Transgendered and Gender-Variant Youth Counseling - CESCaL.rtf

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					                                                                     Transgendered and   1
gender-variant youth

RUNNING HEAD: Transgendered and gender-variant youth counseling

Counseling and advocacy with transgendered and gender-variant children and adolescents

                                     Stuart F. Chen-Hayes

                       Lehman College of the City University of New York
                                                                          Transgendered and           2
gender-variant youth
Chen-Hayes, S. F. (2001). Counseling and advocacy with transgendered and gender-variant persons in

     schools and families. The Journal of Humanistic Counseling, Education, and Development, 40(1),



Nontraditional gender identity and gender expression have often been ignored or pathologized in

the counseling literature for persons of all sexual orientations.    Yet, gender identity and

gender expression can be critical components of counseling and advocacy in school and family

settings. The similarities of being targeted for violence and oppression due to transgenderism

and/or heterosexism due to nontraditional gender identity/expression or sexual orientation are

profound and potentially lethal. Counseling and advocacy utilizing strengths and unique

cultural contexts of transgendered and gender-variant persons promote an ethical and

successful path toward healing that challenges pathology-based frameworks. Suggestions and

resources for culturally sensitive counseling and advocacy with transgendered and gender-

variant persons of all sexual orientations are given.
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gender-variant youth


The professional counselor’s role has expanded to include advocacy for social justice and

challenging oppression and violence (Barret, 1998; Chen-Hayes, 2000; Lee & Walz, 1998; Lewis

& Arnold, 1998). School and family counselors can advocate against oppression that targets

gender-variant and transgendered youth and adults of all sexual orientations.    They can promote

environments that affirm all sexual orientations and gender identities at individual, cultural,

and systemic levels (Chen-Hayes, 1997; Chen-Hayes, 2000; SIECUS, 1996). While the

American Counseling Association’s Code of Ethics and Standards of Practice states counselors

must provide nondiscriminatory services based on variables such as ethnicity, race, gender,

sexual orientation, religion, disability, and social class (ACA, 1995), the omission of gender

identity /expression can no longer be ignored.


       Many, but not all, lesbian, bisexual, and gay children and youth exhibit cross-gender

behavior (Pleak, 1999). In addition, heterosexual youth may also exhibit cross-gender behavior.

These gender variations, however, often target lesbian, bisexual, and gay youth and gender-
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variant heterosexuals for violence (Israel & Tarver, 1997; Remafedi, 1994; Ryan & Futterman,

1998). Similarly, transgendered and gender-variant youth and adults of all sexual orientations

are vulnerable to violence in cultures that enforce a dichotomous, conformist set of gender roles

and expression (Bornstein, 1995; Feinberg, 1996; Israel & Tarver, 1997; Remafedi, 1994;

Rottnek, 1999; Wilchins, 1997).

       In schools and families where rigid gender expectations are the norm, gender-variant

children and youth are the targets of multiple victimizations or oppression. (Remafedi, 1994;

Israel & Tarver, 1997). Internalized oppressions (Creighton & Kivel, 1992; Lewis & Arnold,

1998) can include hypervigilance, poor self-esteem, self-hatred, alcohol and other drug

abuse/dependence, overachieving, self-mutilation, or suicide attempts. Suicide attempts of

transgendered youth are estimated as high or higher than for lesbian, bisexual, and gay youth

(Remafedi, 1994). Externalized oppressions can include: humiliation; emotional, physical, and

sexual abuse; peer pressure; lack of role models; rigid dress codes; and coercive mental health

or religious practices that attempt to “extinguish” gender nonconforming behaviors (Israel &

Tarver, 1997; Pleak, 1999; Remafedi, 1994; Rottnek, 1999). While transsexualism was

eliminated as a disorder from the most recent DSM-IV (APA, 1994), gender identity “disorder”

remains, allegedly with an etiology that starts in childhood. However, rather than using a

pathologizing medical model, preventive guidelines exist to assist school and family counselors

to encourage dialogues to promote comprehensive sexuality education. Comprehensive

guidelines are available for counselors, teachers, and families to develop appropriate sexuality

and gender information for all children, youth, and families (SIECUS, 1996).
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gender-variant youth


