender might be different from your own. With activities and points for reflection throughout, this book will help people of all genders engage with gender diversity and explore the ideas in the book in relation to their own lived experiences.”
For anyone who's ever wished they had a smart, kind, friend with whom they could calmly and safely discuss gender issues: this most excellent book is that kind of friend --- Kate Bornstein, author of Gender Outlaw
By Sarah Pickle, M.D. Pride in Practice. Jan 2019. (US)
"There were learning curves, missteps, and course corrections in establishing a family medicine practice that strives to make all patients feel affirmed in their gender identities. There still are. But part of the growth of our profession, as physicians and advocates, is to be open to our own evolution and that of our practice when it benefits our patients."
"Pride in Practice is dedicated to empowering health care providers with the information they need to give excellent care to people of all sexual orientations, gender identities, and differences in sex development."
By Mandy S. Coles, MD, Clinical Associate Professor, Pediatrics, Boston University School of Medicine. April 16, 2021. (US)
"Being transgender is not something that goes away. It is something my patients live with for their entire lives. Our multidisciplinary care team continues to see patients like Charlie on a regular basis, often following them into young adulthood. While more research is always needed, a gender-affirmative approach and evidence-based medicine allows young transgender people to live in the world as their authentic selves."
by Allison Rhodes. Pride in Practice. Jul 2020. (US)
"It is essential for clinicians to be informed about LGBT health because of the unique health disparities affecting LGBT populations; the prevalence of violence and victimization related to homophobia, biphobia, and transphobia; and the long history of anti-LGBT bias in health care. It is therefore critical to understand sexual orientation, sexual behavior, gender identity, and gender expression.
In order to improve health care for lesbian, gay, bisexual, and transgender (LGBT) patients, we must include LGBT-related content in medical training. This article contains tips for medical educators and residency program directors on how to begin incorporating LGBT-inclusive content into medical curricula."
Public Facebook page.
" *Note that this Facebook group is not affiliated with WPATH.* This group is for health professionals, researchers, and others involved in trans health to discuss and promote awareness of new developments in trans health. This group's purpose is to share information, articles, and news on trans health. "
It’s a transgenderation: Issues in transgender medicine
By Dr Rachel Levine. Jan 2017. Ted Talk video. (US)
"Admiral Rachel L. Levine (now) serves as the 17th Assistant Secretary for Health for the US Department of Health and Human Services (HHS), after being nominated by President Joe Biden and confirmed by the US Senate in 2021."
by Leslie Lagerstrom. 2019.
"...most patients (myself included, before I had Sam) have no idea how different a trip to the doctor can be for trans people. A common question I field from medical professionals is: ‘As a mother, what how do you suggest we make our practice more inclusive for your child and people like him?’ The following are my recommendations for providers wanting to build a more transgender-inclusive practice."
Leslie Lagerstrom is the creator of the blog Transparenthood, which chronicles her family’s experience raising a transgender child. Her essays have been featured in three anthologies, turned into a stage production that toured the United States, and can be found in The Huffington Post.
By Emily Chudy. Feb 1, 2022. (UK)
"Poet and musician Freddie Lewis has shared his experience of having periods as a man in the hope of allowing trans men to be 'part of that chat too'. In a conversation with the BBC, Lewis, a 22-year-old pop musician and poet from Bristol, spoke about the experience of having periods and how he uses his art to 'show the world my joy in being trans'."
A practitioner’s resource guide: Helping families to support their LGBT children
Prepared by Caitlin Ryan, PhD, ACSW, Director of the Family Acceptance Project at San Francisco State University for SAMHSA (Substand Abuse & Mental Health Services Admin, HHS. 2014. (US)
“This resource guide was developed and is being disseminated throughout health and social service systems to help practitioners who work in a wide range of settings to understand the critical role of family acceptance and rejection in contributing to the health and well-being of adolescents who identify as lesbian, gay, bisexual, and transgender. This includes practitioners who work in primary care, behavioral health, school-based services, family service agencies, homeless and run-away programs, and foster care and juvenile justice settings.
Its intent is to help practitioners implement best practices in engaging and helping families and caregivers to support their LGBT children. The family intervention approach discussed in this guide is based on research findings and more than a decade of interactions and intervention work by the Family Acceptance Project (FAP) at San Francisco State University with very diverse families and their LGBT children.”
