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Journal of LGBT Issues in Counseling

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Introduction to the Special Issue: Translating the Competencies for Counseling with Transgender Clients into Counseling Practice, Research, and Advocacy

Anneliese A. Singha; Theodore R. Burnesb a Department of Counseling and Human Development Services, University of Georgia, Athens, Georgia, USA b Department of Clinical Psychology, California School of Professional Psychology, Los Angeles, California, USA Online publication date: 13 December 2010

To cite this Article Singh, Anneliese A. and Burnes, Theodore R.(2010) 'Introduction to the Special Issue: Translating the

Competencies for Counseling with Transgender Clients into Counseling Practice, Research, and Advocacy', Journal of LGBT Issues in Counseling, 4: 3, 126 134 To link to this Article: DOI: 10.1080/15538605.2010.524837 URL:


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Journal of LGBT Issues in Counseling, 4:126134, 2010 Copyright Taylor & Francis Group, LLC ISSN: 1553-8605 print / 1553-8338 online DOI: 10.1080/15538605.2010.524837

Introduction to the Special Issue: Translating the Competencies for Counseling with Transgender Clients into Counseling Practice, Research, and Advocacy
Department of Counseling and Human Development Services, University of Georgia, Athens, Georgia, USA
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Department of Clinical Psychology, California School of Professional Psychology, Los Angeles, California, USA

This article introduces the Special Issue of the Journal of LGBT Issues in Counseling on Counseling Competency with Transgender Clients. The purpose of the special issue is to explore how counselors may use the ACA Competencies for Counseling with Transgender Clients in research, practice, advocacy, training, and supervision. A brief overview of the articles included in the special issue is provided, and the implications for the use of the counseling competencies with transgender clients are discussed. KEYWORDS transgender, competency, social justice, advocacy, counselor training Historically, clients who identify as transgender, gender-variant, and/or gender nonconforming have entered counseling and psychological settings where treatment has focused on a decit model with issues of diagnosis and pathology central to guiding conceptualizations of client well-being (Carroll, 2010; Singh & Burnes, 2009). The purpose of the current special issue on counseling competency with transgender clients is to call the eld of counseling and psychology to move beyond a decit model to frameworks that are based on client resilience and strengths and grounded in client conceptualizations and treatment modalities that are feminist, multicultural, and
Address correspondence to Anneliese A. Singh, The University of Georgia, 402 Aderhold, Athens, GA 30602-7124, USA. E-mail: 126



social justicerelated in practice and values. In this article, we provide a brief overview of the work with transgender clients in counseling and psychology. Next, we discuss the development of the American Counseling Association (ACA) Competencies for Counseling with Transgender Clients (2009) and review the highlights of the articles in the special issue that apply these competencies to transgender clients in specic settings and to counseling and psychological work from a transgender-positive stance. Finally, we review challenges the counseling and psychological elds must address to provide services that are competent, culturally relevant, and accountable to issues of privilege and oppression within the counseling relationship. For this article, we will use the word transgender to encompass the broad diversity that exists in terms of clients who identify as gender-variant, gender nonconforming, and/or outside of binary constructions of gender identity and expression.
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The diagnosis of gender identity disorder (GID), for better or for worse, remains in the Diagnostic and Statistical Manual of Mental Disorders (DSMIV-TR; American Psychiatric Association, 2000). There are scholars who emphasize the benets of having diagnosis as a dening feature of counseling and psychological work with transgender clients (Bockting & Goldberg, 2007). Winters (2005) argued that having access to diagnostic tools provides people who have limited understandings of issues inuencing the lives of transgender people with concrete evidence, legitimizing and creating public awareness of a transgender identity. For instance, having a diagnosis of GID can facilitate issues of accessing health care and supporting transgender youth and adults in family, school, community, and employment settings among providing other access to important resources for transgender people. Other scholars (e.g., Swans & Herbert, 2009) argued against the centralization of diagnosis and a decit model in counseling and psychological services with transgender clients. These scholars have challenged the dening of GID as a mental disorder by the helping professions, asserting that GID at its core is an issue of biology and should be categorized as a medical issue where issues of client well-being may arisebut are not necessarily a dening feature of being transgender. Mizcock and Lewis (2008) noted the importance of challenging mental health paradigms that pathologize nontraditional expressions of gender identity and sexual behavior. As diagnosis often creates criterion based on innate, problem-focused behaviors without considering environment, context, and/or coping strategies of the transgender client (Hanssmann, Morrison, & Russian, 2008), the need to critically


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examine the diagnostic assessment process of gender identity is an important issue in need of greater conversation and awareness.