       Traditionally, a dichotomy of gender identity/expression has been a given in most

families, schools, and communities in European and Judeo-Christian cultures (Bullough &

Bullough, 1993; Feinberg, 1996; Namaste, 1996; Wilchins, 1997). Any variation from

traditional male and female gender roles, gender identities or expression, heterosexuality, or

challenges to sexuality as solely for procreation have been challenged, condemned, and subject

to punishment or failed attempts at extinction (Rekers, 1980,1995) or at least controlled or

modified (Zucker & Bradley, 1995).

       Many European and Judeo-Christian values and world view constructs about gender and

sexual orientation have been codified by the psychiatric establishment (Bullough & Bullough,

1993) in the Diagnostic and Statistical Manual of Mental Disorders (DSM) (APA, 1994;

Seligman, 1998). Yet, the DSM has always been malleable to social action and politics.

Sexual orientation was dropped as a mental disorder from the DSM in the early 1970s, as was

“ego-dystonic homosexuality” in the early 1980s. Transsexualism as a “disorder” was dropped

in the mid 1990s, and the remaining “disorders” related to gender are “gender identity disorder”

and “transvestic fetishism.” Gender identity disorder didn’t exist in earlier DSM editions.

Note, however, that only heterosexual men can be diagnosed as having “transvestic fetishism” by

DSM diagnostic criteria; lesbian, bisexual, heterosexual women and gay and bisexual men

may be sexually stimulated by cross-gendered clothing without it being considered a pathology.

Yet, practitioners Israel & Tarver ( 1997) and Pleak (1999); academics Fausto-Sterling (1999)

and Namaste (1996); and transgender/gender variant community members Bornstein (1994),
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Denny (1994), Feinberg (1996) and Wilchins (1997) all challenge this essential model of gender

and question the validity of any type of gender as a disorder. Many persons see gender as a

socially constructed continuum of varied possibilities (Fausto-Sterling, 1999; Pleak, 1999).

       The need to enforce rigid codes of gender can then be seen as a means of social control,

i.e., oppression (Creighton & Kivel, 1992; Lewis & Arnold, 1998) that can have grave

consequences for persons of nontraditional gender identity/expression. Transgenderism, which

can be defined as prejudice toward persons with nontraditional gender identity/expression plus

power used by members of dominant gender groups to enforce the prejudice and limit access to

resources by gender-variant persons

(Chen-Hayes, 2000).     Like transgenderism, heterosexism can be defined as prejudice toward

lesbian, bisexual and gay persons plus power used by heterosexuals to enforce the prejudice and

limit access to resources by lesbian, bisexual, and gay persons (Chen-Hayes, 1997).

Transgenderism and heterosexism are constructed based on dominant social values that

marginalize nontraditional gender identity/expression and sexual orientation . They traditionally

have legitimized invisibility, pathologizing, and other forms of violence and privileged

heterosexual and gender-traditional behavior as most valid or appropriate in schools and families

(Barret, 1998; Casper & Schultz, 1999; Chen-Hayes, 2000).



       Many professional counselors have had little or no coursework or education in sexual

orientation and gender identity/expression counseling. To be culturally competent in sexual
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orientation and gender identity/expression counseling, it is helpful to clarify basic concepts of

biological sex, gender, gender identity, gender role, and sexual orientation. While many persons

erroneously assume that transgendered persons are lesbian, bisexual, and gay, many

transgendered persons identify as heterosexual. However, because transgendered persons of all

sexual orientations challenge traditional gender norms and values, they are regular targets of

heterosexism, transgenderism,     misogyny, and other oppressions in schools, families, and

institutions (Bornstein, 1994; Denny, 1994; Feinberg, 1996; Israel & Tarver, 1997; Wilchins,


