Diversity in Clinical Practice
Week 4 - Lecture Content: Gender Diversity in
Clinical Practice
Slide Notes
Terminology
Gender VS Sex
Gender: Socially-constructed roles, behaviours, expressions, and identities of girls. women,
boys, men and gender diverse people.
Sex: Biological attributes of humans and animals, including physical features,
chromosomes, gene expression, hormones and anatomy.
The Gender Unicorn
→Gender Identity - Female/Woman/Girl or Male/Man/Boy or Other Gender(s)
This is one’s internal sense of being male, female, neither of these, both, or another gender.
Diversity in Clinical Practice 1
, For transgender people their sex assigned at birth, and their own internal sense of gender identity
are not the same.
→Gender Expressions/Presentation - Feminine, Masculine, or other
The physical manifestations of one’s gender identity through clothing, hairstyle, voice, body
shape, etc.
Many transgender people seek to make their gender expression match their gender identity rather
than their sex assigned at birth.
→Sex assigned at birth - Female, Male, or Other/Intersex
The assignment and classification of people as male, female or intersex is based on a
combination of anatomy, hormones, and chromosomes.
→Physically attracted to
Sexual orientation. Important to note that sexual and romantic/emotional attractions can be from
a variety of factors including but not limited to gender identity, expression, and sex. These are
simply two common forms of attractions.
→Emotionally attracted to
Romantic/emotional orientation
Why is gender diversity significant in clinical practice?
mental health professionals have all types of clients
you will encounter transgender people even if you do not work in a gender clinic
transgender and gender diverse population is vulnerable for mental health challenges
Gender Dysphoria
-Gender dysphoria is an unhappy state of mind that is found in people whose gender identity is
not matching with their assigned biological sex.
→Signs of GD
Discomfort with the assigned gender roles
desire to be treated as opposite gender
likes the dressing style and mannerism of the opposite sex
Diversity in Clinical Practice 2
, unhappiness
→Treatments
hormone replacement therapy
sex reassignment surgery
psychotherapy
mindfulness meditation
DSM-V Gender Dysphoria
A- Criterium
A marked incongruence between one’s experience/expressed gender and assigned gender, of at
least six months duration, as manifested by at least 2 of the 6:
1. Incongruence between experienced gender and sex characteristics
2. desire to be rid of one’s sex characteristics
3. desire for the sex characterics of the other/alternative gender
4. desire to be of the other gender/or alternative gender
5. desire to be treated as the other/or alternative gender
6. conviction that one has the typical feelings and reactions of the other/alternative gender.
B-Criterium
The condition is associated with clinically significant distress, or impairment in social,
occupational, or other important areas of functioning.
Types of Dysphoria
1. Social
Discomfort with presenting socially as your birth-gender
2. Body
Discomfort with your body being of a different gender
3. Mind
Discomfort with your mind and emotions not lining up with your gender identity
Diversity in Clinical Practice 3
, *Note: NOT ALL transgender people experience physical distress.
Specialized Gender Care in the NLs: Trends & Numbers
Gender Affirming Care
Medical Care
eg: hormone therapy, and gender affirming surgery
Mental Health
eg: support identity exploration, mental health problems, coping strategies.
Social Support
eg: legal support, community support, employment, education
Trends & Numbers
→Over the years referrals for specialized care have increased, for example: To the AMsterdam
UMC
Diversity in Clinical Practice 4
