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Safe Schools for Transgender and Gender Diverse Students - Final draft

Safe Schools for Transgender and Gender Diverse Students - Final draft

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Published by Jill Davidson
Not the final edited version as passed by the NASP Delegate Assembly 02/22/2014
Not the final edited version as passed by the NASP Delegate Assembly 02/22/2014

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Published by: Jill Davidson on Feb 23, 2014
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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 be disseminated, quoted, or cited by any person except as part of its review and revision with NASP governance Transgender Students Draft January 10, 2014 1
Safe Schools for Transgender and Gender Diverse Students
1 2
The National Association of School Psychologists (NASP) supports efforts to ensure that
3
schools are safe and inclusive learning environments for all students, family members, and
4
school staff, including those who are transgender or gender diverse
. NASP respects a person’s
5
right to express gender identity, and the right to modify gender expression when necessary for
6
individual well-being. In addition, NASP supports all students
 right to explore and question
7
their gender identity.
 
 NASP is committed to a policy of nondiscrimination and the promotion of
8
equal opportunity, fairness, justice, and respect for all persons (NASP, 2012).
9
 NASP acknowledges that having a transgender identity or being perceived as gender diverse
10
are not
disorders, and that efforts to change a person’s gender identity are ineffective, harmful,
11
and discriminatory. NASP works to ensure that settings in which school psychologists work are
12
safe and welcoming and provide equal opportunity to all persons regardless of actual or
13
 perceived characteristics, including gender, gender identity, gender expression, sexual
14
orientation, and any other personal identity or distinguishing characteristics (NASP, 2010). A
15
glossary is found at the end of the statement.
16 17
Needs of Transgender Students
18 19
In many communities, it is dangerous to be gender non-conforming or to be known as
20
transgender. Many children, youth, and adults blend with their chosen gender, and are safe to the
21
extent that their transgender status is hidden. Data concerning school-age transgender youth are
22
limited, but what data are available suggest that school staff and administrators should be aware
23
of the needs of this often hidden population and ensure that schools are places where these
24
students can thrive.
25
Because transgender youth are so hidden, it would be easy to believe that these students are
26
extremely rare. It is difficult to estimate the prevalence of transgender students in school (Meier
27
and Labuski, 2013). One of the few large districts to gather data is San Francisco. In 2011, 0.5%
28
of San Francisco high school students self-identified as transgender on the annual Youth Risk
29
Behavioral Survey (Timothy Kordic, personal communication December 20, 2013). A large
30
representative sample of New Zealand high school students found that 1.2% self-identify as
31
transgender, and 2.5% were questioning their gender identity (Clark, Lucassen, Bullen, Denny,
32
Fleming, Robinson, & Rossen, 2014). The prevalence of self-identified transgender adults has
33
 been estimated as 0.3% of the US general population (Gates, 2011).
34
The experiences that transgender students have at school appear to have effects on their well
35
 being as adults. Toomey, Ryan, Diaz, Card, and Russell (2010) showed that while gender
36
nonconformity alone had no direct effect on these outcomes, the
victimization
experienced at
37
school associated with gender nonconformity had a lasting impact and put these children at risk
38
for negative mental health outcomes in adulthood. Harassment and assault lead to anxiety about
39
school, leading to missing days of school. Nearly half (46%) of transgender students reported
40
missing at least one school day in the previous month because they felt unsafe (Greytak, Kosciw,
41
& Diaz, 2009).
42
 Nearly half of transgender adults (41%) report attempting suicide at least once in their lives,
43
compared to 1.6% for the US population as a whole
 (
Grant, Mottet, Tanis, Harrison, Herman,
44
and Keisling, 2011). Nearly half of these suicide attempts occur before the age of 25 (Grant, et
45
al., 2011). In the New Zealand study of transgender high school students, 20% had reported at
46
 
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 be disseminated, quoted, or cited by any person except as part of its review and revision with NASP governance Transgender Students Draft January 10, 2014 2
least one suicide attempt in the previous year, and transgender students were twice as likely to
47
have been physically assaulted at school (Clark, et al., 2014). In the US sample, suicide attempts
48
were more prevalent among those who said they had been harassed at school (55%), who had
49
 been physically assaulted at school (61%), or who had been sexually assaulted at school (64%)
50
(Grant, et al., 2011). Three quarters (76%) of those assaulted by school staff attempt suicide
51
(Grant, et al., 2011). The incidence of suicide attempts is 51% among those whose families
52
rejected them, but only 32% among those from accepting families (Grant, et al., 2011). Nearly
53
half (48%) of parents of transgender children report that their child has expressed thoughts of
54
self-harm to them (Meier, Pardo, Olson, & Sharp, 2014). Suicide risk diminishes as a
55
transgender adult is able to complete transition (Travers, 2012).
56
Research suggests that gender diverse children are at higher risk of physical, emotional, and
57
sexual abuse and are at higher risk of post-traumatic stress disorder (PTSD) in adulthood, with
58
about a third of the higher risk of PTSD accounted for by being abused as a child (Roberts,
59
Rosario, Corliss, Koenen & Austin, 2012). Coming out to family members often results in
60
 physical assault and expulsion from the family home (Ray, 2006). In one study, more than half
61
of transgender youth reported initial parental reaction to coming out as negative or very negative
62
(Grossman, D’Augelli, &
Frank, 2011). Young adults who experience low family acceptance of
63
identity are more likely to be at risk for depressive symptoms, substance use, and suicidal
64
ideation and attempts (Ryan, Russell, Huebner, Diaz, & Sanchez, 2010).
65
In addition to longitudinal outcome risks, transgender youth face immediate challenges
66
during their school-age years. Transgender youth are often desperate to transition. However,
67
even if they have medical insurance, the health care procedures necessary to transition are
68
explicitly excluded from most health insurance plans. Psychotherapy for gender dysphoria is
69
often excluded. Transgender youth may take hormones obtained on the street or through the
70
internet without medical supervision, and take excessive doses. They may seek silicone
71
injections at “pumping parties”, resulting in severe disfigurement or death.
 
