Health and Wellness for Transgender, Bisexual, Lesbian and Gay Individuals and
Families: Social Work Practice in a Health Care Setting
Social Work Course #790.004
June 11 and 18th 8:30am-4:30pm
Instructor: Carrie A Ross LMSW MDiv
Email: firstname.lastname@example.org (best method)
Class location: SSWB 2752
Office hours/location: by appointment
This course will provide an overview of health care disparities and concerns for
transgender, bisexual, lesbian and gay patients and families. Participants will become
familiar with barriers to health care access for this population as well as strategies for
helping patients and families advocate for themselves as they navigate the increasingly
complex system that is health care delivery in the US. We will review practice models for
culturally competent social work practice with TBLG people and apply these to work in
an interdisciplinary health care setting.
Upon completion of the course, students will be able to
• Demonstrate familiarity with particular health concerns for TBLG individuals as
well as health care disparities for this population. Actively discuss the particular
ways in which TBLG people must navigate the system in order to receive
appropriate medical care.
• Understand barriers to health care access facing TBLG individuals and families.
Identify within the health care delivery system specific opportunities for
improving access through social work advocacy and cultural change.
• Explore the above issues of health care disparities in terms of interconnecting
identities; examine how sexual orientation and gender identity intersect with other
identities such as race, class, chronic/stigmatized diagnoses, etc. may mediate or
further complicate issues of access.
• Discuss the social workers role within an interdisciplinary team to provide
counseling, education, advocacy, and other assistance to the TBLG patient and
family. Identify relevant best practice models with this population and how they
apply to the health delivery setting.
• Explore the participant’s own preconceived notions or potential biases, and those
of the health care team, about TBLG populations and how that can be managed in
The objectives of the course will be pursued through lecture, case studies, literature
review, guest speakers, and interactive discussion. Designed to be an intense immersion
into the topic, the class will meet for two full days. The sessions are scheduled from
8:30am-4:30pm. We will build in a lunch break and shorter breaks throughout the day.
Course Expectations and Grading
As we will only have 2 days together, 100% attendance is required. Engagement in
discussion about the readings and topics at hand are also expected. Please be on time,
ready to participate fully, and be prepared both to learn and teach as we talk about these
topics together. Grading will be on a satisfactory/unsatisfactory basis.
Course relationship to four curricular themes
• Multiculturalism and Diversity: Class discussions will focus on the diversity of
experience and health behaviors/access among TBLG people and their families.
We will also focus on the ways in which multiple identities overlap and inform
how one’s sexual orientation and gender identity are expressed and experienced in
a health care arena.
• Social Change and Social Justice: One of the major focus points of the class will
be taking a look at our own work and field placement settings to make a realistic
assessment of the relative cultural competency and sensitivity toward TBLG
populations. We will use this evaluation to talk about ways to effect change in our
settings to make them more accessible and just. We will seek to understand health
care access as an issue of social justice.
• Promotion, Prevention, Treatment and Rehabilitation: As an underserved
population, TBLG patients and families can show us much about our values of
promotion and prevention in terms of health care. We will discuss the micro and
macro level impact of health care disparities and lack of access to routine care.
We will discuss ways to reach out to these populations for the purposes of better
health promotion and access.
• Behavioral and Social Sciences Research: Our readings will include research on
the health care utilization behaviors of TBLG communities and ways to increase
Course relationship to social work ethics and values:
The NASW code of ethics sets forth the following set of core values: service, social
justice, dignity and worth of the person, importance of human relationships, integrity, and
competence. All of these will be central to our discussions, and we will focus particularly
on issues of dignity, social justice, and professional competence. This class will also
focus heavily on our professional commitment to “help meet the basic human needs of all
people, with particular attention to the needs and empowerment of people who are
vulnerable, oppressed, and living in poverty” (NASW Code of Ethics).
Accommodations for Students with Disabilities
If you need or desire an accommodation for a disability, please contact me at your earliest
convenience. Many aspects of the course can be modified to facilitate participation and
progress throughout the course. Resources are available (i.e. services for students with
disabilities, adaptive technology computing site, etc.) to make learning more effective for
you. To the extent permitted by law, the information will be treated as private and
Field Site Evaluation, at least 3 pages, double spaced, 12 pt font. Due by email
attachment to me no later than June 25th at 4:00pm.
Using the information we discuss during the first session about creating welcome clinical
environments for TBLG patients/clients and families, please take a focused and critical
look at your field site and provide your perspective on its relative “friendliness” and
competency in providing care to these populations. Refer back to the GLMA article for
information and ideas about what to look for. Feel free to interview agency staff, if
appropriate, about their impressions regarding providing care to TBLG persons. Make
sure to provide a brief description of your setting, the population the agency serves, etc.