Considering the range of approaches that scholars, practitioners, and professional organizations (e.g., World Professional Association of Transgender Health and American Psychiatric Association) have outlined for treatment with transgender clients, there has been a growing need to understand how to understand the diversity of approaches from a counseling and strengthbased perspective that incorporates attention to feminist, multicultural, and social justice analyses of the contextual factors inuencing transgender client well-being. For this reason, the Transgender Committee of the Association for Lesbian, Gay, Bisexual, and Transgender Counseling (ALGBTIC) developed counseling competencies for working with this group that address individual and contextual factors. These competencies were subsequently endorsed by the American Counseling Association (ACA) and have been renamed the ACA Competencies for Counseling with Transgender Clients (2009) and are published as the lead article in this special issue. The history of how and why the competencies were developed is also important, as the process involved an intentional and conscious attention to feminist consensus building and collaborations between those in the counseling profession, transgender individuals, and other experts in transgender counseling and advocacy. Initially, a Transgender Task Force was formed within ALGTIC in 2005 to begin an organizational assessment of the levels of attention and importance placed on transgender counseling concerns and responsiveness to our divisions transgender members. Members of the Transgender Task Force wanted to ensure that the T was not merely added to the division without ensuring ALGBTIC was prepared as a division to have a transgender-positive and afrmative approach to counseling concerns and its members. In this preparation, the Transgender Task Force wrote articles for Counseling Today, worked with our multicultural consultant in the division, sought input from transgender and transgender ally members, and communicated information about transgender concerns in counseling to the ALGBTIC Board. In 2007, the Transgender Task Force became a formal standing committee in ALGBTIC to begin work on developing counseling competencies with transgender people. A signicant component of the accomplishment in creating these competencies is the process by which members of the division made sure that the competencies met the high standards within the profession. The

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competencies were created using a team composed of ALGBTIC members with expertise in transgender concerns in counseling: four counselor educators, three practitioners, and one student in counseling that met on a series of monthly conference call for 15 calendar months. The team divided the eight domains of the Council for Accreditation of Counseling and Related Educational Programs (CACREP) standards between themselves (one domain per team member), and each identied areas of knowledge, attitudes, and skills that counselors working with transgender clients would need to know in their respective domain. The team then processed these domains as a group and gave one another feedback; each team member incorporated this feedback and his or her existing areas into a series of competencies for each domain. Each team member sent the rest of the team his or her respective domains, and domains were processed one at a time on monthly calls and feedback was given to the domains writer, who edited the domain accordingly. The need for the counseling competencies with transgender clients is clear, as transgender people often interact with counseling and mental health systems that are uneducated or misinformed about their counseling needs. In addition, transgender clients do not have employment and health care rights and protections that others in the United States and around the world enjoy. Most important, counselors bring important strengths from their training to the counseling processincluding values of multiculturalism, advocacy, and wellnesswhich all can be leveraged to create transgender-positive counseling spaces. These competencies are not only grounded in strength-based, wellness, multicultural, feminist, and social justice principles, but also recognize the resilience transgender clients have despite the systems of oppression that inuence their well-being.


The articles included in this special issue seek to apply to Counseling Competencies with Transgender Clients to a variety of settings and from a diverse range of perspectives. In Using the ACA Transgender Competencies to Increase Rural Transgender Well-Being, Daniel Walinsky and David Whitcomb (this issue) use a grounded theory methodology to understand the daily lived experiences of transgender adults living in rural settings attending a transgender support group. The authors specically identify how the phenomenon of well-being develops for transgender people in these rural settings and identify four themes salient for their participants in developing their wellbeing with a transgender identity. The authors use of a qualitative method to deepen our elds understanding of an understudied group within the transgender community is an important contribution to the eld. In addition,