         In addition, multiple cultural identities are important for many gender-variant and

transgendered persons. Culturally competent counselors must negotiate the value and world

view frameworks that their clients present in schools and families, and there is terrific variation

across the transgender and gender-variant communities based on ethnicity, race, social class,

religion/spirituality, age, levels of ability/disability, family type, and appearance.       While

multicultural counseling competencies have been developed (Sue, Arredondo, & McDavis, 1992)

and operationalized (Arredondo et al, 1996), few specifics have been given for transgender and

gender-variant counseling competencies. Israel & Tarver (1997) list counseling guidelines for

working with transgendered youth, as well as insights on how to work effectively with

transgendered and gender-variant persons of all ages, social classes, and levels of

ability/disability. As counselors learn about “the gender community,” they can unlock loaded

terms that have kept nontraditionally gendered persons locked in a binary gender system. The

following terms include English-language gender identity and expression conceptualizations that

are not universal around the globe.
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       Biological sex is a person’s genetic composition and physical body, including genitalia

and secondary sex characteristics at birth and/or later in the life cycle developed through the use

of hormones or surgical procedures. It is not necessarily fixed over a person’s lifetime. Gender

is a cultural term that societies apply in various ways to classify the attitudes, behaviors, social

functioning, and power relations between women, men, girls, boys, cross-dressers, transsexuals,

intersexed persons, gender blenders, drag queens and drag kings, and other transgendered

persons. Certain cultures maintain a rigid dichotomy of either/or in gender; other cultures

recognize and celebrate a gender continuum.

       Gender    identity is a person’s internal, subjective experience of how they feel and

express themselves as a “gendered” person in terms of gender roles, attitudes, and behavior. A

person's internal gender identity is like a world view; it may or may not match the person's

external gender expression in terms of clothing or other gendered signals and cues. It may be

experienced by some persons as their masculinity, femininity, and/or the combination of their

personal and cultural experience and expressions of masculinity and femininity. Persons may

choose to live with their internal and external gender identity congruent or incongruent based on

a variety of personal, social, cultural, spiritual, and political factors. Gender role/expression is

the outward presentation of one's gender identity in sociocultural context. Gender role is how a

person is expected to act in terms of their social behavior in a culture based on how that culture

names or defines behavior based on masculinity, femininity or a combination of multiple gender

identities. There is a continuum of gender roles and expression in cultures around the world.

       Sexual orientation is a person's capacity for sexual and emotional attractions, fantasies,

and behaviors toward other persons. A multivariable dynamic that includes past, present, and

ideal feelings about who is attractive and/or desirable in sexual and/or romantic ways. It can
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include one’s sexual attractions, behaviors, fantasies, gender emotional preference, gender social

preference, sexual identity in a community (lesbian, bisexual, gay, heterosexual), and use of a

sexuality self-label (Klein, Sepekoff, & Wolf, 1985). There is no definitive answer for how

sexual orientation occurs in humans; it is on a continuum and can be fluid or fixed over a

person’s lifetime. The term sexual preference is vague and unhelpful because it implies that

people can choose their sexual orientation which is not the case for most persons. While anyone

may choose various sexual behaviors, sexual orientation is much more than behavior (Klein,

Sepekoff, & Wolf, 1985).    Not all cultures use similar terms to describe sexual orientation.

       Transgendered is an umbrella term inclusive of all members of the nondominant gender

identity communities, including transsexuals (pre, post and non-operative), cross-dressers, gender

blenders, drag queens and drag kings, and intersexed persons. Cross-dressers are primarily

heterosexual men who dress in traditionally gendered women’s clothing. Cross-dressing may

include an erotic component when wearing the clothing (this has been labeled transvestic

fetishism, a paraphilia, in the DSM-IV) (APA, 1994). However, many cross-dressers and allies

challenge this definition as transphobic and question who, if anyone, is harmed by sexual

pleasure gained in wearing cross-gendered clothing. Persons may cross-dress part-time or full-

time. The cross-dressing community is often secretive and more hidden than the transsexual

community. Major concerns are the ability to pass successfully as women and the ability to be

affirmed by other cross-dressers in the community.

