Working with Gender Diverse and Gender-Questioning Children and Adolescents (3 HR) Syllabus

I. Understanding Gender Diversity and Identity

• Define key terms: transgender, non-binary, genderfluid, agender, bigender, genderqueer, two-spirit
• Clarify distinctions between gender identity, gender expression, sex assigned at birth, and sexual orientation
• Recognize the broad spectrum of identities that fall under the gender-diverse umbrella
• Explore how children and adolescents may express or question their gender identity

II. Assessing Gender Dysphoria

• Understand gender variance as distinct from pathology
• Review DSM-5 diagnostic criteria for gender dysphoria in children, adolescents, and adults
• Assess duration, consistency, insistence, and persistence of gender identity
• Explore social and environmental stressors contributing to dysphoria and emotional distress

III. Treatment Approaches and Clinical Strategies

• Emphasize client-centered, developmentally appropriate approaches
• Address the importance of parental support and psychoeducation
• Manage therapy expectations and provide space for identity exploration
• Assess the role of internalized homophobia or transphobia in identity development
• Understand and rule out “rapid-onset gender dysphoria”

IV. Supporting Parents and Caregivers

• Recognize common parental concerns and fears about gender identity
• Support parents through grief, guilt, fear of social stigma, and intrafamily conflict
• Help families navigate cultural, religious, and societal influences on gender norms
• Offer tools to foster a supportive home and community environment

V. Creating an Affirming Clinical Environment

• Use inclusive intake paperwork with open-ended gender and pronoun questions
• Foster physical safety and visibility through affirming office design (e.g., restroom options, waiting areas)
• Employ affirming language and curiosity when discussing identity with young clients
• Normalize fluidity and exploration in child and adolescent development

VI. Navigating the Transition Process

• Understand types of transition: social, medical, and legal
• Support social transitioning in home, school, and community settings
• Explain puberty blockers and their physical, emotional, and developmental impacts
• Discuss masculinizing and feminizing hormone therapy and surgical options

VII. Addressing Mental Health Risks and Protective Factors

• Recognize high rates of suicidality, self-harm, and mental health issues among transgender youth
• Promote protective factors such as family acceptance, affirming environments, and peer support
• Validate identity while building coping skills for navigating stigma and discrimination

VIII. Writing Referral Letters for Medical Interventions

• Understand the clinician’s role in gender assessments and referrals
• Follow WPATH guidelines for documentation and informed consent
• Gather clinical history, identity development, and readiness for medical intervention
• Include details on family support, emotional impact, treatment understanding, and transition goals

IX. Tools, Resources, and Continued Education

• Provide access to supportive organizations like PFLAG
• Share affirming literature, workbooks, and teen-centered guides
• Offer video and online content to educate clients and families
• Encourage further clinician training on gender-affirming care and ethical practice