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the authors discuss how counselors and psychologists may apply the counseling competencies to a group that faces signicant issues of socioeconomic barriers and geographic isolation while supporting their well-being. In the next article, Achieving Competency with Transgender Youth: School Counselors as Collaborative Advocates, Maru Gonzalez and Jesse McNulty (this issue) interpret the competencies to school settings so that school counselors may become proactive and transgender-positive advocates for transgender youth within their schools. The competencies were not written with a youth focus, so the authors provide several strategies to translate the competencies to become applicable to transgender youth. A signicant foundation of the competencies is the importance of self-reection and self-awareness of the helping professional as a way to foster advocacy and recognize societal barriers transgender people must navigate. The authors expound on this foundation by drawing from their own experiences as safe school activists in Georgia practicing from a feminist education perspective. In the following article, Workplace Hostility, Violence, and Discrimination: Toward Social Justice and Advocacy for Transgender Individuals, Varunee Faii Sangganjanavanich and Javier Cavazos Jr. (this issue) continue the exploration of socioeconomic factors to consider when working with transgender clients in counseling as these contextual factors relate to employment settings and workplace discrimination. The authors focus on the counselor and psychologist role as advocate to address transprejudice in the workplace that is covert and overt in nature. In doing so, the authors review the literature on transgender people within the workplace and denitions of workplace hostility, while providing specic strategies counselors may use to create social change and minimize transprejudice in work settings. In the article, Inviting Kates Authenticity: Relational Cultural Theory Applied in Work with a Transsexual Sex Worker of Color Using the ACA Transgender Competencies, Jason Patton and Stacee Reicherzer (this issue) build upon the transgender-positive and feminist themes of other authors of the special issue and outline their use of the competencies in their work with a transgender client in individual counseling. The authors focus on their theoretical framework of relational cultural theory and give details about their conceptualization, intervention, and counseling process in working with Kate. The authors also incorporate writings of how they specically incorporated the competencies into their work as advocates for the client, demonstrating specic strategies counselors may use to create transpositive counseling interventions inside and outside of the counseling ofce. In Informing Counselor Training and Competent Counseling Services through Transgender Narratives and the Transgender Community, Shannon Chavez-Korell and Les Johnson (this issue) expand readers notions of transgender-positive theoretical frameworks by discussing the use of narrative counseling with transgender clients and how such a theoretical

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approach can aid clinicians, supervisors, and advocates to better solidify a theoretically based approach focusing on strengths. The authors focus on the counselor and psychologist role as support in the construction of the transgender clients narrative and the provider and identier of resources in various ecological levels and systems of the clients world. Additionally, the authors review existing scholarship on narrative approaches to counseling while providing specic intervention strategies that counselors may use to create positive therapeutic contexts. In Breaking the Binary: Providing Effective Counseling to Transgender Students in College and University Settings, Erica Lennon and Brian Mistler (this issue) introduce their readers to how counselors can work within various ecological levels of university communities to develop empowering environments and systemic change when working with transgender clients. The authors utilize a developmental framework to understand the unique mental health needs of college students who are developing a transgender identity within the context of various other identity and developmental processes. The authors also make concrete suggestions for collaboration and consultation with various other ofces within the university community and also identify implications for research, practice, and training in the eld of transgender-focused college counseling.


The various articles in this Special Issue create a framework that move the understanding of mental health needs for transgender people from a pathological, decit model to one of resilience and strength-based approaches. In providing this framework for the eld and as a lens with which to view the Special Issue, we also recommend specic strategies for developing a counseling profession that is collaborative with and celebratory of transgender experiences, individuals, and communities:

1. Encouraging and mentoring new voices in the counseling profession. A profession that is resilient and focuses on strengths-based approaches to counseling with transgender clients must acknowledge the many new voices and perspectives that are a part of the eld. These voices should not only be welcomed to write, advocate, and share their perspectives, but also should be mentored and share ideas with more seasoned professionals. The engagement of mentorship will not only help new professionalstrainees, early career, and other established professionals new to counseling competency with transgender clientsbut will also


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provide learning and growth for mentors who can often learn about fresh perspectives and ideas from these exchanges. Developing partnerships with transgender communities vs. acting on their behalf. Nelson and Prilliltensky (2005) wrote about the importance of engaging communities in many ways to create mental well-being. Specically, the authors emphasized the importance of not only acting on behalf of communities, but also creating community-based partnerships with organizations and stakeholders to truly learn about communities and share knowledge and ideas with them. A resilience-based model of counseling competency with transgender clients must create such partnerships to understand the numerous needs and issues that affect mental health service delivery with transgender people (Singh, Hays, & Watson, in press; Singh & McKleroy, in press). These partnerships may include such forms as participatory-action research projects, various forms of community engagement, and participation in legislative events and actions. Training the next generation of counseling professionals on resilience and wellness-focused approaches to counseling transgender clients. Burnes and Singh (2010) noted the importance of training future counseling professionals to understand and incorporate strength and resilience-based approaches to counseling in academic coursework as well as applied mental health training sites. These approaches include speaking about work with transgender clients to help counseling trainees learn the many ways in which transgender clients need a variety of different skill sets and to value the many coping sources transgender people have before they seek counseling. Validating and nourishing those who advocate with and for transgender people. A wellness-focused approach to counseling with transgender clients must acknowledge the effort and strength it takes to work in the eld of counseling and the vicarious internalization of trauma and oppression with which many professionals engage when they work with transgender communities. Identifying and engaging with restorative processes is a need that must be a part of the shift to a wellness-based approach so as to model for counseling trainees and professionals the importance of self-care and sustainability of advocacy and activism. Making room for the many realities of diagnostic assessment with transgender clients. As mentioned previously, there are complexities in using diagnostic assessment with transgender clients (e.g., gender identity disorder). A wellness-focused approach must make room for the multiple viewpoints on diagnosis and diagnostic assessment that exist within the transgender community itself and among the professionals who work with transgender clients. Developing spaces for continuing professional development, conversations across divergent viewpoints, and acknowledgment of these multiple perspectives must occur for understanding and social change to occur.