       Gender blenders have an external gender identity reflecting a combination of traditionally

feminine and masculine attire and/or accessories. Gender blenders question traditional gender

dichotomies by replacing them with a continuum. Two-spirit persons have traditionally been

recognized as shamans and healers in indigenous communities in their abilities to cross gender
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realms.      Two-spirit persons may have a combination of nontraditional gender identity,

expression, and sexual orientation , and in many traditional indigenous communities they are

appreciated and affirmed within the community.

          Intersexed persons are born with both traditional male and female genitals.         Many

persons in traditional Euro-American cultures have been surgically altered at birth by physicians

to “fit” into one traditional gender identity. This practice has recently come under intense

challenge as culturally inappropriate as babies can’t be asked what their internal gender identity

is at birth (Israel & Tarver, 1997) . Drag queens are gay and bisexual men who wear traditional

women’s clothing and drag kings are lesbian and bisexual women who wear traditional men’s

clothing to celebrate gay pride , to question traditional gender and sexual orientation roles in

lesbian, bisexual, gay, and heterosexual communities, to express nontraditional gender identities,

to challenge authority, and/or to perform and entertain. Drag queens and drag kings are often

subject to sexism, misogyny, heterosexism, and transgenderism inside and from outside the

lesbian and gay communities, as well as the dominant heterosexual communities.

          Transsexuals are persons whose external gender identity may not match their

internal gender identity. In other words, the external genitalia and gender role socialization/

expression do not necessarily correspond with internal gender role identity. Male-to-

female (MtoF) transsexuals have internal female gender identity and seek to alter their

biologically male body characteristics to match an internal female gender identity.

Female-to-male (FtoM) transsexuals have internal male gender identity and seek to

alter their biologically female body characteristics to match an internal male gender

identity. Pre-operative (pre-op) transsexuals await sex reassignment surgery (SRS).

Post-operative (post-op) transsexuals have completed SRS and known as
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transwomen or transmen. Non-operative (non-op) transsexuals elect to not alter

their bodies through physical surgery.



       Much of how professional counselors have viewed gender identity and expression in the

past have come from a philosophical paradigm of essentialism. This modernity-influenced

philosophy concludes that sexual orientation, gender, and gender identity/ expression are

constructs developed based on biology that can be demonstrated through traditional scientific

method, i.e., the quantitative research traditions of logical positivism. Social constructionists,

however, challenge essentialism.     Post-modern influenced social constructionist counselors

would suggest that there are multiple truths in terms of sexual orientation, gender, and gender

identity/expression. Social constructionists believe that language helps to shape truth and that

there are multiple possibilities and that sexual orientation, gender and gender identity are fluid

constructs on a continuum (Casper & Schultz, 1999).

       They reject the idea that either gender or sexual orientation is fixed or based primarily on

biological factors. They believe that both sexual orientation and gender identity are arrived at

due to multiple factors and that there is no one truth or correct way of being sexual or gendered.

They are more interested in the qualitative or subjective truths of how persons become gendered

or develop their sexual orientations through sociopolitical and cultural means as opposed to

biology.   Casper & Shultz (1999). provide an excellent discussion of how traditional and
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nontraditional gender theory can be used in schools to provide an affirmative atmosphere for all

persons, including lesbian, bisexual, gay and transgendered children, youth, staff, and families.

