Trans-affirmative Care: The Evolving Role of Clinical Social Workers with Transgender, Transsexual and Gender Nonconforming Individuals
Lisette Lahana, L.C.S.W

International standards of care and clinical guidelines are moving toward collaborative treatment planning that takes into account each client's unique gender identity and life circumstance. For over sixty years mental health clinicians have been placed in the role of a gatekeeper to needed medical interventions. Increasingly, therapists are shifting from a "one size fits all" approach to one that takes into account a variety of gender presentations and identities, as well as medical interventions outside of the established male/female gender binary. However, when existing systems are slow to change, trans-affirmative therapists are often presented with challenging clinical and ethical questions for which there are no clear answers. Clinical social workers are well suited for this complex work, which may include depth psychotherapy, assessment, case management, advocacy and activism.