What is Gender-Affirming Care?
Gender-affirming care may be a term you’re not super familiar with, or perhaps you’d like to learn a bit more about what gender-affirming care looks like.
As usual, let’s start with a definition:
“Gender-affirming care, as defined by the World Health Organization, encompasses a range of social, psychological, behavioral, and medical interventions “designed to support and affirm an individual’s gender identity” when it conflicts with the gender they were assigned at birth.”
In other words, gender-affirming therapy does not try to “fix” or “cure” an individual’s gender identity but instead is there to support and respect each person for who they are.
“The goal is not treatment, but to listen to the [client] and build understanding — to create an environment of safety in which emotions, questions, and concerns can be explored,” says Rafferty, lead author of a policy statement from the American Academy of Pediatrics (AAP) on gender-affirming care.”
Gender-Affirming Care in Action
Gender-Affirming Therapy looks like:
Gender affirmation
Space for processing and understanding
Linking to social supports, legal services, health care providers
Creating a safe zone
Allowing for diversity
Reflection and empathy
According to the American Psychiatric Association (APA), there are eight core themes of gender-affirming therapy which are important for healthcare providers to be aware of:
Trauma
“Transgender and Gender Nonconforming (TGNC) people have essentially grown up and live in a world that is, more often than not, transphobic. Encountering messages and behaviors that discourage and are hostile to gender diversity creates the experience of repeated trauma with physical and psychological effects.”
Shame
“The feeling of being flawed or different leads to shame. Avoidance of the feeling of shame can cause anxiety.”
Depression
“Those who suffer from repeated trauma may have higher levels of depression. TGNC people have a disproportionately high rate of mental illness that is influenced in part by lack of societal support.”
Self-harm
“TGNC people have been shown to have high levels of suicidal ideation and as many as 50% have attempted suicide in their lifetime. This is influenced by the lack of social supports and transphobic hostility that is repeated over time.”
Violence
“TGNC people are often the victims of hate crimes and at least 25% have reported being attacked in their lifetime.”
Sexuality
“Those who live on a more diverse gender spectrum are still placed into discrete “boxes” regarding their sexual orientation. It is important to understand that sexual orientation can present in many forms and can be fluid over time.”
Medical Treatment
“Exploring the pros and cons of hormone interventions is important, along with helping the individual understand where they fit on the gender spectrum.”
Societal Stigma
“This includes exploring feelings related to “passing” or not passing as a particular gender and how to navigate an often transphobic world. This also includes helping TGNC patients find social support and families of choice.”
Sadly, discrimination can be often found within the healthcare system for LGBTQ+ folks. Therapists and other healthcare providers are not always experienced in providing gender-affirming care, so it’s important to do some research and ask questions.
What is Gender Dysphoria?
Oftentimes individuals who are seeking gender-affirming care experience gender dysphoria. According to the NHS,
“Gender dysphoria is a term that describes a sense of unease or distress that a person may have because of a mismatch between their biological sex and their gender identity.
This sense of unease or dissatisfaction may be so intense it can lead to depression and anxiety and have a harmful impact on daily life.”
Gender dysphoria occurs at different ages for everyone: sometimes beginning in childhood, starting at puberty or much later in life.
According to the APA, “People who are transgender may pursue multiple domains of gender affirmation, including social affirmation (e.g., changing one’s name and pronouns), legal affirmation (e.g., changing gender markers on one’s government-issued documents), medical affirmation (e.g., pubertal suppression or gender-affirming hormones), and/or surgical affirmation (e.g., vaginoplasty, facial feminization surgery, breast augmentation, masculine chest reconstruction, etc.).
Not all trans individuals will desire all domains of gender affirmation, as these are highly personal and individual decisions.”
It’s important for individuals who are experiencing gender dysphoria to have mental health support and a therapist that has knowledge of gender-related issues.
Support and Resources for LGBTQ+ Individuals
If you’re reading this and need some support, here are some great resources you can check out:
Trans Lifeline: 877-565-8860
The National Suicide Prevention Lifeline: 800-273-8255
Online Chat
The Crisis Text Line: Text START to 741-741
National Center for Transgender Equality (NCTE)
Trans Youth Equality Foundation
2015 US Trans Survey (Kentucky Report)
While there is still a lot of work to be done, I am proud to offer my services as an experienced gender-affirming mental health provider. I strive to continually educate myself on the latest information and strategies to help my clients to the best of my abilities. (It’s the least I can do to support my LGBTQ+ clients!) Please reach out if you’re interested in working together!