       Essentialism has been the basis of what is now called Gender Identity “Disorder” in the

DSM-IV. It traditionally has been the focus of mental health professionals who have often

resorted to abusive behaviors to force persons into rigid traditional gender roles that replicate

traditional “norms” often against the well-being of clients (Scholinski & Adams, 1997; Pleak,

1999). It unscientifically blames the victim and pathologizes persons with nondominant gender

identities as being the problem as opposed to a culture that restricts gender to two rigid categories

and expects all persons to be “either/or.” An American Psychiatric Association task force is

currently considering dropping Gender Identity Disorder altogether from the next revision of the


       So, the dominant medical and mental health communities traditionally saw lesbian,

bisexual, and gay sexual orientations, transgendered, intersex, cross-dressing, drag king, drag

queen, androgyne, gender-blending and masculine girls/women and feminine boys/men as

problematic in the least and pathologized or disordered at worst (APA, 1994; Bullough &

Bullough, 1993; Pleak, 1999; Rekers, 1980, 1995; Seligman, 1998). Current research,

scholarship, and gender community activists and allies question such “reasoning.” From a social

constructionist stance, it is seen as culturally biased and transgenderist in upholding rigid,

dichotomous definitions of one particular world view, reinforcing traditional European-American

and Judeo-Christian concepts of gender identity/expression. Contrary to this view, many

cultures, including nondominant European-American, Asian, African, and Indigenous ones

(Feinberg, 1996; Israel & Tarver, 1997), have seen a nondichotomous view of gender as a sign of

mental health, as challenging dominant culture values, or simply as an enjoyable pleasure.
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       A strengths-based model is recommended for school and family counselors as a way to

counsel gender-variant children, youth, and family members in affirmative ways. A strengths-

based model challenges pathologizing of gender-variant and transgendered persons and sees

gender as a cultural construct, not a pathology. Instead of pathologizing, professional counselors

need to affirm the truth and courage of what Feinberg (1996) calls “transgender warriors.” It

takes honesty, clarity, courage, perseverance, dignity, self-determination, creativity, intelligence,

and passion to challenge traditional gender norms in schools and families. Professional

counselors can aid children, youth, and families with histories and herstories of transgenderism

and gender variation to reduce isolation and fear.



       There are many specific gender identity and transgender counseling issues that can be a

focus school and family counseling. Transitioning is the period whereby a transsexual person

begins the process of crossing from one gender identity to another to create congruence between

internal and external gender identities. It often includes taking hormones and may include sex

reassignment surgery, legally changing one’s gender, and dealing with others’ reactions in one’s

relationships and at work. (Brown & Rounsley, 1996; Walworth, 1998). Sexual orientation

labels may also shift in transition, depending on the person. Passing is a highly developed skill

for many cross-dressers and transsexuals; the goal is to pass for the gender identity one wishes to

be or to display in public. Certain persons have an easier time passing than others based on their

features, height, weight, etc. A significant portion of time in the community may be spent being
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critiqued on tips for passing and/or dressing successfully. The risk of violence increases for

gender-variant and transgendered persons who do not pass successfully.

        Hormones, in the gender community, usually refer to estrogen and testosterone that are

administered to defeminize or demasculinize secondary sex characteristics of one gender identity

in favor of the desired secondary sex characteristics of another gender. Dangers include persons

who use mail-order or off-the-street hormones . Sex reassignment surgery (SRS) is a medical

procedure whereby a penis and testes are surgically removed or altered to create a vagina and

clitoris or whereby a vagina and clitoris are removed or altered to create a penis and testes. It

may also include other plastic surgery of other body parts to more resemble the desired gender

identity.   The Harry F. Benjamin guidelines are the traditional two-year process whereby

persons seeking SRS must be in counseling and live for a period of at least six-months in the

desired gender identity full-time (also known as the real-life test) to assess their ability to be

successful and to ensure that the surgery is not undertaken without adequate emotional

preparation (Israel & Tarver, 1997). The guidelines are controversial and challenged by some

transsexuals and allies as inappropriate and unnecessary; no other major surgery for a medical

procedure requires prior intensive mental health intervention (Bornstein, 1994; Wilchins, 1997).

