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1 Introduction
1 Introduction
The purpose of this CPD course is to improve the cultural competence of practitioners who may work or are working therapeutically with trans people. Trans cultural competence helps to ensure practitioners are in a position to provide benefit rather than harm to trans clients who routinely access their services.
Who is this training for?
This CPD is for anyone offering therapeutic or mental health support to trans people, e.g., practitioner psychologists, counsellors and psychotherapists. Robust, self-reflective engagement with the course material should significantly develop a practitioner’s ability to engage with, empathise with, and understand the needs of their trans clients. This CPD may also usefully update the knowledge of people already working with trans people, including trans practitioners.
What this CPD does not do
As an 8-hour introductory CPD, this course does not provide sufficient training for people intending to specialise in working with gender diversity. Completion of the course is not a qualification or a guarantee of competencies. For those who complete this course and are interested in seeking further training, suggestions can be found in the Resources to support further learning section of the course.
Learning outcomes
By the end of this 8-hour course, you will:
- Have a critical awareness of the impact of (historical) pathologising of trans identities on the mental health treatment experiences of trans people today.
- Have reflected on the meaning of their own opinions, experiences and practices in relationship to therapy practice for trans people.
- Understand the range of ways that trans people have experienced psychological therapies/psychological therapists.
- Have considered the importance of an affirmative therapy model and learned what this might encompass.
You have read the learning outcomes but what do you want to gain from this course?
Pause for Reflection
Please take a few minutes to reflect, and take our pre-course survey.
Discussion
You might have had some experience of working with trans clients and want to learn more to improve your ability to support such clients, or this may be a totally new subject to you. If you don’t feel very confident don’t worry – engaging with this CPD will help.
A word about ethics
This training aims to improve your ability to work with trans clients in a non-discriminatory way. The ethical codes of most professional bodies in psychological therapies, including the British Association for Counselling and Psychotherapy (BACP), the United Kingdom Council for Psychotherapy (UKCP) and the British Psychological Society (BPS), expect a commitment to anti-discriminatory practice.
1.1 The ICTA project
A core feature of this course is that it is evidence-informed – meaning the content is based on research findings rather than anecdote or opinion. The course incorporates understandings from existing research as well as from a major research study which is described below.
The Integrating Care for Trans Adults (ICTA) project has been a major National Institute for Health and Care Research (NIHR) study looking at what constitutes best practice in the care of trans people. You can find more information about the study and the findings related specifically to mental health on the ICTA website.
ICTA did not originally plan to look at mental health. However, the COVID-19 pandemic impacted the mental health of populations globally (Robinson et al., 2022; Wu et al., 2021) and of trans people specifically (Hawke et al., 2021; van der Miesen et al., 2020). Moreover, an ICTA survey found that many participants disclosed mental health difficulties. All of this suggested that ICTA needed to focus on trans adults’ experiences of mental health and mental health treatment.
Activity 1.1: Mental health in the ICTA survey participants
To find out what participants reported, answer the following multiple-choice questions. When you are finished, click the ‘Check your answer’ button to see if you are correct.
Accessing psychology therapy (but not for anything related to gender transition)
a.
4%
b.
11%
c.
26%
d.
35%
The correct answer is c.
a.
14%
b.
28%
c.
32%
d.
39%
The correct answer is b.
Accessing community-based mental health care
a.
1.6%
b.
6.6%
c.
12%
d.
18%
The correct answer is d.
a.
1.6%
b.
6.6%
c.
12%
d.
18%
The correct answer is b.
Discussion
More than 1 in 4 ICTA participants currently and historically had felt the need to seek psychological therapy. Almost 1 in 5 had accessed community-based mental health services. 55% also wanted psychological therapy to support them in their gender transition. Overall, the data suggests a higher-than-average mental health burden and need for mental health support. This finding corresponds with other prior research (Tan et al., 2021; Ellis et al., 2015; McNeil et al., 2012).
1.2 A note on language
At this point it is worth saying something about the choices we have made in this CPD course regarding the terms we are using and the concepts we are drawing on.
Throughout this course, we use the word ‘trans’ as a shorthand for a diverse group of people, including non-binary people. We acknowledge that not all non-binary people will use the word trans to describe themselves. Also, there are many other terms across the globe that are used to describe gender diversity. This means there is no perfect umbrella term or single definition of ‘trans’ that encompasses the full range of global gender diversity. Nonetheless, in the UK context, the word ‘trans’ has come to mean a broad group of people that includes trans men, trans women and non-binary people. We use ‘cis’ to mean not trans, but we recognise there are complexities and imperfections around use of this term for some, including intersex people.
We use the terms ‘psychological therapies’ and ‘psychological therapist’ in this course to encompass counsellors, psychotherapists, and practitioner psychologists who do therapy (like clinical and counselling psychologists) as well as mental health practitioners.
Activity 1.2: Language around gender diversity
The following terms are used for different ways of thinking about some aspects of gender diversity. Match the term with the culture it comes from.
Two lists follow, match one item from the first with one item from the second. Each item can only be matched once. There are 7 items in each list.
Two Spirit
Hijra
Bakla/lakin-on
Muxe
Kathoey
Mashoga
Sistergirls/brotherboys
Match each of the previous list items with an item from the following list:
a.India
b.Zapotec of Oaxaca (Mexico)
c.Turtle Island (Indigenous American)
d.Kenya (Swahili)
e.Thai (Buddhist)
f.Indigenous Australian
g.Filipino (Tagalog)
- 1 = c,
- 2 = a,
- 3 = g,
- 4 = b,
- 5 = e,
- 6 = d,
- 7 = f
Discussion
We can trace gender diversity throughout history and across the globe. The words people have used, and the way cultures have thought about gender, differ widely. We suggest further reading on the terms named above, which cannot be used as straightforward translations of ‘trans’. Many cultural expressions of gender diversity were looked down upon and criminalised by European colonisers, and this has had a global impact on the way gender diverse people are seen today (Hussain, 2019).
Pause for reflection
Some things to think about before moving on:
- What goals do you want to set for yourself on completion of the training?
- How will you know when you have achieved these goals?
Now, continue to 2 Examining our biases and assumptions.