Guiding questions might include some of the following:
• In what ways are TBLG patients/clients and families welcomed? In what ways are
• How are the intake processes structured, and how is information about sexual
orientation or gender identity elicited or assumed?
• How could the environment, from first entry into the building, to forms that are
completed by or about the patient, to each conversation the person might expect to
have, be changed and improved to better create a welcoming clinical
• What reactions or assumptions might patients and families have to the
environment and the visual/attitude cues there?
• Are there multicultural initiatives already in place? Do these include content on
sexual orientation and gender identity?
• Do you have a non discrimination policy or clear avenue for patient complaints?
• Are there particular barriers TBLG patients might face seeking your services?
How might this be compounded or ameliorated by other aspects of their
• What recommendations, if any, would you make to the agency to improve its care
to these populations?
All readings are available on CTools. Feel free to read prior to the first meeting day, but
this is not a requirement. If you do read ahead, I suggest starting with the chapters from
the Fenway Guide and the GLMA article.
• Chapter 1: Clinicians and the Care of Sexual Minorities. In Mkadon, H., Mayer,
K., Potter, J., and Goldhammer, H. (2008). The Fenway Guide to Lesbian, Gay,
Bisexual and Transgender Health. Philadelphia, American College of Physicians.
• Chapter 7: Health Promotion and Disease Prevention. In Mkadon, H., Mayer, K.,
Potter, J., and Goldhammer, H. (2008). The Fenway Guide to Lesbian, Gay,
Bisexual and Transgender Health. Philadelphia, American College of Physicians.
• Gay and Lesbian Medical Association: Creating Welcoming Clinical
Environments for LGBT Patients. link on CTools.
• Crisp, C. (2001). The Gay Affirmative Practice Scale. A New Measure for
Assessing Cultural Competence with Gay and Lesbian Clients. Social Work 51
• WPATH Standards of Care
• Tom Waddell Health Center Guidelines for Hormonal Reassignment of Gender
• GLAM/HRC Healthcare Equality Index. On CTools
Supplemental Reading (please read at least one of the following)
• Chapter 1: The Transsexual Dilemma. In Brown, M., and Rounsley, C. (1996).
True Selves: Understanding Transsexualism for Families, Friends, Coworkers,
and Helping Professionals. San Francisco, Jossey-Bass.
• Chapter 9: Medical and Surgical Options. In Brown, M., and Rounsley, C.
(1996). True Selves: Understanding Transsexualism for Families, Friends,
Coworkers, and Helping Professionals. San Francisco, Jossey-Bass.
• Intersex Society of North America. Philosophy, mission statement, various
articles on website. Link included on CTools.
• US Trans Health Priorities. National Coalition for LGBT Health.
• Why Lesbians are Medically Underserved. The Mautner Project.
• Out and Aging: The MetLife Study of Gay and Lesbian Baby Boomers
• Dean, L. et al (2000). LGBT Health: Findings and Concerns. Journal of the
American Medical Association 4 (3).
Other books suggested for your personal/professional library
• Chris Beam. Transparent: Love, Family and Living the T with Transgender
• Jerry Bigner and Joseph Wetchler. Relationship Therapy with Same Sex Couples.
• Mary Boenke. Trans Forming Families: Real Stories About Transgendered
• Helen Boyd. She’s Not the Man I Married: My Life with a Transgender Husband.
• Mildred Brown and Chloe Rounsley. True Selves: Understanding
Transsexualism--For Families, Friends, Coworkers and Helping Professionals.
• Bill Burleson. Bi America: Myths, Truths, and Struggles of an Invisible
• Jeffrey Chernin and Melissa Johnson. Affirmative Psychotherapy and Counseling
for Lesbians and Gay Men.
• Randi Ettner. Gender loving care: A guide to counseling gender-variant clients.
• Jack Hart. Gay Sex: A Manual for Men who Love Men.
• Kelly Huegel. GLBTQ: The Survival Guide for Queer and Questioning Teens.
• Ski Hunter and Jane Hickerson. Understanding and Working With Gay, Lesbian,
Bisexual and Transgender Persons.
• Gianna Israel and Donald Tarver. Transgender Care: Recommended Guidelines,
Practical Information and Personal Accounts.
• Felice Newman. The Whole Lesbian Sex Guide: A Passionate Guide For All of
• Caitlin Ryan. Lesbian and Gay Youth: Care and Counseling
• Tristan Taoramino. Opening Up: Creating and Sustaining Open Relationships.