Competence and Bias in Transgender Mental Health

Historically, clinicians have functioned as gatekeepers to access gender-affirming care for individuals identifying as transgender. However, current best practice standards by reputable professional associations have encouraged clinicians to minimize potential barriers for clients seeking gender-affirming care. This care includes hormone replacement therapy (HRT) and gender confirmation surgeries, and other gender-affirming interventions such as name and gender marker change. This study seeks to describe Texas clinicians’ attitudes toward transgender clients and their self-perceived competency to perform gender affirming care. Licensed mental health care clinicians were recruited from various professional associations to complete an anonymous internet-based survey on providing gender-affirming mental health care. Seventy-five clinicians completed all survey measures. Approximately 86.7 % of respondents scored below the clinical cutoff score for effective counseling for transgender clients. Results further indicated that a range of demographic variables of respondents was associated with self-reported levels of competence and bias. Implications for social work education, practice, policy, and research are offered to help support increased competence of social workers in this area.