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The articles in this Special Issue highlight the importance of designing new counseling approaches that are grounded in strength-based, resilience, multicultural, feminist, and social justice perspectives to most effectively meet the needs of transgender clients who come from many different backgrounds. The development of this Special Issue is one of many steps that we hope will encourage the counseling eld to seriously address issues of counselor training and professional development on transgender issues from these perspectives. The authors of the Competencies for Counseling with Transgender Clients (ACA, 2009) and of the Special Issue articles together have called the counseling eld to respond quickly and proactively to ensure that every transgender client who walks into a counselors ofce nds not only an environment where the client does not have to educate the counselor, but also an environment that mirrors their strengths and supports their future wellness.

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American Counseling Association. (2009). Competencies for counseling with transgender clients. Alexandria, VA: Author. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author. Bockting, W. O., & Goldberg, J. M. (2007). Guidelines for transgender care. Binghamton, NY: Haworth Medical Press. Burnes, T. R., & Singh, A. A. (2010). Integrating social justice training into the practicum experience for psychology trainees: Starting earlier. Training and Education in Professional Psychology, 4(3), 135159. Carroll, L. C. (2010). Counseling sexual and gender minorities. Upper Saddle River, NJ: Merrill/Pearson. Chavez-Korell, S., & Johnson, L. T. (2010). Informing counselor training and competent counseling services through transgender narratives and the transgender community. Journal of LGBT Issues in Counseling, 4, 202213. Gonzalez, M., & McNulty, J. (2010). Achieving competency with transgender youth: School counselors as collaborative advocates. Journal of LGBT Issues in Counseling, 4, 176187. Hanssmann, C., Morrison, D., & Russian, E. (2008). Talking, gawking, or getting it done: Provider trainings to increase cultural and clinical competence for transgender and gender non-conforming patients and clients. Sexuality Research and Social Policy, 5(1), 523. Lennon, E., & Mistler, B. J. (2010). Breaking the binary: Providing effective counseling to transgender students in college and university settings. Journal of LGBT Issues in Counseling, 4, 228240. Mizcock, L., & Lewis, T. K. (2008). Trauma in transgender populations: Risk, resilience, and care. Journal of Emotional Abuse, 8(3), 335354.


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Nelson, G., & Prillilentsky, I. (2005). Community psychology: In pursuit of well-being and liberation. New York, NY: Palgrave/Macmillan. Patton, J., & Reicherzer, S. (2010). Inviting Kates authenticity: Relational cultural theory applied in work with a transsexual sex-worker of color using the ACA transgender competencies. Journal of LGBT Issues in Counseling, 4, 214227. Sangganjanavanich, V. F., & Cavazos, J. (2010). Workplace aggression: Toward social justice and advocacy in counseling for transgender individuals. Journal of LGBT Issues in Counseling, 4, 188202. Singh, A. A., & Burnes, T. R. (2009). Creating developmentally-appropriate, safe counseling environments for transgender youth: The critical role of school counselors. Journal of LGBT Issues in Counseling, 3(3/4), 215234. doi:10.1080/15538600903379457 Singh, A. A., Hays, D. G., & Watson, L. (in press). Strategies in the face of adversity: Resilience strategies of transgender individuals. Journal of Counseling and Development. Singh, A. A., & McKleroy, V. S. (in press). Just getting out of bed is a revolutionary act: The resilience of transgender people of color who have survived traumatic life events. International Journal of Traumatology. Swans, S. K., & Herbert, S. E. (2009). Ethical issues in the mental health treatment of transgender adolescents. In G. P. Mallon (Ed.), Social work practice with transgender and gendervariant youth (2nd ed., pp. 3852). New York, NY: Routledge. Walinsky, D., & Whitcomb, D. H. (2010). Using ACA competencies to increase rural transgender well-being. Journal of LGBT Issues in Counseling, 4, 160175. Winters, K. (2005). Gender dissonance: Diagnostic reform of gender identity disorder for adults. Journal of Psychology and Human Sexuality, 17(3), 7189.