Trans issues are the topics de jour and as social workers we are required to have an understanding of the culture of the communities that we serve and part of that understanding is knowing what questions to ask and what not to ask.
Social work covers a number of disciplines and is usually divided into micro which is working with individuals or groups and macro which focuses on communities and organizations, my concentration is in Community Organizing.
First on my list of what NOT to ask is if they are trans* it is not relevant. When would you ask another member of a minority community if they are minority? Probably only when it necessary on a form or necessary for their healthcare, the same is true about trans* people. It is permissible to ask what pronouns they prefer, some may use he or she, while others may use “ze” and “zie” while others may prefer using “they” and “them.”
The same thing is true about their surgeries don’t ask unless it is pertinent to your questions, if you are doing an intake form for emergency housing knowing if they have had Gender Confirming Surgery is not important. HUD requires a homeless shelter to house trans people in the shelter of their gender identity. However, if you must ask their surgical status let them know why you need to ask them about it.
Another DON’T is learning about the trans* community from your client. We do not want to hear “You’re my first trans client. Can you tell me…” we don’t want to be your teacher, so do your homework before you get your first trans* client walks in the door.
I work with a group of non-profits and state agencies to help training senior centers, long term care facilities on the needs of the elder LGBT community. We arranged training for an agency that helps individuals to live at home, a couple of days after the training we received an email from a case worker,
Yesterday I met my first transgender person in the line of work. Both the case manager and myself felt prepared to advocate and were comfortable with the issues that presented themselves.Are you under HIPAA? Then DON'T divulge a client’s transgender status or if they are transgender because doing so might be a HIPAA violation! Gender Dysphoria is a medical diagnosis (Look it up in the DSM) it is protected under HIPAA statues.
I do not have many “DOs” because they are all apply to every client, do treat everyone with respect and dignity.
DO understand like many of your clients this maybe the first time that they had a need for a social worker, for many trans* people when we transition we may find ourselves unemployable or working at jobs under our skill level. We may find ourselves homeless for the first time or we maybe are victim of violence or faced discrimination for the first time. They might be accessing social services for the first time and do not know their way around in the system.
Awhile back I had a Latino client who is in her early twenties walk into the clinic where I volunteer; she had just come out to her family and they threw her out of the house. She is couch surfing with friends, and was unable to find a job She didn’t know how to change her documentation and she needed to desperately to change them. (DO you know the procedures for changing driver license, Social Security information, Medicare, and Medicaid gender markers in your state?) So I helped her with the forms and contacted a case worker to help her with intake forms and other programs available to her (she has since found a job but is still in need of housing and food assistance).
Lastly I would say know the law! I did training at a homeless shelter for their case workers last week and when I got to the part in the training about state and federal laws, all their jaws dropped and they looked at one and other. It seems that they had a trans* woman in the men’s shelter and they had no idea that they were breaking both state and federal law. DO know if your state has protections for sexual orientation and gender identity/expression? If you do not know and research it, and if they do not have legal protection for LGBT people, what can you do to help pass the law? As a social worker one of the items in the NASW Code of Ethics is “Social and Political Action.”
One of the most rewarding experiences was when after working with a client to help change her documentation, and giving her therapist sample letters for surgery was getting a phone call from her that she has gotten an appointment to see a surgeon for her GCS.
A couple of resources:
The World Professional Association for Transgender Health (WPATH) Standard of Care v7
Creating Equal Access to Quality Health Care for Transgender Patients: Transgender-Affirming Hospital Policies
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