        The emotions of being in a gender- dichotomous culture and not fitting in are powerful

and intense for any person at any age. Feelings can include: fear, anxiety, loneliness, alienation,

isolation, anger, rage, sadness, loss, grief, pain, and numbness. As a transgendered or gender-

variant person gains clarity about who they are and how they will live as a gender-variant or

transgendered person, other feelings including euphoria, happiness, excitement, clarity, and joy

are common. Yet, the ever-present possibilities of oppression and violence are never far from

the surface of most transgendered and gender-variant person’s lives. Many transgendered
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persons are targets of emotional, physical, and sexual abuse or harassment, and often have few

places to turn for help, which increases the likelihood of repeat victimizations (Israel & Tarver,

1997). Money for gender-related surgery, hormones, clothes, and accessories is often scarce

and many gender-variant or transgendered persons may engage in prostitution to survive (Israel

& Tarver, 1997). For gender-variant youth and young adults, the likelihood of being thrown out

of the house when discovered is a reality, and the dangers of homelessness, drug and alcohol

abuse, running away, and associated health concerns are serious. Many transgendered and

gender-variant persons are seen as “freaks” by law enforcement agencies, and if assaulted, may

be further victimized in police custody. Many states have laws criminalizing gender

nontraditional behavior.

       Few laws recognize gender identity and gender expression concerns and transgendered

and gender-variant persons are often the target of hate crimes with little legal recourse.   As a

direct result of transgenderism and heterosexism in most schools and families, transgendered and

gender-variant children, youth, and adults often lack accurate information , support networks,

and role models about emotional health and well-being as transgendered or gender-variant.

Finally, certain religious, political, and cultural attitudes that shun or shame persons who are

nontraditional in their gender role or presentation can be harmful to optimal emotional health.

       It is only in the past few years that stories about affirmative gender identity and gender

expression in families have begun to emerge in the literature of both activists and clinicians

(Brown & Rounsley, 1996; Boenke, 1999; Just Evelyn, 1999; Xavier, Sharp, & Boenke, 1998).

While never an easy road for any family member, narratives that show successful gender identity

and transgender family members indicate that families can and do embrace all of their members

even if they are nontraditional in how gender is conceptualized. Parents of transgendered
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children are now sharing their stories as a developmental journey of hope, courage, and

compassion and refusing to “hide” in the closet any longer, along with their children (Boenke,

1999; Evelyn, 1999; Xavier, Sharp, & Boenke, 1998).

       Similarly, the stories of success for gender-variant and transgendered youth are beginning

to appear in the literature (Boenke, 1999). Professional school counselors can work with

teachers, administrators, students, families, and communities to ensure that gender identity and

expression are handled with dignity, respect, and intellectual clarity in the curriculum and

through inclusive policies, procedures, and forms at all levels of the school community. Casper

& Schultz (1999) provide many ideas for how same-gendered parents can interface with

“straight” schools, and many of their suggestions ring true for transgendered and gender-variant

parents as well. Perhaps most importantly, school counselors can provide consultations to end

violence based on gender, gender identity/expression, and sexual orientation in schools.


       An excellent anti-violence teaching and school counseling curricula that can easily be

applied to transgender and gender-variant issues is the work of Creighton and Kivel (1992),

who have taught children, youth, and adults of all cultural identities how to end violence by

challenging multiple oppressions in schools and families. Challenging racism, sexism,

heterosexism, classism, and other oppressions, Creighton and Kivel (1992) give specific tools

easily applied to affirming nontraditional gender identity/expression .

       Professional counselors can encourage political advocacy for transgendered and gender-

variant rights and freedom from violence by co-sponsoring hate crimes legislation and joining
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state and national advocacy organizations such as GenderPAC. Indeed, counseling

transgendered and gender-variant persons is a sociopolitical act. The following are additional

transgender and gender-variant advocacy ideas for professional counselors:

         Examine your ideas about gender, gender identity/expression, and sexual orientation.

          Seek consultation, supervision, or referral to transgender activists and community

          members, gender specialists, and/or persons with affirmative expertise.

         Use correct gender pronouns. Always use the gender that the person is currently

          presenting/expressing. If you are unsure, ask. (Israel & Tarver, 1997)

         Promote comprehensive sexuality education to counteract inaccurate information

          from peers and the media with accurate, developmentally appropriate information in an

          affirming school or family environment (SIECUS, 1996; Chen-Hayes, 1997).

