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Safe Schools for Transgender and Gender Diverse Students

Safe Schools for Transgender and Gender Diverse Students

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Published by Jill Davidson
This is our current draft of a proposed position paper for the National Association of School Psychologists.
This is our current draft of a proposed position paper for the National Association of School Psychologists.

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Published by: Jill Davidson on Sep 29, 2013
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D R A F T: This is a draft of a proposed position paper of the National Association of School Psychologists.It has not been approved by the NASP Delegate Assembly and, given its draft status, should not bedisseminated, quoted, or cited by any person except as part of its review and revision with NASPgovernanceSafe Schools for Transgender & Gender Diverse StudentsThe National Association of School Psychologists supports efforts to ensure that schools are safeand inclusive learning environments for students, family members, and school staff who are transgenderor gender diverse
. NASP acknowledges that the terms “transgender” or “trans” includes persons
identifying as female-to-male, male-to-female, two-spirit, gender queer, and other terms. Genderdiverse individuals have a gender expression that does not fit cultural expectations for their genderassigned at birth and may or may
not identify as trans. NASP respects a person’s right to express their
gender identity, and the right to modify their gender expression when necessary for their well-being.NASP acknowledges that neither having a trans identity nor being perceived as gender diverse are
disorders, and that efforts to change a person’s gender identity are ineffective, harmful, and
discriminatory. NASP is committed to a policy of nondiscrimination and the promotion of equalopportunity, fairness, justice, and respect for all persons. NASP works to ensure that settings in whichschool psychologists work are safe and welcoming and provide equal opportunity to all personsregardless of actual or perceived characteristics, including . . . gender, gender identity, genderexpression, sexual orientation, . . . or any other personal identity or distinguishing characteristics (NASP,2010).Terminology
Transgender,
or
trans,
 
is an umbrella term for persons whose
gender identity 
or
gender expression
 does not meet expectations typically associated with the sex to which they were assigned at birth within
one’s cultural context (APA, 2011). People who are not transgender are refer
red to as
cisgender 
.Someone is
gender diverse
if their
gender expression
does not match what is culturally expected forthe sex they were assigned at birth. They may dress or act in ways that others believe is not feminineenough or masculine enough. Such individuals have also
been called “gender nonconforming” or“gender variant”
. Gender diverse people may or may not identify as transgender.
Sex 
refers to a person’s biological characteristics including chromosomes, hormones, and anatomy.
 
Gender 
refers to the socially constructed roles, behaviors, activities, and attributes that a givensociety considers appropriate for boys/men and girls/women. While sex is a biological construct, gender
is a social construct. As most people’s sex and gender align, the
two terms are commonly conflated.
Gender assignment 
is the process of assigning a legal gender (sex) to a child soon after birth,triggering a variety of social events and developmental tasks related to gender role.
Gender identity 
 
is a person’s internal
sense of being male, female, both, or neither. Shortly afterchildren begin to speak, most are able to state whether they are a boy or a girl, and this identity is stableand resistant to change. Gender identity typically forms between 2 and 5 years of age. For most people,gender identity is consistent with sex assigned at birth
.
 
Gender expression
 
refers to how people express themselves through gestures, gait, clothing,hairstyles, voice, body characteristics, or other gendered expressions. Gender expression is visible, whilegender identity is not. Some transgender people do not appear gender diverse: they may havetransitioned to another gender and blend in well, or, they might not transition and have a genderexpression consistent with their birth-assigned gender. Some people with diverse gender expression arehappy with their sex assigned at birth and have no desire or intention to transition genders.
Gender constancy 
 
is the understanding that a person’s gender is an unchanging characteristi
c, andthis understanding develops for most children around the age of seven. School entry presents greaterpressure to conform to gender expectations. At this age, some children with a gender identity that isincongruent with their birth assigned sex may experience distress if they are not permitted to expressand be witnessed as their gender. At clinically significant levels, this distress is called
gender dysphoria
.The degree of distress can vary from mild to severe, and can be lifelong, although not all trans people
 
D R A F T: This is a draft of a proposed position paper of the National Association of School Psychologists.It has not been approved by the NASP Delegate Assembly and, given its draft status, should not bedisseminated, quoted, or cited by any person except as part of its review and revision with NASPgovernanceexperience
gender dysphoria
. The child with gender dysphoria may demonstrate symptoms of depression, anxiety, self-harm, or oppositionality.
Transgender 
is an umbrella term which includes diverse identities and modes of expression. Aperson may adopt a gender expression that is inconsistent with cultural expectations associated withtheir birth assigned sex permanently
 ,
temporarily, or situationally. They may adopt an appearance thatis perceived to be both masculine and feminine (
androgynous
), or they may mix masculine and feminineelements (
gender queer 
). Some may alternate expressed genders day to day (
gender fluid)
. The transumbrella
 
includes those assigned female at birth who are or who wish to be living as men (
trans men
),and those assigned male at birth who are or who wish to be living as women (
trans women
). Many transpeople are indistinguishable from cisgender people of the same gender
.
They may or may not desirebody modifications to express their affirmed gender. Body modifications may be temporary (e.g.,shaving, hair style, binding, hormone blockers) or permanent (hormones, electrolysis, surgeries). Manytrans people prefer to live their lives without revealing their gender transition history to anyone
(colloquially, living “
stealth
”). Trans women typically
 
