Monday, August 31, 2015

New American Psychological Assn Guidelines On Trans and Non Gender Conforming Folks

The American Psychological Association has released a 55-page document detailing guidelines for psychologists treating transgender and gender non-conforming (TGNC) individuals. 
The purpose of the Guidelines for Psychological Practice with Transgender and Gender Nonconforming People (hereafter Guidelines) is to assist psychologists in the provision of culturally competent, developmentally appropriate, and trans‐affirmative psychological practice with TGNC people. Trans‐affirmative practice is the provision of care that is respectful, aware, and supportive of the identities and life experiences of TGNC people.
Here are the new guidelines:
  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.
In the past, some psychologists have attempted to change gender identity (as well as sexual orientation) through so-called "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. In this statement, the APA underscores the need for ethical treatment of transgender people and of affirming transgender and gender non-conforming people.

Thanks to Open Minded Health for blogging on the APA document.


Monday, August 24, 2015

GUEST BLOG: Non-suicidal self injury, and gender and sexual minorities

Open Minded Health discusses self-injury. In all likelihood, you know someone who does this.

Recent reports have highlighted the frequency of non-suicidal self-injury among gender and sexual minorities. 41.9% of transgender people have self-injured. I was unable to find a percentage for cis lesbian, gay and bisexual people beyond the general report that the rate was “much higher”. Gender and sexual minority (GSM) youth are at particular risk, as are cis women.
So let’s take a quick look at non-suicidal self injury this week. What is it? Why do people do it? And what should those who currently self-injure, and their loved ones, know?
Non-suicidal self injury (NSSI) is a term that refers to deliberate attempts to cause oneself injury without intending suicide. The “without intending suicide” is the important bit there. This is a separate phenomenon from suicidality, though both suicidality and NSSI can come from the same psychological source. NSSI can take many forms, but cutting and burning are the most common. People who have higher levels of stress, such as GSMs, are at higher risk for NSSI. Transgender people may have an additional risk factor because of extreme body dysphoria.
To most who have never participated in NSSI, it can seem baffling.

Monday, August 17, 2015

Cataract Journey: Interregnum

in·ter·reg·numˌin(t)ərˈreɡnəm/. noun. A period when normal government is suspended, especially between successive reigns or regimes. An interval or pause, as in, "the interregnum between the discovery of radioactivity and its detailed understanding."
After cataract surgery on my first eye, I entered a bizarre period in which that eye had excellent vision at intermediate distances (computer screen, conversation) and the other was a total blur. I’m very near-sighted (as in -15 diopters), so there was no possibility of fusing images. So the world looks blurry and sharp at the same time, and I have to use parallax (shifting my head) for any kind of depth perception. Needless to say, I do not feel safe driving. Or pouring water from a pitcher, unless I can brace the lip of the pitcher against the glass – we found this out in a somewhat spectacular fashion.

One solution might have been to wear a contact lens in the nonsurgical eye, and I had worn hard or RGP (rigid gas permeable) lenses for over 50 years. But a couple of years ago my eyes, which had become drier over the decades, flatly refused to put up with contact lenses. I tried all sorts of lubricating drops, but was never able to wear my lenses more than a few (2-4) hours a day. If I did any work on the computer, that time dropped to an hour (people blink less often while staring at a computer monitor, hence increase in scratchy, red eyes). Finally, earlier this year, I lost one of my lenses. This has happened maybe half a dozen times over  the years. I looked everywhere (if you wear contacts or are close to someone who does, you know the crawling-around-on-the-floor routine) and eventually concluded that after I had cleaned them the night before, the lens had stuck to my finger instead of sliding off into the soaking solution. Since then, I had washed my hands and tidied up the counter area. So, no hope. I’d been wrestling with spectacles ever since.

My next idea, which friends have tried, was to pop a lens out of my spectacles, so that my nonsurgical eye sees through the remaining lens. Great idea, right? And it worked – so long as I covered one eye, didn’t matter which. When I tried to fuse the equally-clear images, however, my brain went nuts. It turned out the images were of sufficiently different sizes, too disparate for my brain to turn them into one. This might not have been the case with a person less near-sighted than I am. So, rather than putting a patch over one eye – toss a coin as to which one – I’ve been wandering around in this visually bizarre state.