         Coach clients in the nuances of transgender or cross-dressing identity disclosure.

          Israel & Tarver (1997) suggested that adults disclosing their transgendered identity to

          children/youth reflect on several issues: What will be the consequences on others?

          What will their concerns/reactions will be? Disclosers can prepare a written statement

          or notes about items to discuss; set a particular time to have a discussion; reaffirm the

          relationship/friendship during the disclosure; be as factual as possible in disclosure;

          affirm and respect the person being disclosed to and that person’s right to agree,

          disagree, or be unsure; and reflect after the process about how it feels. With children,

          disclosure is based “on a child’s need to know” (Israel & Tarver, 1997, p. 53).

          Regular adult cross-dressing or pre-surgery transition needs should be addressed as

          the adults’ issues only. Coaching on perceived or actual peer teasing or harassment is

          also an essential part of disclosure. Above all, children need to know they are valued
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         and loved (Israel & Tarver, 1997) . Validate gender-variant and transgendered

         concerns; offer Internet or print media resources; discuss pros and cons of coming out;

         ask who in the family is/not supportive; assess the likelihood of rejections and coping

         skills; and develop strategies for potential harassment/violence, finance, and gender

         reassignment issues.

         Assist in gender presentation tips and success in passing.

         Report acts of violence to authorities including sexual/gender expression/sexual

         orientation harassment and teach self-defense skills (Harris & Associates, 1993).

         Focus on multiple oppressions. Classism and the high costs of transitioning and

         difficulty finding insurance reimbursement are paramount for many transgendered

         persons. Racism includes the invisibility of transgender and gender-variant people of

         color and few transgender-specific resources for persons of color (Namaste, 1996;

         Israel & Tarver, 1997; Wilchins, 1997).        Ageism occurs as gender-variant and

         transgendered children and youth are often targets for abuse from some parents and

         clinicians who coerce them to change.         Other oppressions include ableism and

         beautyism, particularly as they affect persons who have been given a DSM-IV

         diagnosis as “disordered,” and what the appropriately gendered standards of

         appearance are according to the dominant culture’s norms.

        Make a list of heterosexual and traditionally gendered identity privileges and how to

         challenge them (Barret, 1998; Chen-Hayes, 2000).

         Develop gender-identity, gender-expression, and sexual orientation inclusive school

         policies such as a policy on a parent or child/adolescent who comes out as gender-

         variant and proceeds to gender transition/sex reassignment.
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gender-variant youth
         Create a policy for when a child or youth demonstrates gender-variant behavior and

         discuss peer reinforcement, harassment, and adult/systemic responses.

         Develop a safe school/safe families approach that empowers all community member

         (Morrison, Furlong, & Morrison , 1997). Create a mission statement and regular staff

         development that affirm gender identity/expression           and     sexual orientation

         similarities and differences to ensure everyone is valued.

         Take a transgendered or gender-variant person to lunch. Become an advocate/ally

         (Lewis & Arnold, 1998; Chen-Hayes, 2000; Reynolds & Koski, 1995). Interrupt

         jokes, challenge myths and stereotypes, provide accurate information, and take a zero-

         tolerance stand toward emotional, physical, or sexual violence and harassment based

         on gender identity or sexual orientation.

         Invite transgendered and gender-variant persons to speak to community, religious, and

         classroom groups.

         Ensure transgendered and gender-variant       literature is in school and community

         libraries and teaching curricula related to family life (SIECUS, 1996).

         Question school policies that limit children, youth, and adults in gender identity and

         sexual orientation. (Casper & Schultz, 1999). Promote gender expression-sensitive

         workplaces. (Brown & Rounsley, 1996; Walworth, 1998).

        Explore your own family of origin for persons with nontraditional gender

         identity/expression. How did/does your family deal with gender variance?