72
Despite these challenges, many transgender youth are resilient and there are a number of
73
factors that may help them guard against the worst outcomes. Resilience in children and youth
74
appears to depend on personal characteristics like being outgoing, resourceful, and having a
75
 positive self-concept; as well as social relationships, such as having an emotional bond with at
76
least one adult over a period of time; and having a supportive community (Werner, 1995).
77
Specifically for transgender and gender diverse children, attention has been focused on
 family
78
acceptance
 and
 school acceptance.
 LGBT Youth from families rated high in acceptance (e.g.,
79
they discuss
their child’s gender identity or sexual orientation openly,
i
ntegrate their child’s
80
LGBT friends into family activities; expressed appreciation for their child’s clothing choices
81
even if the clothing was gender nonconforming) reported better self-esteem, better health, lower
82
levels of depression, lower rates of substance abuse, lower rates of suicide attempts, and lower
83
rates of risky sexual behavior (Ryan et al., 2010).
84 85
Considerations for Parents, Schools, and Physicians
86 87
To adequately support their child’s growth, parents must allow their child’s personality to
88
unfold while simultaneously protecting them from harm (Ehrensaft, 2011). Families go through
89
a developmental process in accepting a transgender or gender diverse child. Much depends on a
90
 parent’s beliefs and understanding of child development and of gender. Some children have
91
unexpected gender behavior at an early age, which persists in spite of parent attempts to divert
92
 
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 be disseminated, quoted, or cited by any person except as part of its review and revision with NASP governance Transgender Students Draft January 10, 2014 3
the child to gender conforming behavior. Pare
nts may be embarrassed or ashamed of their child’s
93
 behavior, depending on conformity pressures coming from extended family members, neighbors,
94
clergy, daycare providers, and others. Parents may fear the future for their child, as well as their
95
own future as they are judged by other adults. The parent who is the same sex as the child may
96
question his or her own effectiveness as a role model. Children and youth are more likely to have
97
successful outcomes if parents work to create safe and supportive spaces for their child within
98
the home, require others to respect their child, and express love for their child (Brill and Pepper,
99
2008).
100
The World Professional Association for Transgender Health (WPATH)
Standards of Care
101
for 
 
the psychiatric, psychological, medical and surgical management of gender transition note
102
that “Treatment aimed at trying to change a person’s gender identity and expression to become
103
more congruent with sex assigned at birth has been attempted in the past without success. Such
104
treatment is no
longer considered ethical”
 (Coleman, et al., 2011, p. 175).
105
Some students arrive at kindergarten already living in their asserted gender, while others
106
express a desire to make a gender transition later in elementary or in secondary school. The
107
majority of gender diverse children under age 9 who assert that they are a different gender than
108
assigned at birth do not persist in asserting that gender in adolescence and early adulthood. By
109
comparison, the majority of youth age 11 and older asserting a gender different than assigned at
110
 birth persist in that identity throughout adolescence and adulthood (Steensma, Biemond, de Boer,
111
Cohen-Kettenis, 2011). For children under age 9, only reversible social transitions are
112
recommended (e.g., clothing, hair styles, activity preferences). For children aged 11 or older,
113
other treatments may be appropriate. A reversible medical treatment involving the
114
administration of a gonadotropin-releasing hormone agonist (GnRH) in early puberty can put
115
 puberty on hold for several years, allowing the child time to mature and be ready for permanent
116
changes. After puberty, youth can make more informed decisions regarding long-term treatment
117
(Delemarre-van de Waal and Cohen-Kettenis, 2006, Spack, et al., 2012).
118
Educational persistence of transgender and gender diverse students may depend on their
119
sense of safety and belonging in the school environment. Title IX of the Education Amendment
120
Act of 1972 prohibits harassment of students on the basis of gender expression.
It’s helpful for
121
schools to consider transgender students in planning the school’s infrastructure.
For example,
122
 providing gender-neutral bathroom options and avoiding the use of gender segregation in
123
 practices such as school uniforms, school dances, and extracurricular activities are structural
124
ways to provide safer school environments (Toomey et al., 2010).The presence of a Gay-Straight
125
Alliance (GSA) in school can lead to greater feelings of safety and of belonging, better
126
attendance, and lower rates of harassment. (Toomey, Ryan, Diaz, and Russell, 2011).
127
Comprehensive anti-harassment policies that include protections for transgender and gender
128
diverse students are helpful for all students. Adult intervention is helpful when homophobic or
129
transphobic statements are heard. Written policies and procedures addressing the needs of
130
transgender and gender diverse students are helpful for staff and administrators and all students
131
and families (e.g., Gay-Lesbian-Straight Education Network/National Center for Transgender
132
Equality, 2011, Massachusetts DOESE, 2012).
133 134
Role of the School Psychologist
135 136
The school psychologist should be in tune to the needs of students and staff, and can provide
137
evidence-based information about transgender issues. The school psychologist should be
138

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