identify as
women,
and trans men typically identifyas
men.
Some trans people may perceive being trans as a passage, something that describes theirhistory, but not their present. The process of changing gender expression from that of one gender toanother is called
transition
. The gender they transition to is called their
affirmed 
gender.
Social transition
can include changes in clothing, grooming, name and/or pronoun changes and more.
Medical transition
can include hormones and surgeries.Some transgender adults transition genders. Many do not transition and do not desire to do so.Some students arrive at kindergarten already living in their affirmed gender, while others may express adesire to transition genders while in elementary or in secondary school. The majority of children under
age 9 identifying as the “opposite” gender do not persist in doing so in adolescence and early adulthood.The majority of youth age 11 and older identifying as the “opposite” gender persist in their identity
throughout adolescence and adulthood. For children under age 9, only reversible social transitions occur(adopting clothing, hair styles, toy/game preferences). The difference between those who persist in
identifying as the “opposite” gender and thos
e who do not persist appears to be related to the degreeof disgust or satisfaction with bodily changes brought about by puberty for the stud
ent’s birth gender.
Many such changes are irreversible, such as the extended growth spurt, lengthening of arms, beardgrowth, and voice deepening in trans women, or widening hips, breast development, menstruation, andearly fusion of bone growth plates leading to shorter stature in trans men. These changes precipitate anemotional crisis with risk of self-harm for many persistently trans youth. Medical treatment involvingthe administration of a gonadotropin-releasing hormone agonist (GnRH) can put puberty on hold forseveral years, allowing the child time to cognitively mature. The puberty-delaying effect is completelyreversible
 –
 
when treatment stops, puberty associated with the youth’s birth ge
nder resumes. Theyouth can make an informed decision to receive hormones for their affirmed gender at age 16 or older,avoiding irreversible signs of their birth sex and avoiding expensive and painful corrective procedures.
A person’s gender identity is d
istinct from their sexual orientation.
Sexual orientation
refers to anenduring pattern of emotional, romantic, and/or sexual attractions to men, women, both sexes,transgender people, none, or all genders (APA, 2008).
One’s sexual orientation identity lab
el is typicallyderived from their gender identity, and not their assigned sex. For example, a female-to-male trans manwho is primarily attracted to men is likely to identify as gay. A male-to-female trans woman who isprimarily attracted to men is likely to identify as straight. Trans people are more likely to also identify asLGBQ than cisgender people.
 
D R A F T: This is a draft of a proposed position paper of the National Association of School Psychologists.It has not been approved by the NASP Delegate Assembly and, given its draft status, should not bedisseminated, quoted, or cited by any person except as part of its review and revision with NASPgovernanceBeing transgender is not related to
erotic preferences
. The confusion of eroticism and transidentities in popular culture leads to disbelief that children could declare an identity different than theirbirth assigned sex.RationaleTrans and gender diverse students are uncommon, but not rare. It is difficult to get reliableestimates of prevalence. Early trans prevalence estimates of 1 in 30,000 persons born male and 1 in100,000 born female were based on the number of adults seeking surgeries in Europe in the 1960s, butare still presented as current in a number of texts, including DSM-5 (American Psychiatric Association,2013). Medical and social support for gender transition has become more widely accessible since the1960s. Transgender adults in the USA, based on five recent health surveys, have been estimated as 0.3%of the general population (Gates, 2011), but this may be an underestimate. Adults, who can undergo allmedical and social aspects of transition, may not identify as trans after transition and may not becounted in population surveys. In 2010-11, 1.3% of San Francisco middle school students and 2.7% of high school students identified as transgender on an annual health survey (Shields, 2009). This likelydoes not include all gender diverse students. Nor does it include trans students who are reluctant toidentify as such on a survey: in a city known for gender tolerance, students report high rates of harassment on the basis of gender expression. Given that adult trans people report they knew theyidentified with a different gender at a median age of 5
(Kennedy and Hallen, 2010), it’s likely that in any
one school, 3% of students are transgender, gender nonconforming, or gender questioning.As transgender children become adults, they are at risk for an array of unfortunate outcomes.Nearly half of trans adults (41%) report attempting suicide at least once in their lives, compared to 1.6%for the USA population as a whole. Suicide attempts were more prevalent among those who had beenharassed at school (55%), who had been physically assaulted at school (61%), or who had been sexuallyassaulted at school (64%). Three quarters (76%) of those assaulted by school staff attempted suicide.Suicide attempts were 51% among those whose families rejected them, but only 32% among those withaccepting families (Grant, Mottet, & Tanis, 2011).There are relationships between school events and later adult outcomes. Half of the relationshipbetween gender nonconformity in adolescence and adult life satisfaction/depression is mediated by theexperience of school victimization (Toomey, Ryan, Diaz, Card, and Russell, 2010), while gendernonconformity alone had no direct effect on these adult outcomes. Harassment and assault lead toanxiety about school, leading to missing days of school. Nearly half (46%) of trans students reportmissing at least one school day in the previous month because they felt unsafe (
Greytak, Kosciw, &Diaz, 2009)
. If a trans student retaliates against harassment, they are likely to be suspended.Gender diverse children are at higher risk of physical, emotional, and sexual abuse and are at higherrisk of post-traumatic stress disorder in adulthood, with about a third of the higher risk of PTSDmediated by being abused as a child (Roberts, Rosario, Corliss, Koenen and Austin, 2012). Coming out tofamily members often results in physical assault and expulsion from the family home (Ray, 2006). Mosthomeless shelters are segregated by gender and turn away trans youth. With few employable skills,desperate for shelter and money, trans youth may turn to sex work. Sex work may be superficiallyaffirming of their gender identity, but puts them at high risk of arrest, of contracting HIV and other STDs,of physical assault, sexual assault, and homicide. Intersectionality compounds risk factors: 47% of blacktransgender adults report having done sex work and25% are HIV positive. This compares to 2.64% fortrans people of all races and 0.6% for the US population being HIV positive.Transgender youth are often desperate to transition. Even if they have health insurance,psychotherapy and medical procedures related to gender transition are specifically excluded from mosthealth insurance plans at this time. Hormones are relatively inexpensive, but lab work and physician

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