Five Keys to Service
The five keys in this section are quick reminders that will help you serve transgender clients respectfully and appropriately. Use them to build a strong working alliance with transgender clients, which will help to ensure the success of your services.
Key #1: Don't Categorize; Use Your Client's Terms
Our brains organize incoming information into categories. We automatically (and usually unconsciously) sort objects and concepts into groups; for example, animal/cat, tree/leaf, house/window. We also sort other people into boxes, generally based on their appearance (e.g., perceived gender, race, age, disability). Some aspects may not be as easily identified as others. When there are aspects about people that are harder to identify, our brains will work diligently to figure out how and where these people fit.
When learning about transgender individuals, people may seek firm definitions and distinct labels to help categorize them. For example, common questions revolve around the difference between "gender non-conforming" and "gender variant," between "transgender" and "transsexual," between "cross-dresser" and "drag king," or other terms heard via the media, coworkers, clients, or friends. Some people believe that if they know the "right" terms (and definitions), they will be able to better understand someone who is different from themselves and will be able to effectively provide them with the services they need.
Many "transgender 101" documents and trainings currently available are based on the concept that providers must know specific terms and definitions to be culturally competent. Although this approach may satisfy people who want to know the "right answer," FORGE believes that much more than terms and definitions are needed to ensure a provider is culturally sensitive and inclusive. Focusing on terms and definitions may lead to a reduced understanding of the complexity of transgender lives, which can result in increasing client discomfort. This can be especially true if providers use terms that the client does not identify with or that do not accurately represent the client's experience.
Key #2: Know Why You're Asking, and Explain Why
Because a transgender person's identity label by itself won't directly provide you with useful information about treatment, you will need to more carefully think through what it is that you do need to know. Unfortunately, this seemingly simple advice is complicated in practice. We frequently ask insensitive, ineffective, and unnecessary questions out of habit, curiosity, or ignorance. For example, a routine intake question such as "are you married?" may work reasonably well for some clients but does not sensitively serve all clients. A health care provider asking this question might actually want to know whether someone is available to drive a patient home. On the other hand, a facility hosting support groups for survivors that offers a sliding scale based on a couple's joint income may need to know the federal marriage status of the couple to determine what rate each partner will pay for services.
Because transgender people and their loved ones are routinely asked inappropriate questions (at best) and may have been treated offensively or even violently in the past (at worst), they may be on guard when approaching a service provider. It is up to you, as the professional, to prove yourself by asking only appropriate questions and by prefacing potentially sensitive questions with an explanation of why you need the answer. For example, rather than asking "are you on hormones?," consider asking "so that I can consider potential side effects of any medication I prescribe, could you tell me which medications you're currently using?" In other words, know why you are asking a question, and explain why to your clients.
Key #3: Consider the Whole Person
When observing others, people tend to define them by one aspect of their identity: their skin color, their religion, whether they have a disability, and so forth. When applied to transgender people, the single-focused lens of presuming that everything is related to a person's transgender history or identity can hinder appropriate and objective care.
For example, a transgender organization received a technical assistance request from a domestic violence program. The caller indicated she had a transgender client and needed the transgender organization's help. After some discussion, it became clear that the client had come to the domestic violence program seeking advice about a violent intimate partner. What this client needed was support and services related to intimate partner violence, not support or services related to being transgender. In this example, the caller presumed that her client needed undefined services from a transgender organization, completely overlooking the client's stated need for domestic violence services.
Typically, these myopic presumptions and classifications are incomplete, and they play out in more subtle ways. For example
All of us, transgender or not, have many identities, roles, labels, and needs. In addition to gender identity, each person also has a racial heritage, an educational level, an income class, a developmental history, and many, many other characteristics. Don't fall into the trap of thinking that once you know one fact about a person, you know everything you need to know; listen and consider all of their many pieces.
Key #4: Partner With Your Client
Although it is your job to provide professional services to your transgender client, keep in mind that your client likely knows much more about being transgender than you do. It is not only acceptable but good practice to ask transgender clients for their preferences when you face a gender-related question, such as whether a single-sex setting would be comfortable for them.
Transgender people knowquite well, in factthat they confound many gender-based systems and may need individualized solutions. Chances are good that they have already found a way around the challenge, or at least know how they would prefer to have it handled. When you encounter a service-related question that you don't know how to answer, ask your clients about it. Their knowledge and experience, coupled with your professional knowledge and skills, will result in a respectful, workable solution that meets everyone's needs.
Key #5: Manage Your Curiosity
Your job is to serve clients. Transgender people, just like other consumers, expect professionals to provide the services they hire them to supply. They do not expect to provide services to their providers. When providers ask their transgender clients (directly or indirectly) to educate them about their lives or experiences as transgender people, they have stepped outside of their professional role.
There may be a timeafter you've served your clients' needs and have developed a strong, positive bond with themwhen it is acceptable to ask these types of questions. Transgender people may be willingand some are eagerto educate professionals, as long as they get their immediate needs met first and the subsequent conversation remains respectful. The individuals who are open to educating providers know that the more trans-savvy professionals there are, the better it is for other transgender people.
If you are unclear on what is or is not an appropriate question to ask, consider whether you might be able to get the information from another source. For example, if you are a therapist working on sexual function problems with a client and have questions about the effects of hormones on sexual function, you can find this information through an academic, medical, or advocacy organization.
Also consider whether you would ask a non-transgender client the same questionor how you would feel if someone asked you the question. "Do unto others as you would have others do unto you" is a good guiding principle for managing your curiosity and maintaining a solid, professional, respectful, and service-focused relationship with your client.
To learn more about transgender people, see Transgender 101, in this e-pub.