Aug 312015
 
Psy_II

The Greek letter Psy is often used to symbolize psychology or the APA.

The American Psychological Association has released a 55-page document detailing guidelines for psychologists treating transgender and gender non-conforming individuals. To my knowledge, this is the first such document the APA has published. It’s a huge milestone in trans mental health care.

APA guidelines provide standards for both trainees and practicing psychologists on the expected conduct of psychologists. They’re used in both introductory and continuing education.

In this document, the APA lists out the following guidelines (note that TGNC stands for “transgender/gender non-conforming”):

  1. Psychologists understand that gender is a non‐binary construct that allows for a range of gender identities and that a person’s gender identity may not align with sex assigned at birth.
  2. Psychologists understand that gender identity and sexual orientation are distinct but interrelated constructs.
  3. Psychologists seek to understand how gender identity intersects with the other cultural identities of TGNC people.
  4. Psychologists are aware of how their attitudes about and knowledge of gender identity and gender expression may affect the quality of care they provide to TGNC people and their families.
  5. Psychologists recognize how stigma, prejudice, discrimination, and violence affect the health and well‐being of TGNC people.
  6. Psychologists strive to recognize the influence of institutional barriers on the lives of TGNC people and to assist in developing TGNC‐affirmative environments.
  7. Psychologists understand the need to promote social change that reduces the negative effects of stigma on the health and well‐being of TGNC people.
  8. Psychologists working with gender questioning and TGNC youth understand the different developmental needs of children and adolescents and that not all youth will persist in a TGNC identity into adulthood.
  9. Psychologists strive to understand both the particular challenges that TGNC elders experience and the resilience they can develop.
  10. Psychologists strive to understand how mental health concerns may or may not be related to a TGNC person’s gender identity and the psychological effects of minority stress.
  11. Psychologists recognize that TGNC people are more likely to experience positive life outcomes when they receive social support or trans‐affirmative care.
  12. Psychologists strive to understand the effects that changes in gender identity and gender expression have on the romantic and sexual relationships of TGNC people.
  13. Psychologists seek to understand how parenting and family formation among TGNC people take a variety of forms.
  14. Psychologists recognize the potential benefits of an interdisciplinary approach when providing care to TGNC people and strive to work collaboratively with other providers.
  15. Psychologists respect the welfare and rights of TGNC participants in research and strive to represent results accurately and avoid misuse or misrepresentation of findings.
  16. Psychologists seek to prepare trainees in psychology to work competently with TGNC people.
This is all excellent.
There is a history of psychologists attempting to change gender identity through conversion therapy or other coercive means. The APA’s statement, in effect, states very strongly that attempts to change gender identity should not be attempted. Instead, the APA is embracing the ethical treatment of transgender people and of affirming transgender and gender non-conforming people.
Do these guidelines mean anything for you if you’re receiving therapy? Possibly. Talk with your therapist, whether you’re trans or cis, to make sure they’ve seen the updated guidelines. If you’re receiving therapy that is not within these guidelines, consider talking with your therapist about these guidelines or seeking another therapist.
And spread the word! The document itself is publicly available as a PDF.
Oct 102012
 

On September 30, 2012 Governor Jerry Brown signed SB-1172 into law. This law (full text here) prohibits health professionals from attempting to change the sexual orientation of anyone under age 18. This is a fabulous step.

I looked at the text of the law, and the following things stood out to me:

  • There are no fines or jail time for violating the law. It says that attempts to change sexual orientation in minors “shall be considered unprofessional conduct and shall subject the provider to discipline by the provider’s licensing entity.” To me, that’s essentially a slap on the wrist. I’m not a legal expert . . . but I found it to be a little disappointing.
  • The law only applies to mental health professionals. It does not appear to affect spiritual advisors like priests.
  • The law also prohibits attempts to change gender expression. It doesn’t, however, prohibit attempts to change gender identity.

So I do see some loopholes in the law. It’s not perfect. But it is a good step to protecting our vulnerable LGB youth.

Jan 102011
 

The HPV (human papillomavirus) vaccine Gardasil has just been approved for use in preventing anal cancer (Source). HPV is a sexually transmitted disease that causes genital warts and has been implicated in some cancers, including anal and cervical cancer. The majority of anal and cervical cancers are associated with HPV (Source).

HPV is common (around 50% of the US population has it) and difficult to control. HPV has a number of different strains. Some cause warts (including hand and genital warts), and some cause cancers (Source). It spreads by skin-to-skin contact, so any activity involving touching or licking genitals or anus can spread it. Barriers are useful in prevention, though not completely effective. As with all STIs, having few sexual partners is considered a preventative measure. Populations considered to be at high risk for HPV include men who have sex with men (presumably because of unprotected anal sex), people having anal sex, men who are not circumcised, and people with multiple partners (Source).

Gardasil is a three-shot series. It can’t grant immunity once a person’s been exposed to HPV, so it’s recommended for people who are not yet sexually active.

Anal cancer happens in both men and women, and is largely caused by HPV. Risk factors separate from the HPV-related ones include: smoking, having HIV, having a compromised immune system, and having anal sex (Source).

The FDA’s approval comes on the heels of a study showing that, in a high-risk population (men who have sex with men), Gardasil was shown to be 78% effective in preventing infection with the HPV strands that cause anal cancer (Source).

I think this is fabulous. More tools have definitely been needed in preventing HPV-related cancer. Anal cancer also seems to be something that’s rarely talked about, so I hope this will spur discussion. I certainly have further questions:

Resources and Sources:

Anal Cancer Overview

HPV Fact Sheet

FDA News Release

Wikipedia: HPV

Wikipedia: Anal cancer