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Trans Counseling

Trans Counseling

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Published by Molly Gum

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Published by: Molly Gum on Jul 04, 2012
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Counselling and Mental Health Care ofTransgender Adults and Loved Ones
Walter Bockting, PhD
*
Gail Knudson, MD, MPE, FRCPC
Joshua Mira Goldberg
 January 2006
a collaboration between Transcend Transgender Support & Education Society and Vancouver Coastal Health’s Transgender Health Program, with funding from the Canadian Rainbow Health Coalition’s 
Rainbow Health – Improving Access to Care
initiative 
 
*
Coordinator, Transgender Health Services, University of Minnesota, Minnesota, USA
Department of Sexual Medicine, University of British Columbia/Vancouver Hospital, Vancouver, BC, Canada
Education Consultant, Transgender Health Program, Vancouver, BC, Canada
 
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Acknowledgements
Project coordinators
 
Joshua Goldberg, Donna Lindenberg, and Rodney Hunt
Research assistants
 
Olivia Ashbee and A.J. Simpson
Reviewers
 
Lin Fraser, EdD, MFT
 
San Francisco, CA, USAMelady Preece, PhDVancouver, BC, CanadaRupert Raj, MAToronto, ONT, CanadaOliver Robinow, MD, FRCPCVancouver, BC, CanadaHershel T. Russell, MA, MEd(c)Toronto, ONT, CanadaSandra L. Samons, PhD, DCSWAnn Arbor, MI, USAJulian Young, PhD, RCCVictoria, BC, Canada © 
2006 Vancouver Coastal Health, Transcend Transgender Support & Education Society, and the CanadianRainbow Health Coalition
This publication may not be commercially reproduced, but copying for educational purposes with credit isencouraged.This manual is part of a set of clinical guidelines produced by the
Trans Care Project 
, a joint initiative ofTranscend Transgender Support & Education Society and Vancouver Coastal Health’s Transgender HealthProgram. We thank the Canadian Rainbow Health Coalition and Vancouver Coastal Health for funding thisproject.
 
Copies of this manual are available for download from the Transgender Health Program website:http://www.vch.ca/transhealth. Updates and revisions will be made to the online version periodically.For more information or to contribute updates, please contact:Transgender Health Program#301-1290 Hornby StreetVancouver, BC Canada V6Z 1W2Tel/TTY/TDD: 604-734-1514 or 1-866-999-1514 (toll-free in BC)Email:trans.health@vch.caWeb:http://www.vch.ca/transhealth
 
 
Pag
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Table of Contents
Scope............................................................................................................................................................1Clinical Picture..............................................................................................................................................2Initial Evaluation............................................................................................................................................4Trans-specific issues in building therapeutic rapport........................................................................4Discussing client and clinician goals and expectations.....................................................................4Documenting client history and current concerns.............................................................................5Evaluating capacity to make care decisions.....................................................................................6Initial clinical impression...................................................................................................................7Assessment and Treatment of Gender Concerns.........................................................................................8Gender assessment..........................................................................................................................8Care plan for gender concerns.......................................................................................................11Psychotherapy for gender concerns...............................................................................................12Addressing co-existing mental health or psychosocial concerns........................................12Exploring gender history and development of transgender identity..........................
........23Counselling of loved ones...............................................................................................................24Trans-specific Assessment and Treatment of Mental Health Issues...........................................................25Depression, anxiety, and suicidality................................................................................................27Self-harm........................................................................................................................................27Compulsivity...................................................................................................................................28Thought disorders...........................................................................................................................28Personality disorders......................................................................................................................29Trans-specific Elements in General Counselling.........................................................................................29Body image.....................................................................................................................................30Grief and loss..................................................................................................................................30Sexual concerns.............................................................................................................................31Social isolation................................................................................................................................33Spiritual/religious concerns.............................................................................................................33Substance use................................................................................................................................34Violence/abuse...............................................................................................................................35Case Studies...............................................................................................................................................35Concluding Remarks...................................................................................................................................40Summary of Recommendations..................................................................................................................41References..................................................................................................................................................49Appendices.................................................................................................................................................57

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