Puberty suppression linked to improved well-being in transgender youth
By Cordelia Ross, MD, MS and Leah H. Carr, MD. Sep 8, 2014. (US
"1. Youth with gender dysphoria (GD; significant discontent with the sex assigned at birth), who underwent treatment with puberty suppression reported significant improvements in GD and body image difficulties.
2. After treatment with puberty suppression, participants reported improvements in global psychological functioning as well as on measures of objective and subjective well-being."
By Nick Nicoletti, Founder of Dx: Q. (US)
"Dx: Q was founded out of a curiosity for how medicine, love, and understanding intersect. It was an idea that started in the small, very well decorated, Boston apartment of my friend Ethan. We were talking about one of several experiences I had where I observed how little the medical community understood the LGBTQ+ community. We talked about my experience with my primary care physician as well as how teaching staff at my medical school address LGBTQ+ issues. I distinctly remember him being in awe, saying "You should do something about this. This is not okay."
I realized that this could be happening to more people than I previously thought. I began writing down my thoughts, thinking to myself that indeed something had to be done. At the top of my notepad in bold was the word DIAGNOSIS.
I reached out to friends in the queer community. After a few brave people were willing to share their story with me...I found that the LGBTQ+ community's relationship with healthcare is worse than I imagined. From there, over the next few months, Diagnosis: Queer was created. Or as we like to call it, Dx:Q.
Our experiences in healthcare are intimate, deeply personal, and define our wellbeing. It is Dx: Q's greatest goal to share stories of how the queer community interacts with medicine. It is important for more people to understand this relationship and to read the stories of queer individuals who have have benefited by our healthcare system, and have been failed by it.
If you identify with the letters LGBTQ+, you will face challenges when practicing and receiving healthcare. Queer identity changes the situation for some reason and Dx: Q is here to bring light to this reality.
Our hope is that queer visibility will bring change. Change that can improve the lives of LGBTQ+ individuals."
By Rowan Giffel & Dr Jae Puckett, Trans-ilience: The Transgender Stress and Resilience Research Team at Michigan State University. Infographic.
"... some key takeaways from our study on how to improve healthcare services for transgender clients. " Click for info on Trans-ilience and their research.
Suggestions from trans and gender diverse people for improving health care. By Rowan Giffel & Dr Jae Puckett.
Trans-ilience: The Transgender Stress and Resilience Research Team, Michigan State University.
By American Academy of Pediatrics, American College of Osteopathic Pediatricians and Human Rights Campaign (HRC). Sept 2016.
“Supporting & Caring for Transgender Children is a groundbreaking resource that explains how families and healthcare professionals are helping transgender children thrive.’
By Finn V. Gratton. Oct 2019.
“Providing advice on how professionals working with autistic trans youth and adults can tailor their practice to best serve their clients and how parents can support their trans autistic children, this book increases awareness of the large overlap between trans identities and autism.
By including chapters on gender diversity basics, neuroqueer trauma and how to support neuroqueer individuals, this book sets out strategies for creating more effective support that takes into account the unique experiences of trans people on the spectrum. Written by a therapist who identifies as neuroqueer, this book is the perfect companion for professionals who want to increase their knowledge of the experiences and needs of their trans autistic clients.”
Transgender health: A practitioner’s guide to binary and non-binary trans patient care
by Benjamin Vincent, PhD. 2018. (US)
“The number of people coming out as transgender continues to rise, and this book shows healthcare and medical practitioners how to deliver excellent primary and secondary care to gender diverse patients. This guide provides accessible and practical advice on tailoring the social and ethical aspects of practice to the needs of each individual. Beyond setting out how clinical procedures should work for gender reassignment, it explains how to use language and pronouns in a respectful way, provides information on transgender services and resources, and offers insights into the challenges commonly faced by transgender people in both medical and social contexts. Based on cutting edge research and the lived experience of the author as a non-binary person, this is essential reading for all those working to meet the needs of transgender people in healthcare settings.”
Transgender kids show consistent gender identity across measures
Reported by Association for Psychological Science. Jan 29, 2015
“A study with 32 transgender children, ages 5 to 12, indicates that the gender identity of these children is deeply held and is not the result of confusion about gender identity or pretense. The study, led by psychological scientist Kristina Olson of the University of Washington, is one of the first to explore gender identity in transgender children using implicit measures that operate outside conscious awareness and are, therefore, less susceptible to modification than self-report measures.”
