Affirmative Counseling for Transgender and Gender Diverse Clients

llore m. dickey, PhD, is a licensed and board-certified counseling psychologist. His work in the field of psychology has included serving as a faculty member at both the undergraduate and graduate levels. Most recently he was a behavioral health consultant at a federally qualified health center. Although lore is retired, he is actively engaged in writing and speaking about the lives trans people. Jae A. Puckett, PhD, is a licensed clinical psychologist. They are an assistant professor at Michigan State University where they also direct Trans-ilience: The Transgender Stress and Resilience Research Team, as well as supervise graduate trainees in the Sexual and Gender Minority Clinic. Dr. Puckett has published numerous articles on the experiences of stress and resilience in the lives of transgender and gender diverse individuals and about affirming clinical practice, in addition to teaching, training, and supervising those providing clinical services to trans clients.

1 Description
1.1 Terminology
1.2 Definitions
1.3 Overview
1.3.1 Indigenous People
1.3.2 Medical Model
1.3.3 Transgender Movement
1.3.4 Nonbinary Movement
1.4 Gatekeeping
2 Theories and Models
2.1 Minority Stress Theory
2.1.1 Challenges With Minority Stress and
Trans People
2.1.2 Suicide and Minority Stress
2.2 Gender Dysphoria
2.2.1 Reclassifying Gender Dysphoria
2.3 Medical Necessity
2.4 Informed Consent
2.5 Harm Reduction
2.6 Shaping the Therapeutic Dialogue
2.6.1 Introducing Yourself With Your Pronoun(
s)
2.6.2 Presentation of Experience and
Training
2.6.3 Assumptions About What an Identity
Term Means for the Client topic?
2.6.4 Trans Client Fluidity in Their Gender
and Sexuality
2.6.5 Assumptions About Meaning of Transition
for a Client
2.6.6 How to Respond When You Make a
Mistake
2.6.7 Understanding Diverse Experiences
Gender
2.6.8 Reviews of Client Experience in Your
Practice
2.6.9 Knowledge of Local Resources
2.7 Shaping the Therapeutic Relationship
2.7.1 Grief
2.7.2 Suicide and Trans People
2.7.3 Nonsuicidal Self-injury
2.7.4 Reasonably Well-Controlled Mental
Health
3 Assessment and Treatment Indications
3.1 Assessment
3.1.1 Screening Tools
3.1.2 Outcome Measures
3.1.3 Critique of Personality Assessment
Tools
3.1.4 Progress Monitoring Tools
3.1.5 Measures Designed for Trans Clients
3.1.6 Caution When Interpreting Results
4 Treatment
4.1 Method of Treatment
4.1.1 Conversion Therapy
4.1.2 Specific Clinical Concerns
4.2 Efficacy and Prognosis
4.2.1 Affirmative Practice
4.2.2 Therapeutic
4.3 Variations of the Method: Letter Writing
4.4 Problems in Carrying Out Treatments
4.4.1 Trauma
4.4.2 Trans Clients in Rural Locations
4.4.3 Rapid Onset Gender Dysphoria
4.4.4 Autism Spectrum Disorder in Trans
People
4.4.5 Co-Occurring Medical Concerns
4.4.6 Persistence, Insistence, and Consistence
4.5 Multicultural Issues
4.5.1 Intersectionality
4.6 Importance of Interrogating Your Gender
5 Case Vignette
5.1 Assessing Eliza's Need for Support
6 Further Reading
7 References
8 Appendix: Tools and Resources