        A third or more of all teen suicide attempts and actual suicides are made by lesbian,

         bisexual, gay, transgendered, and questioning youth (Remafedi, 1994).          Suicide
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gender-variant youth
          prevention workshops must focus on gender identity and sexual orientation harassment

          and the precipitating factors for suicidal ideation.

          Never assume one’s current or future gender identity or sexual orientation.

          Read and develop expertise in transgender and gender-variant histories and herstories

          (Bullough & Bullough, 1993; Feinberg, 1996; Rottnek, 1999).

          Work with local police departments, judges, and clergy to educate them on hate

          crimes, violence, harassment, suicidal ideation, run-away or “throw-away” youth, and

          the dangers of hate-filled sermons or other religious speech.

         Challenge horizontal hostility (Pharr, 1996). Horizontal hostility is internalized

          oppression that occurs when nondominant group members use prejudice against each

          other (i.e., cross-dressers fight transsexuals) rather than challenging the dominant

          group (i.e., traditionally gendered persons’ privilege and power to limit access to

          resources). Horizontal hostility maintains the status quo.

          Rofes (1995) suggests that schools stop baiting boys who are seen as “sissies” by

          their peers. Teachers and administrators must interrupt bullies/bullying.


       School and family counselors, to be culturally competent in sexual orientation, gender

identity, and gender expression counseling, can view gender-variant or transgendered children,

youth, and adult family members from a strengths-based perspective.          The strengths of the

unique cultural contexts of transgendered and gender-variant persons challenge pathologizing

models of mental health that see nontraditional gender identity and expression as an illness. The
                                                                      Transgendered and      21
gender-variant youth
major issues confronting our schools and families is to provide a safe, nurturing, nonviolent

atmosphere in which to grow and develop for all persons of varied sexual orientations and gender

identities/expression.   Silence and ignorance related to sexual orientation and gender

identity/expression can no longer be tolerated in schools and families. Professional school and

family counselors can provide developmentally sensitive interventions that help children, youth,

and families to understand and affirm the range of sexual orientations and gender

identities/expression as part of the human spectrum.       School and family counselors with

sexual orientation and gender identity/expression competence help create and maintain safe,

supportive, and affirming schools and families. The following groups provide transgendered

and gender-variant advocacy and support:

 American Educational Gender Information Service (AEGIS)
Box 33724, Decatur, GA 30333, (770) 939-0244,

 FTM (Female-to-Male) International
1360 Mission St. # 200 San Francisco, CA 94103, (415) 553-5987

 International Foundation for Gender Education
P.O. Box 229, Wayland, MA 02254-0229, (617) 899-2212,

 Society for the Second Self (Tri-Ess) (Cross-dressers)
8880 Belaire B2 #104 Houston, TX 77036

 Gender Political Advocacy Coalition (GenderPAC)
733 15th St. NW, 7th Flr., Washington, D.C., 20005 (202) 347-3024

 Harry Benjamin International Gender Dysphoria Association (HBIGDA)
1300 South 2nd St. #180 Minneapolis, MN 55454 (612) 625-1500

 International Conference on Transgender Law and Employment Policy (ICTLEP)
P.O. Box 1010 Cooperstown, NY 13326 (607) 547-4118

 Intersex Society of North America (ISNA)
P.O. Box 31791, San Francisco, CA 94131,

   Parents and Friends of Lesbians and Gays (PFLAG)
                                                                         Transgendered and      22
gender-variant youth
Includes T-SON, Transgender Special Outreach Network
1101 14th St. NW, Washington, D. C., 20005 (202) 638-4200,


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Author Note:
Stuart F. Chen-Hayes, Ph.D. is Coordinator and Assistant Professor of Counselor

Education/School Counseling in the Specialized Services in Education Department at Lehman
                                                                     Transgendered and        28
gender-variant youth
College of the City University of New York. Correspondence regarding this article should be

sent to the author at Carman Hall B-20, 250 Bedford Park Boulevard West, Bronx, NY 10468 or


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