Mandala Center for Change. 2018. YouTube video. (US)
“We Are Here is an educational video focusing on transgender healthcare produced by Mandala Center for Change and Whaleheart Productions. Commissioned by Jefferson Healthcare, this video was a direct outcome of the Mandala Center's Transgender Youth Legislative Theatre project and is being integrated as required training for local medical providers and support staff. The training video itself is 12 minutes long followed by credits and 3 minutes of Cast Interviews. www.mandalaforchange.com "
Suggestions from trans and gender diverse people for improving health care. By Rowan Giffel & Dr Jae Puckett. Trans-ilience: The Transgender Stress and Resilience Research Team, Michigan State University.
vs Gender Expression
vs Anatomical Sex
vs Sexually Attracted To
vs Romantically Attracted To
Infographic. “A teaching tool for breaking the big concept of gender down into bite-sized, digestible pieces”
Worksheet: "A printer-friendly version of Genderbread Person 4.0 Worksheet, which is great for lesson plans and one-on-one guided walkthroughs."
Click for French version.
Trans Student Educational Resources.
The identity-bread person (graphic)
By Rainbow Coalition of Yellowknife. Infographic. (NT/Canada)
A graphic similar to the Genderbread Person and the Gender Unicorn.
By Clio Hartzer. Being’ Enby blog. Infographic/poster last revised Jan 2021.
“I designed this for ...(those)... who prefer a visual summary of the key ideas on degendering language. I also have longer text-based pieces for those who want more details:
* Non-binary students: Non-binary 'they' and style guides
* Non-binary students and pronouns ”
CHILDREN'S BOOK ON GENDER DYSPHORIA
Me And my dysphoria monster: An empowering story to help children cope with gender dysphoria
By Laura Kate Dale, illustrated by Hui Qing Ang. Aug 18, 2022. Ages 6-8.
"Nisha's monster follows her everywhere. It used to be small, but recently her monster has begun to grow. And as her monster gets bigger and bigger, Nisha feels more and more unlike herself.
When people refer to her as a boy, or when she tries to hide her true gender identity, Nisha's dysphoria monster grows larger and larger. Until, one day, Nisha meets Jack - a trans man - who shows Nisha how she can shrink her dysphoria monster back down to size.
This touching story is the perfect book for discussing gender dysphoria with children, explaining what it is and how they and their families can deal with it. It also includes an accompanying guide for parents with further information about gender dysphoria, terminology, and first-hand examples of the author's own experiences.
Laura Kate Dale is a queer trans woman and author, who uses She / Her pronouns. Laura lives near London, UK, with her cat Smudge, and her wife Jane. When Laura isn't writing she loves to play roller derby, and play video games with her friends."
A DARK TIME IN THE HISTORY OF
TRANSGENDER HEALTH CARE IN CANADA
NOTE: Some medical practitioners, including psychiatrists,
still believe the misinformation of this discredited doctor.
Source: Transgender Map website by Andrea James, under RESOURCES.
"The historical shift in trans rights for Canadians can be directly traced to the 2015 staffing changes at the conservative gender clinic at Toronto’s Centre for Addiction and Mental Health (CAMH). For nearly 50 years, practitioners at that clinic:
* promoted rigid gatekeeping for trans healthcare
* created diseases to describe trans people and those who love us
* developed a non-affirming model of care for gender expansive children
They turned Toronto into the global epicentre for the academic exploitation of sex and gender minorities. For half a century, they damaged trans people the world over through their influence. It took legislation to remove them from power.
Of the hundreds of people who worked to end CAMH’s devastating impact on trans healthcare, I want to acknowledge Ontario MPP Cheri DiNovo, who helped pass two critical pieces of legislation:
• Bill 33, or Toby’s Law (2012), outlawing discrimination based on gender identity and gender expression
• Bill 77 (2015) banning CAMH-style “therapy” on gender-expansive children
Bill 77 led to the investigation and closure of CAMH’s gender clinic and firing of program head Kenneth Zucker. CAMH now has new affirming policies and staff in place.
In 2019 Canada rejected a federal ban on gender identity change efforts, but according to CBC, some provinces had placed restrictions:
• Ontario has made the practice illegal by initiating an outright ban.
• Manitoba has outlawed health professionals from offering conversion therapy.
• Vancouver has passed a law restricting businesses from offering it.
• Nova Scotia has made it it illegal for health professionals to provide conversion therapy for minors."
[NOTE: list of provinces banning conversion therapy is not completely updated]